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MTBI - Mild Traumatic Brain InjuryNCT05524402

Live Video Mind-body Treatment to Prevent Persistent Symptoms Following mTBI

A study testing TOR-C 1 and TOR-C 2 in people with MTBI - Mild Traumatic Brain Injury and Anxiety, run by Massachusetts General Hospital at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The investigator aims to conduct a pilot randomized controlled trial to test the feasibility of two symptom management programs for college-age individuals with recent concussions and anxiety, TOR-C 1 and TOR-C 2. Read more about this study

Who is it for?
Ages 18 to 35 yearsHealthy volunteers can take part
Conditions the study is for
MTBI - Mild Traumatic Brain Injury, Anxiety
What is being tested?
TOR-C 1 and TOR-C 2
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteUnited States
Study dates
15 Oct 2022to 12 Jul 2024
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 35 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Male and female outpatients, ages 18-35
  • English fluency and literacy
  • Diagnosed with a concussion in the past 10 weeks
  • Owns a smartphone or computer with Internet access
  • Willingness and ability to participate in four 45-minute program sessions and answer remote questionnaires before, after, and 3-month following the program
  • Free of concurrent psychotropic or have been on stable dosage for at least 6 weeks
  • Clinically significant anxiety symptoms (score ≥ 5 on GAD-7 anxiety scale)

Who cannot join

  • Previous history of moderate or severe TBI OR concussion in the past 2 years that resulted in symptoms lasting 3 months or more
  • Diagnosed with a medical illness expected to worsen in the next 6 months (e.g., malignancy)
  • Lifetime history of schizophrenia, bipolar disorder, or other psychotic disorder
  • Current substance abuse or dependence and current substance use disorder
  • Current active self-reported suicidal ideation
  • Practice of mindfulness techniques for greater than 45 minutes per week within the last 3 months
  • Participation in a mind-body or CBT treatment in the past 3 months
  • Currently pregnant

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Massachusetts General Hospital

    Boston, Massachusetts, 02129

Other trials in United States

About this study

The investigator aims to conduct a pilot randomized controlled trial to test the feasibility of two symptom management programs for college-age individuals with recent concussions and anxiety, TOR-C 1 and TOR-C 2. The investigator will assess the feasibility of recruitment procedures (screening, eligibility, and enrollment) and data collection as well as the feasibility, credibility, and acceptability of the programs (adherence, retention, fidelity, and satisfaction), following prespecified benchmarks. Both programs will be delivered virtually (Zoom).

Read the detailed description

The investigator aims to conduct a pilot randomized controlled trial to test the feasibility of two symptom management programs for college-age individuals with recent concussions and anxiety, TOR-C 1 and TOR-C 2. The investigator will assess the feasibility of recruitment procedures (screening, eligibility, and enrollment) and data collection as well as the feasibility, credibility, and acceptability of the programs (adherence, retention, fidelity, and satisfaction), following prespecified benchmarks. Both programs will be delivered virtually (Zoom).

Each program will consist of four 45-minute sessions over the secure Zoom platform. Participants will receive a treatment manual. There are 3 assessment points consisting of self-report surveys: baseline, post program, and 3-month follow-up.

Being tested
TOR-C 1, TOR-C 2
Keywords
MTBI - Mild Traumatic Brain Injury, Anxiety, Mindfulness
Medical subject headings
Brain Concussion, Anxiety Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TOR-C 1Behavioural

    TOR-C 1 is an active intervention, adapted from the original Toolkit for Optimal Recovery program, adjusted for patients with mTBI and anxiety. The TOR-C 1 sessions address mind-body skills, including eliciting the relaxation response (eg, body scan, deep breathing, mindfulness), cognitive-behavioral strategies (eg, reframing), acceptance and commitment skills (eg, acceptance), and skills for returning to activity (eg, goal setting, activity pacing). The format is a 4-week program with weekly sessions and home practice.

