Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury

Short Title:
Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury
Model System:
SCI
Reference Type:
Journal Article
Accession No.:
J70620
Journal:
Journal of Rehabilitation Research and Development
Year, Volume, Issue, Page(s):
2015, vol. 1, issue 51, pp 1057-1068
Publication Website:
Abstract:
Study examined postacute changes in bowel and bladder continence and cognition after severe traumatic brain injury (TBI) in patients with long-term functional recovery to full independence. This case series included 9 patients initially admitted to inpatient rehabilitation (IR) with severe TBI who had returned to prior responsibilities and functional independence by 8 to 15 months. Patients had initial Glasgow Coma Scale scores of 3 to 6, posttraumatic amnesia durations of 18 to 70 days, time-to-follow-commands of 16 to 56 days, initial abnormal brain computed tomography scans, and initial pupil abnormalities. IR Functional Independence Measure (FIM) cognitive and sphincter score improvements were compared with national TBI FIM data on 16,638 patients from the Uniform Data Systems for Medical Rehabilitation (UDSMR) for 2010. All patients had IR improvements in cognitive and sphincter FIM scores approximately twice the national 2010 UDSMR data. All patients had combined IR discharge sphincter FIM scores that were 12 or greater, indicating independence to modified independence with bowel and bladder function with no incontinence. Five of the 9 participants (55 percent) were admitted to IR with sphincter FIM scores of 11 to 12, indicating recovery of continence during acute care. These findings suggest potential usefulness of IR cognitive FIM score changes and of the recovery of bowel and bladder continence for predicting favorable functional outcomes following severe TBI.
Author(s):
Clark, T. Irwin, R. Felix, E. Cowan, R. Corbett S, Cardenas, C.
Author Address(es):
Participating Centers:

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