Evidence map›Paper›PMID 42891011›Full record

ArticleEClinicalMedicine2026

Interdisciplinary intervention (GAIN) vs. enhanced usual care for reducing severe post-concussion symptoms in adults 2-4 months post-injury: a stepped wedge cluster randomised controlled trial.

Line Amalie Hellemose, Mille Møller Thastum, Henriette Holm Stabel, Lene Odgaard, Charlotte Ulrikka Rask, Noah D Silverberg, Toril Skandsen, Hana Malá Rytter, Charlotte Nygaard, Peter Preben Eggertsen and 2 more

Registry-linked trialAbstract read
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In one paragraph

Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04798885 (Interdisciplinary Intervention for Patients With Post-concussion Symptoms 3-6 Months Post-injury), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04798885 naunknown statusnot on this map

Interdisciplinary Intervention for Patients With Post-concussion Symptoms 3-6 Months Post-injury (GAIN 2.0). A Stepped Wedge Cluster Randomised Trial: Effect on Symptoms, Participation in Daily Activities, and Labour Market Attachment

TypeinterventionalSponsorUniversity of AarhusRan2021 to 2024Enrolled310ConditionsCommotio Cerebri, Mild Traumatic Brain InjuryArmsGAIN 2.0
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Line Amalie HellemoseHammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark.
Mille Møller ThastumHammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark.
Henriette Holm StabelHammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark.
Lene OdgaardHammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark.
Charlotte Ulrikka RaskDepartment of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus N, Denmark.
Noah D SilverbergDepartment of Psychology, University of British Columbia, Vancouver, BC, Canada.
Toril SkandsenDepartment of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Hana Malá RytterThe Danish Concussion Center, Copenhagen, Denmark.
Charlotte NygaardHammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark.
Peter Preben EggertsenDepartment of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
Carsten B PedersenHammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark.
Jørgen Feldbæk NielsenHammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Up to 30% of adults presenting to emergency departments develop persisting post-concussion symptoms (PPCS). Get going After concussIoN (GAIN), has previously shown promising effects in reducing PPCS in adolescents and young adults. Methods: This stepped wedge cluster randomised trial tested the effect of GAIN in reducing high levels of PPCS (i.e. a score ≥20 on the Rivermead Post-concussion Symptoms Questionnaire (RPQ)) 2-4 months post-injury in adults (18-60 years). GAIN was delivered in five clusters of municipalities in the Central Denmark Region sequentially allocated to implement the intervention, with one cluster transitioning to deliver GAIN every 3 months over six recruitment periods in the order of a computer-generated randomisation schedule. Participants were allocated to enhanced usual care (EUC) or GAIN + EUC depending on time and their place of residence. Masking of participants and therapists was not feasible. Primary outcome was change in RPQ total score from baseline to 3-month follow-up. Analyses were based on intention to treat using linear-mixed models. The trial is registered with ClinicalTrials.gov, NCT04798885. Findings: Between May 1, 2021 and November 1, 2022, 310 participants were included. The average difference in change in RPQ score between GAIN + EUC (n = 170) and EUC (n = 140) from baseline to 3-month follow-up was -2.4 points (95% CI -5.4 to 0.4, Interpretation: This study could not confirm the hypothesis that GAIN added to EUC led to a larger long-term reduction in PPCS than EUC alone in adults. However, GAIN may improve long-term prognosis by reducing maladaptive, symptom-related perceptions and behaviours. Funding: The foundation Sygeforsikringen "danmark" and Central Denmark Region.

Indexed as

Brain concussionCognitive behavioural therapyGraded exercise therapyIllness perceptionsInterventionMild traumatic brain injury

Identifiers

PMID42891011
PMCPMC13672966

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.