Participation following inpatient rehabilitation for traumatic disorders of consciousness: A TBI model systems study

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J84127

Journal:

Frontiers in Neurology

Year, Volume, Issue, Page(s):

2019 , 10, 1314,

Publication Website:

Abstract:

Study determined the level of participation among patients with traumatic brain injury (TBI) between 2005 and 2017 who were admitted to inpatient rehabilitation unable to follow commands and subsequently enrolled in the TBI Model Systems National Database. The Participation Assessment with Recombined Tools-Objective (PART-O) Productivity, Social Relations, and Out and About subscales was evaluated in 333 patients at 1 to 5 years after injury. A mixed-effects model was used to longitudinally compare participation between patients who did and did not regain command-following during inpatient rehabilitation. Researchers also explored the level of participation associated with increasing levels of functional performance, measured with the Functional Independence Measure (FIM). Participation across groups, at all follow-up time points, on all PART-O subscales, was remarkably low (mean range = 0.021–1.91, maximum possible score = 5). Performance was highest on the Social Relations subscale and lowest on the Productivity subscale. Longitudinal analyses revealed no difference in level of participation or change in participation across time for patients who regained command-following during rehabilitation compared to those who did not. While productivity increased over time, social participation did not and participation outside the home increased more for younger than for older persons. Across all three PART-O subscales, FIM Motor scores positively predicted participation. FIM Cognitive scores positively predicted level of participation on the Productivity and Social Relations subscales. Exploratory analyses revealed that even persons who achieved independence on the FIM Motor and Cognitive subscales had low levels of participation across domains and follow-up years.

Author(s):