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SCORE Study Manuals

Study of Cognitive Rehabilitation Effectiveness

The National Defense Authorization Act for Fiscal Year 2010 tasked the TBICoE, known as the Defense and Veterans Brain Injury Center at the time, with completing a clinical trial to assess the efficacy of cognitive rehabilitation in service members and veterans who sustained a mild traumatic brain injury while deployed in support of Operation Iraqi Freedom or Operation Enduring Freedom.

TBICoE partnered with investigators at Brooke Army Medical Center in San Antonio, Texas, to execute this randomized controlled treatment trial titled “Study of Cognitive Rehabilitation Effectiveness.” The research aimed to improve the health and quality of life for service members with mild TBI, also known as concussion, through the development of empirically validated cognitive rehabilitation interventions.

The three-year study evaluated the efficacy of different types of cognitive rehabilitation interventions (computer-based, traditional and an integrated approach) for service members who were diagnosed with mild TBI during OEF or OIF and who had persistent symptoms. Outcome measures examined improvements in the following areas: cognitive functioning, post-concussion symptoms, cognitive complaints, cognitive fatigue, quality of life, health care use and work status.

TBICoE created a study manual for researchers and clinicians based on the randomized controlled treatment trial—“Study of Cognitive Rehabilitation Effectiveness”—TBICoE completed in 2015. Review the study manual below to learn how clinicians conducted this three-year study.

Study manuals provide the detailed methodology of key research trials. Making this information available allows others to replicate or extend the research in other settings, thereby expanding the body of knowledge and evidence in an area of research.

SCORE Chapter 1

Chapter 1 provides a concise overview of the SCORE clinical trial and measures, plus the Congressional mandate for the study, and implications for the military and veterans.

Chapter 1: Study of Cognitive Rehabilitation Effectiveness Clinical Trial: Overview

Authors: Douglas B. Cooper, Ph.D., ABPP-CN; Amy O. Bowles, M.D.; Rodney D. Vanderploeg, Ph.D., ABPP-CN; David F. Tate, Ph.D.; and Jan E. Kennedy, Ph.D.

SCORE Chapter 2

Chapter 2 summarizes the psychoeducational interventions used for the control group in the first SCORE treatment arm.

Chapter 2: Psychoeducational Interventions for Persistent Post-Concussion Symptoms Following Combat-Related Mild Traumatic Brain Injury (SCORE Arm 1)

This educational material has been specifically adapted for use with service members and veterans who experience a more chronic course of symptoms following combat-related concussion. Section 1 explains the background of psychoeducation in the treatment of mild TBI, and Section 2 provides the psychoeducational tool, called the client’s guide to recovery.

Authors: Heather Belanger, Ph.D, ABPP-CN; Tracy S. Kretzmer, Ph.D.; Rodney D. Vanderploeg, Ph.D., ABPP-CN; Amy O. Bowles, M.D.; Michelle A. Lindsay, ANP-BC; and Douglas B. Cooper, Ph.D., ABPP-CN

SCORE Chapter 3

Chapter 3 describes the computerized cognitive rehabilitation interventions used in the second SCORE treatment arm.

Chapter 3: Computerized Cognitive Rehabilitation Interventions for Persistent Symptoms Following Mild Traumatic Brain Injury (SCORE Arm 2)

Chapter 3 describes the computerized cognitive rehabilitation interventions used in the second SCORE treatment arm, including clinician procedures and BrainworksTM content.

Authors: Anne E. Bunner, Ph.D.; Henry W. Mahncke, M.D.; Catherine N. Stasio; Amy O. Bowles, M.D.; Christy Muncrief, CTRS; Michelle A. Lindsay, ANP-BC; Douglas B. Cooper, Ph.D., ABPP-CN

SCORE Chapter 4

Chapter 4 is divided into two clinician guides and two client manuals. Parts I and II describe SCORE treatment Arm 3 individual cognitive rehabilitation interventions, while Parts III and IV combine Arm 3 and Arm 4 interventions.

Chapter 4: Traditional Cognitive Rehabilitation for Persistent Symptoms Following Mild Traumatic Brain Injury (SCORE Arm 3)

Authors: Melissa R. Ray, CCC-SLP; M. Marina LeBlanc, OTR/L; R. Kevin Manning, Ph.D., CCC-SLP; Christine S. Fox, CCC-SLP; Christopher J. Gillis, OTR/L; Micaela V. Cornis-Pop, Ph.D.; Donald L. MacLennan, M.A., CCC-SLP; Linda M. Picon, M.C.D., CCC-SLP; and Deborah Voydetich, OTR/L, SCLV

SCORE Chapter 5

Chapter 5 describes the fourth SCORE treatment arm, which integrates behavioral health and cognitive rehabilitation interventions for individual and group therapy.

Chapter 5: Integrated Behavioral Health and Cognitive Rehabilitation Interventions for Persistent Symptoms Following Mild Traumatic Brain Injury (SCORE Arm 4)

Authors: Melissa R. Ray, CCC-SLP; M. Marina LeBlanc, OTR/L; R. Kevin Manning, Ph.D., CCC-SLP; Christine S. Fox, CCC-SLP; Christopher J. Gillis, OTR/L; Jon Grizzle, Ph.D.; Laurence P. Perotti, Ph.D.; Rodney D. Vanderploeg, Ph.D., ABPP-CN; Micaela V. Cornis-Pop, Ph.D.; Donald L. MacLennan, M.A., CCC-SLP; Linda M. Picon, M.C.D., CCC-SLP; Deborah Voydetich, OTR/L, SCLV; and Douglas B. Cooper, Ph.D., ABPP-CN

SCORE Chapter 6

Chapter 6 reviews SCORE implementation work at Washington University Center for Implementation Studies, publication of the Fidelity Tool for clinicians and researchers, and special issues from an administrative/clinic chief viewpoint.

Chapter 6: Implementation of the SCORE Clinical Trial in DoD and VA Healthcare Settings: Administrative Considerations

Authors: Jacob Kean, Ph.D., CCC-SLP; Amy O. Bowles, M.D.; Douglas B. Cooper, Ph.D., ABPP-CN; and Alan McGuire, Ph.D., HSPP

SCORE Chapter 7

Chapter 7 is a concise overview of iSCORE imaging modalities and approaches, plus technical details of magnet, software and image acquisition.

Chapter 7: Imaging Support for the Study of Cognitive Rehabilitation Effectiveness Clinical Trial: Overview

Authors: David F. Tate, Ph.D.; Gerald York, M.D.; and Jeffrey Lewis, M.D., Ph.D.

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Last Updated: July 20, 2023
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