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Graded Exposure Therapy for Fear Avoidance Behaviour After Concussion

Mild Traumatic Brain Injury

Concussions are very common. Although many people recover well from concussion, some will have persistent symptoms and difficulties with daily activities. How people cope with their symptoms following concussion powerfully influences their recovery. Fear avoidance behaviour is a particularly unhelpful approach to coping, in which people perceive their pre-injury activities as unnecessarily dangerous and take great care to avoid overexertion and overstimulation. The investigators developed and pilot tested a behavioural therapy, called graded exposure therapy, to reduce fear avoidance behaviour. Our preliminary work suggested that graded exposure therapy was acceptable to patients with concussion and possibly beneficial for their recovery. The GET FAB after concussion study will assess the effectiveness of graded exposure therapy.

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Participation Requirements

  • Sex:

    ALL

  • Eligible Ages:

    18 to 69

Participation Criteria

Inclusion Criteria:

1. aged 18-70 years;
2. sustained a concussion according to the ACRM mTBI Task Force definition between 1 and 24 months ago
3. fluent in English, because validated translations are not available for most questionnaires and recruiting multilingual therapists is not feasible;
4. access to a computer, tablet, or smartphone with internet capability;
5. 3 or more moderate-severe symptoms on the Rivermead Postconcussion Symptom Questionnaire.

Exclusion Criteria:

1. medical contraindication to aerobic exercise (cardiac disease, chest pain with exertion, acute bone/joint/soft tissue injury aggravated by exercise)
2. change in cardiac medication within the last month, such as beta blockers, calcium channel blockers, or ivabradine
3. involved in personal injury litigation for index mTBI
4. currently pregnant or plan to become pregnant within the next three months
5. severe/unstable medical or psychiatric condition that could worsen over the next year")

Study Location

Sunnybrooke Traumatic Brain Injury Clinic
Sunnybrooke Traumatic Brain Injury Clinic
Toronto, Ontario
Canada

Contact Study Team

G.F. Strong Adult Concussion Services
G.F. Strong Adult Concussion Services
Vancouver, British Columbia
Canada

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Toronto Western Hospital
Toronto Western Hospital
Toronto, Ontario
Canada

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Calgary Brain Injury Program
Calgary Brain Injury Program
Calgary, Alberta
Canada

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Head Injury Clinic at St. Michael's
Head Injury Clinic at St. Michael's
Toronto, Ontario
Canada

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Fraser Health Acquired Brain Injury and Concussion Services
Fraser Health Acquired Brain Injury and Concussion Services
Langley, British Columbia
Canada

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Hull-Ellis Concussion and Research Clinic
Hull-Ellis Concussion and Research Clinic
Toronto, Ontario
Canada

Contact Study Team

Study Sponsored By
University of British Columbia
Participants Required
More Information
Study ID: NCT05365776