Research Reports - Factors associated with long-term functional and psychological outcomes in persons with moderate to severe traumatic brain injury

 J Rehabil Med. 2016 Apr 28;48(5):442-8. doi: 10.2340/16501977-2084.

Khan F(1), Amatya B, Judson R, Chung P, Truesdale M, Elmalik A, Galea MP.

OBJECTIVE: To examine factors impacting long-term functional and psychological
outcomes in persons with moderate-severe traumatic brain injury.
METHODS: A prospective cross-sectional study (n = 103) assessed the long-term (up
to 5 years) impact of traumatic brain injury on participants' current activity
and restriction in participation using validated questionnaires.
RESULTS: Participants' median age was 49.5 years (interquartile range (IQR)
20.4-23.8), the majority were male (77%), and 49% had some form of previous
rehabilitation. The common causes of traumatic brain injury were falls (42%) and
motor vehicle accidents (27%). Traumatic brain injury-related symptoms were:
pain/headache (47%), dizziness (36%), bladder/bowel impairment (34%), and
sensory-perceptual deficits (34%). Participants reported minimal change in their
physical function and cognition (Functional Assessment Measure: motor (median
102, IQR 93-111) and cognition (median 89, IQR 78-95)). Participants were
well-adjusted to community-living; however, they reported high levels of
depression. Factors significantly associated with poorer current level of
functioning/well-being included: older age (≥ 60 years), presence of traumatic
brain injury-related symptoms, a lack of previous rehabilitation and those
classified in "severe disability categories" at admission. Caregivers reported
high levels of strain and burden (55%).
CONCLUSION: Cognitive and psychosocial problems are more commonly reported than
physical disability in the longer-term. A greater focus on participation and
ageing with disability in these persons is needed.

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