Relative contribution of acute cognitive and motor functioning on community integration 1 year after moderate-severe TBI

ABSTRACT

Objectives

The objective of this study was to understand the relative contribution of acute motor versus cognitive functioning on community integration 1 year after moderate-severe traumatic brain injury (TBI).

Methods

Secondary data analysis of 779 participants in the TBI Model Systems National Database who experienced a moderate-severe TBI requiring inpatient rehabilitation. Participants were categorized into four groups: low motor/low cognition, low motor/high cognition, high motor/low cognition, or high motor/high cognition. Community integration outcomes measured 1 year post-TBI included the Participation Assessment with Recombined Tools-Objective (PART-O), driving status, Supervision Rating Scale, residence, re-injury, and employment status.

Results

Participants with both high motor/high cognition had higher scores on the PART-O total score (p < 0.001), living independently (p = 0.023), living in a private residence (p = 0.002), and being employed (p = 0.026) at 1 year. Participants with high motor/high cognition and high motor/low cognition had higher odds of driving (p = 0.001 and p = 0.034, respectively) when compared to low motor/low cognition. All groups relative to the low motor/low cognition group had higher odds of being re-injured.

Discussion and Conclusions

High motor and high cognitive function at rehabilitation are associated with favorable community integration outcomes 1 year post-injury, though greater participation afforded by high function may confer elevated risk of re-injury.

KEYWORDS:

• Brain injuries
• Rehabilitation
• Outcome assessment (health care)
• Function participation assessment with recombined tools-objective
• Functional independence measure
• Brief test of adult cognition by telephone
• Traumatic

Acknowledgments

The contents of this publication were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research: Indiana University School of Medicine/Rehabilitation Hospital of Indiana (Grant #90DPTB0002), North Texas TBI Model System (Grant #90DPTB0013), Icahn School of Medicine at Mount Sinai (90DPTB0009), Mayo Clinic TBI Model System (Grant #90DPTB0012-01-00). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The work was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research [#90DPTB0002,#90DPTB0012,#90DPTB0013,90DPTB0009].