The Model of Occupational Self-Efficacy: A Contemporary Model to Enhance Work Skills, Cognitive and Emotional Skills of Individuals With Brain Injury-A Pilot Randomized Control Trial.

Only 28 people took part, so the study cannot show whether MOOSE works; the authors say the findings cannot be generalised to a larger population. The groups did not start out the same: 71% of the control group had not been employed before their injury, compared with 36% of the MOOSE group, which could explain part of the difference in who was working at the end. The groups were mostly men (71% male in the control group and 93% in the MOOSE group), so the results say little about women with brain injury. The authors state that the outcome assessment was not blinded, which conflicts with the earlier statement that participants and therapists were blinded, and they say this could have affected the results. The employment result, which is the most striking difference reported, was not tested statistically, so it is not known whether it is more than chance. Both groups came from people who were already well enough to have been employed before injury and to have completed multidisciplinary rehabilitation, so the findings may not apply to patients with more severe disability.

The authors declare no conflicts of interest. The study was supported by the South African Medical Research Council.

Do not read the higher employment rate in the MOOSE group as proof that the programme gets people back to work. That comparison was never tested statistically, the control group had far more people who were unemployed before their injury (71% against 36%), and every questionnaire outcome in the trial was non-significant.