  • TOR-C 2Behavioural

    TOR-C 2 is an active intervention teaching educational information on key modifiable factors relating to recovery after concussion, such as return to activity, the role of nutrition and sleep, and the relationship between concussion and anxiety. The format is a 4-week program delivered over live video with weekly sessions.

Study groups in NCT05524402
Study groupRoleWhat they receive
TOR-C 1ExperimentalTOR-C 1 is an active intervention adapted from the original Toolkit for Optimal Recovery program, adjusted for patients with mTBI and anxiety. The TOR-C 1 sessions address mind-body skills, including eliciting the relaxation response (eg, body scan, deep breathing, mindfulness), cognitive-behavioral strategies (eg, reframing), acceptance and commitment skills (eg, acceptance), and skills for returning to activity (eg, goal setting, activity pacing). The format is a 4-week program delivered over live video with weekly sessions and home practice.
Receives: Behavioral: TOR-C 1
TOR-C 2Active comparatorTOR-C 2 is an active intervention teaching educational information on key modifiable factors relating to recovery after concussion, such as return to activity, the role of nutrition and sleep, and the relationship between concussion and anxiety. The format is a 4-week program delivered over live video with weekly sessions.
Receives: Behavioral: TOR-C 2

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants Who Scored Above the Midpoint on Each Subscale of the Credibility and Expectancy Questionnaire (CEQ)

    Assessed using the Credibility and Expectancy Questionnaire (CEQ) which asks the participant indicate how much they believe, right now, that the intervention they will receive will help manage their concussion and related worry. Possible scores on both the credibility and expectancy subscales range from 3 to 27 and have a midpoint score of 14. The number of participants that scored at or above 14 on the credibility and/or expectancy subscales are reported below.

    Measured: Baseline (0 Weeks)

  2. Number of Participants Who Scored Above the Midpoint on the Client Satisfaction Scale

    Measured using the Client Satisfaction Scale which assess participants' satisfaction with participation in the study. The score range is 0-12. Higher scores indicate greater satisfaction.

    Measured: Post-Test (4 Weeks)

  3. Feasibility of Recruitment

    Rate at which recruitment was possible

    Measured: Baseline (0 Weeks)

  4. Acceptability of Treatment

    Rate at which program was accepted, measured by attendance.

    Measured: Post-Test (4 Weeks)

  5. Adherence to Homework

    Rate of participant's completion of homework assigned (practicing at least 1 program skill, 3 days/week on average) throughout the study.

    Measured: Collected during intervention, an average of 4 weeks

  6. Therapist Adherence

    Rate of interventionist's delivering the programs by following the established session topics and practices

    Measured: Collected during intervention, an average of 4 weeks

  7. Feasibility of Assessments at Baseline

    Rate of participant's completion of self-report measures, with no measures missing

    Measured: Baseline (0 Weeks)

  8. Feasibility of Assessments at Post-Test

    Rate of participant's completion of self-report measures, with no measures missing

    Measured: Post-Test (4 Weeks)

  9. Feasibility of Assessments at Follow-up

    Rate of participant's completion of self-report measures, with no measures missing

    Measured: Follow-up (12 Weeks)

  10. Adverse Events

    Any self reported or observed negative events related to participation

    Measured: Collected during intervention, an average of 4 weeks

Secondary outcomes (10)
  1. Numerical Rating Scale

    Rate of a participant's pain at rest and with activity using a Likert scale with 0 being no pain and 10 being worst possible pain.

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

  2. Post-Concussion Symptom Scale (PCSS)

    The PCSS measures post-concussion symptoms on a 1-6-point Linkert scale. Higher scores represent greater symptom severity and total scores can range from 22 to132 points.

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

  3. Generalized Anxiety Disorder Scale (GAD-7)

    7-item questionnaire measuring symptoms of anxiety within the past 2 weeks on a scale of 0 to 3. Total scores range from 0 to 21 and higher scores indicate more symptoms of anxiety.

