Disorders of consciousness due to traumatic brain injury: Functional status ten years post-injury

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J79963

Journal:

Journal of Neurotrauma

Year, Volume, Issue, Page(s):

2018 , , ,

Publication Website:

Abstract:

Study examined functional status during the first 10 years after traumatic brain injury (TBI) among individuals with disorders of consciousness (i.e., coma, vegetative state, minimally conscious state). Participants included 110 individuals with TBI who were unable to follow commands prior to inpatient rehabilitation and for whom follow-up data were available at 1, 2, 5, and 10 years post injury. The sample was subdivided into those who demonstrated command-following early (before 28 days post-injury) versus late (≥ 28 days post-injury or never). The Functional Independence Measure (FIM) was used to measure functional outcomes at 1, 2, 5, and 10 years following TBI. Measureable functional recovery occurred throughout the 10-year period, with more than two-thirds of the sample achieving independence in mobility and self-care, and about one-quarter achieving independent cognitive function by 10 years. Following commands prior to 28 days was associated with greater functional independence at all outcome time-points. Multi-trajectory modeling of recovery of three FIM subscales (self-care, mobility, and cognition) revealed four distinct prognostic groups with different temporal patterns of change on these subscales. More than half the sample achieved near-maximal recovery by 1 year after injury, while the later command-following subgroups recovered over longer periods of time. Significant late functional decline was not observed in this cohort. The proportion of participants achieving functional independence increased between 5 and 10 years post-injury. These findings suggest that individuals with disorders of consciousness may benefit from ongoing functional monitoring and updated care plans for at least the first decade after TBI.

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