Predicting the trajectory of participation after traumtic brain injury: A longitudinal analysis

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J78896

Journal:

Journal of Head Trauma Rehabilitation

Year, Volume, Issue, Page(s):

2018 , 33, 4, 257-265

Publication Website:

Abstract:

Study identified factors that predict trajectories of participation over the first 5 years after moderate-to-severe traumatic brain injury (TBI). A secondary analysis was conducted of data collected from 1,947 community-dwelling individuals with TBI, 16 years of age or older, enrolled in the TBI Model Systems National Database (TBIMS NDB). The variables of age at injury, gender, race, living setting, substance abuse problem, and years of education were derived from demographic and characteristic items in the TBIMS NDB. The main outcome measure of participation was measured using Participation Assessment with Recombined Tools-Objective. Cognitive and motor function were assessed using the Functional Independence Measure (FIM). Depression was assessed using the Patient Health Questionnaire-9. Age at injury and the FIM Motor score predicted trajectory of participation over the first 5 years after moderate-to-severe TBI. Older age predicted generally worse participation overall as well as progressively worsening participation over time. Higher FIM Motor raised the predicted participation values, although it reduced the rate of improvement in participation scores over time. FIM Cognitive scores, race, depression, years of education, and living setting did not predict trajectory but did significantly influence participation consistently at all time points. These findings may enhance the ability of rehabilitation professionals to identify individuals at risk for poor participation after TBI and develop targeted interventions for optimizing involvement in life activities.

Author(s):