To evaluate outcomes of a three week interdisciplinary intensive outpatient treatment program for mild-moderate traumatic brain injury in Veterans and First Responders

Military service members and First Responders are at elevated risk for traumatic brain injury (TBI).  While most individuals with mild TBI report no persisting symptoms > 6 months post injury, approximately 15% experience persisting cognitive, mood, and/or somatic consequences. There is currently no standard of care for treating persistent symptoms associated with mild-moderate TBI.

The Haley Brain Wellness Program (HBWP) is a three-week interdisciplinary intensive outpatient treatment program for Veterans and First Responders with persisting symptoms associated with TBI. Descriptive statistics and paired samples t-tests were conducted to examine IOP-associated changes in self-reported neurobehavioral symptoms as well as changes to measures of cognitive, vestibular and sensory-integration functioning for 106 consecutive participants. 

The majority of attendees were male (79%, n=82). The average age was 49 years old (SD=11.14, range: 25-78). The average time since last TBI with LOC was 17.4 years(SD=13.63).  Upon discharge, HBWP participants reported a mean decrease of 15.1 points (39.6%) on the Neurobehavioral Symptom Inventory (Cohen’s d=1.038). Scores on Addenbrooke’s Cognitive Examination – III improved an average of 6 points (Cohen’s d = 1.332). Further, participants increased their forward (Cohen’s d =.581) and reverse gait speed (Cohen’s d =0.709) and demonstrated large improvements on tests of sensory integration (Bertec SOT Composite, Cohen’s d=0.949) and vestibular function (Proprio-mCTSIB#4, Cohen’s d=0.819).

The HBWP model demonstrates strong preliminary efficacy in reducing symptoms associated with mild-moderate TBI and improving performance on clinical measures of cognition, vestibular function, and sensory integration. These results have implications for the development of a standard of care for persistent post-TBI symptoms in this patient population. Further study is necessary to determine whether these short-term results are sustained over time.