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

  4. Hospital Anxiety And Depression Scale (HADS)

    Measures symptoms of emotional distress and estimates diagnoses. The scale has 14 items, 7 assess anxiety and 7 depression. Scores range from 0-21 on each subscale, wtih higher scores indicating more symptoms. Scores greater than 8 indicate clinically significant symptoms.

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

  5. World Health Organization - Disability Assessment Schedule 2.0 (WHODAS)

    The WHODAS 2.0 measures level of functioning in six domains: cognition, mobility, self-care, getting along, life activities, and participation. Each item is on the scale is measured 0-4, with total scores ranging from 0 to 48. Higher scores indicate more disability (worse outcomes).

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

  6. Fear Avoidance Behavior After Traumatic Brain Injury (FAB-TBI)

    A 16-item questionnaire assessing beliefs about how work and physical activities affect mTBI symptoms, and whether they should be avoided on a scale of 0 to 3. Total scores range from 0 to 48 and higher scores represent higher fear avoidance.

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

  7. Pain Catastophizing Scale (PCS)

    A 13-item questionnaire assessing one's tendency to focus on pain-related thoughts and feel helpless and hopeless due to pain on a scale of 0 to 4. Total scores range from 0 to 25 and higher scores indicate higher pain catastrophizing (worse outcomes).

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

  8. Cognitive And Affective Mindfulness Scale-Revised (CAMS-R)

    Rate of a participant's broad conceptualization of mindfulness, items range from 1-4 and scores range from 12-48, with higher values reflecting higher levels of mindfulness

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

  9. Behavioral Response To Illness (BRIQ) - Limiting Behaviors Subscale

    A 7-item subscale of the BRIQ measuring "limiting behaviors" (frequency of inactivity). This subscale is rated on a scale of 0 to 4, with total scores ranging from 0 to 28. Higher scores indicate more limiting behavior (worse outcomes).

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

  10. Behavioral Response To Illness (BRIQ) - All-or-Nothing Subscale

    A 6-item subscale of the BRIQ measuring "all or nothing behaviors" (tendency for overexertion). This subscale is rated on a scale of 0 to 4, with higher scores indicating more all or nothing behavior. Total scores on this subscale range from 0 to 24.

    Measured: Baseline (0 Weeks), Post-Test (4 Weeks), Follow-Up (12 Weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Sep 2022
  2. Study start15 Oct 2022
  3. Primary completion12 Jul 2024
  4. Study completion12 Jul 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05524402
Sponsor's protocol ID
2022P001521
Other IDs
K23AT010653-01A1
Status last verified
Mar 2025
First submitted
17 Aug 2022
Last updated
20 Mar 2025
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Greenberg J, Singh T, Iverson GL, Silverberg ND, Macklin EA, Parker RA, Giacino JT, Yeh GY, Vranceanu AM. A Live Video Mind-Body Treatment to Prevent Persistent Symptoms Following Mild Traumatic Brain Injury: Protocol for a Mixed Methods Study. JMIR Res Protoc. 2021 Jan 14;10(1):e25746. doi: 10.2196/25746.

    PubMed 33443484
  • Greenberg J, Levey NS, Becker M, Yeh GY, Giacino JT, Iverson G, Silverberg ND, Parker RA, Vranceanu AM. Feasibility Randomized Controlled Trial of the Toolkit for Optimal Recovery After Concussion: A Live Video Program to Prevent Persistent Concussion Symptoms in Young Adults With Anxiety. Arch Phys Med Rehabil. 2025 Apr;106(4):527-536. doi: 10.1016/j.apmr.2024.10.011. Epub 2024 Nov 5.

    PubMed 39505248

Questions about this trial

What is this clinical trial studying?

A study testing TOR-C 1 and TOR-C 2 in people with MTBI - Mild Traumatic Brain Injury and Anxiety, run by Massachusetts General Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 20 Mar 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants Who Scored Above the Midpoint on Each Subscale of the Credibility and Expectancy Questionnaire (CEQ) (time frame: Baseline (0 Weeks)). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05524402, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Mar 2025.

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