PDF(Pubmed)
Abstract：
OBJECTIVE: The objective was to investigate the effectiveness of a person-centred active rehabilitation programme on symptoms associated with suspected Chronic Traumatic Encephalopathy (CTE). This was accomplished by (1) assessing the effect that a person-centred active rehabilitation programme had on participant symptoms, and (2) exploring how temporal contextual factors affected the participants\' experience with, and perceived effectiveness of, the active rehabilitation programme.
METHODS: A twelve-month mixed-methods single case experimental research design was used with six cases (participants). Individual cases were involved in a 51-week study period including an initial interview and three-week baseline phase. Cases were then randomly allocated to one of two n-of-1 study designs (i.e., A-B, B-A, B-A, A-B or B-A, A-B, A-B, B-A) where A and B represent a non-intervention and intervention phase, respectively. Interviews were conducted regularly throughout the study whilst outcome measures were assessed at each follow-up. Analysis of the data included visual, statistical, and qualitative analysis.
RESULTS: Visual and statistical analysis of cognitive and executive function, and mindful attention, demonstrated trivial-to-large effects with the summary reflecting positive or unclear results. A mixed picture was observed for mood and behaviour with effects considered trivial-to-large, and the summary demonstrating positive, unclear and negative effects. Qualitative analysis indicated a perceived improvement in outcome measures such as memory, attention, anxiety, and emotional control despite mixed quantitative findings whilst a clear impact of contextual factors, such as COVID-19, the political atmosphere, exercise tolerance, programme progression, and motivation were evident during the intervention.
CONCLUSIONS: This study has provided primary-level evidence to suggest active rehabilitation as a potential intervention for the management of suspected CTE symptoms. This study has also demonstrated the benefit of a person-centred approach to both clinical research and practice, particularly by considering contextual factors for a better understanding of an intervention effect.
METHODS: A twelve-month mixed-methods single case experimental research design was used with six cases (participants). Individual cases were involved in a 51-week study period including an initial interview and three-week baseline phase. Cases were then randomly allocated to one of two n-of-1 study designs (i.e., A-B, B-A, B-A, A-B or B-A, A-B, A-B, B-A) where A and B represent a non-intervention and intervention phase, respectively. Interviews were conducted regularly throughout the study whilst outcome measures were assessed at each follow-up. Analysis of the data included visual, statistical, and qualitative analysis.
RESULTS: Visual and statistical analysis of cognitive and executive function, and mindful attention, demonstrated trivial-to-large effects with the summary reflecting positive or unclear results. A mixed picture was observed for mood and behaviour with effects considered trivial-to-large, and the summary demonstrating positive, unclear and negative effects. Qualitative analysis indicated a perceived improvement in outcome measures such as memory, attention, anxiety, and emotional control despite mixed quantitative findings whilst a clear impact of contextual factors, such as COVID-19, the political atmosphere, exercise tolerance, programme progression, and motivation were evident during the intervention.
CONCLUSIONS: This study has provided primary-level evidence to suggest active rehabilitation as a potential intervention for the management of suspected CTE symptoms. This study has also demonstrated the benefit of a person-centred approach to both clinical research and practice, particularly by considering contextual factors for a better understanding of an intervention effect.
摘要：
目的：目的是研究以人为中心的主动康复方案对疑似慢性创伤性脑病（CTE）相关症状的有效性。这是通过（1）评估以人为中心的积极康复计划对参与者症状的影响，(2)探索时间背景因素如何影响参与者的体验，和感知的有效性，积极的康复方案。
方法：对6例（参与者）进行了为期12个月的混合方法单病例实验研究设计。个别病例参与了为期51周的研究，包括初始访谈和三周的基线阶段。然后将病例随机分配到两个n-of-1研究设计中的一个(即，A-B,B-A,B-A,A-B或B-A,A-B,A-B,B-A)其中A和B代表非干预和干预阶段，分别。在整个研究过程中定期进行访谈，同时在每次随访中评估结果指标。对数据的分析包括视觉，统计，和定性分析。
结果：认知和执行功能的视觉和统计分析，和专注的注意力，显示出微不足道的影响，总结反映出积极或不清楚的结果。观察到情绪和行为的混合情况，其影响被认为是微不足道的，总结显示出积极的一面，不清楚和负面影响。定性分析表明，记忆等结果指标有了明显的改善，注意,焦虑,和情绪控制，尽管混合的定量结果，而上下文因素的明显影响，比如COVID-19，政治气氛，运动耐受力,方案进展,在干预期间，动机很明显。
结论：本研究提供了初步证据，表明积极康复作为治疗可疑CTE症状的潜在干预措施。这项研究还证明了以人为中心的方法对临床研究和实践的益处。特别是通过考虑环境因素来更好地理解干预效果。
方法：对6例（参与者）进行了为期12个月的混合方法单病例实验研究设计。个别病例参与了为期51周的研究，包括初始访谈和三周的基线阶段。然后将病例随机分配到两个n-of-1研究设计中的一个(即，A-B,B-A,B-A,A-B或B-A,A-B,A-B,B-A)其中A和B代表非干预和干预阶段，分别。在整个研究过程中定期进行访谈，同时在每次随访中评估结果指标。对数据的分析包括视觉，统计，和定性分析。
结果：认知和执行功能的视觉和统计分析，和专注的注意力，显示出微不足道的影响，总结反映出积极或不清楚的结果。观察到情绪和行为的混合情况，其影响被认为是微不足道的，总结显示出积极的一面，不清楚和负面影响。定性分析表明，记忆等结果指标有了明显的改善，注意,焦虑,和情绪控制，尽管混合的定量结果，而上下文因素的明显影响，比如COVID-19，政治气氛，运动耐受力,方案进展,在干预期间，动机很明显。
结论：本研究提供了初步证据，表明积极康复作为治疗可疑CTE症状的潜在干预措施。这项研究还证明了以人为中心的方法对临床研究和实践的益处。特别是通过考虑环境因素来更好地理解干预效果。
