Functional recovery after severe traumatic brain injury: An Individual Growth Curve approach

Short Title:
Functional recovery after severe traumatic brain injury: An Individual Growth Curve approach
Model System:
Reference Type:
Journal Article
Accession No.:
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
2015, vol. 1, issue 95, pp 2103-2110
Publication Website:
Study examined patient, injury, and treatment characteristics associated with recovery trajectories of people with severe traumatic brain injury (TBI) during inpatient rehabilitation. Participants were 206 adults with severe, non-penetrating TBI admitted directly from acute care to 2 specialized TBI rehabilitation centers (1 in the United States and 1 in Denmark). Naturally occurring treatments delivered within comprehensive multidisciplinary teams were recorded daily in 15-minute units provided to patients and family members, separately. Motor and cognitive Functional Independence Measure (FIM) scores were obtained on admission, discharge, and every 2 weeks in between and were analyzed with individual growth curve methodology. Results indicated that inpatient recovery was best modeled with linear, cubic, and quadratic components: relatively steep recovery was followed by deceleration of improvement, which attenuated prior to discharge. Slower recovery was associated with older age, longer coma, and interruptions to rehabilitation. Patients admitted at lower functional levels received more treatment, and more treatment was associated with slower recovery, presumably because treatment was allocated according to need. Therefore, effects of treatment on outcome could not be distinguished from effects of case mix factors.
Kisala, PA, Tulsky, DS, Pace, N, Victorson, D, Choi, S.W., Heinemann, A.W., Victorson, D., Choi, S. & Tulsky, D.S.
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