Neuropsychological correlates of the Functional Independence Measure (FIM) self care items after Traumatic Brain Injury

ABSTRACT:Objective:The goal of this study was to provide a general descriptive and cognitive portrait of a population with traumatic brain injury (TBI) at the time of their acute care stay.Material and methods:Three hundred and forty-eight TBI patients were assessed. The following data were collected for each patient: age, level of education, duration of post-traumatic amnesia, Galveston Orientation Amnesia Test score, Glasgow Coma Scale score, results of cerebral imaging, Neurobehavioral Rating Scale score, the Functional Independence Measure cognitive score and the Glasgow Outcome Scale score.Results:The clinical profile of the population revealed a mean age of 40.2 (±18.7) and a mean of 11.5 (±3.6) years of education. Most patients presented with frontal (57.6%) and temporal (40%) lesions. Sixty-two percent had post-traumatic amnesia of less than 24 hours. Seventy percent presented with mild TBI, 14% with moderate and 15% with severe TBI. The cognitive deficits most frequently observed on the Neurobehavioral Rating Scale were in the areas of attention, memory and mental flexibility as well as slowness and mental fatigability. Most patients had good cognitive outcome on the Functional Independence Measure and scores of 2 and 3 were frequent on the GOS. Forty-five percent of the patients returned home after discharge, 51.7% were referred to in or out patient rehabilitation and 3.2% were transferred to long-term care facilities.Conclusion:Because of the specialized mandate of acute care institutions, the information provided here concerning characteristics of our TBI population is essential for more efficient decision-making and planning/programming with regards to care and service delivery.

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A Single-center Comparison Using Exoskeleton Rehabilitation for Cerebrovascular Accidents and Traumatic Brain Injury in a Cohort of Hispanic Patients

10.21203/rs.3.rs-42275/v1 ◽

2020 ◽

Author(s):

Lisa R Treviño ◽

Kristina Vatcheva ◽

Michael E Auer ◽

Angela Morales ◽

Lama M Abdurrahman ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Length Of Stay ◽

Functional Independence Measure ◽

Retrospective Chart Review ◽

The United States ◽

Functional Independence ◽

Similar Amount ◽

Federal Drug Administration ◽

Robotic Exoskeleton

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of disability in the United States. The EKSO GT Bionics® (EKSO®) is a robotic exoskeleton approved by the Federal Drug Administration (FDA) for rehabilitation following a cerebrovascular accident (CVA or stroke) and recently received approval for use in patients with TBI. The aim of the study was to examine if the use of exoskeleton rehabilitation in patients with TBI will produce beneficial outcomes. Methods This retrospective chart-review reports the use of the (EKSO®) robotic device in the rehabilitation of patients with TBI compared to patients with CVA. We utilized data from a single, private rehabilitation hospital for patients that received post-CVA or post-TBI robotic exoskeleton intervention. All patients that used the exoskeleton were discharged from the hospital between 01/01/2017 to 04/30/2020. Ninety-four percent of patients in the CVA groups and 100% of patients in the TBI group were of Hispanic or Latino ethnicity. Gains in total Functional Independence Measure (FIM), walking and cognition, and length of stay in the rehabilitation facility were measured. Results Patients in the TBI group (n = 11) were significantly younger than the patients in the CVA group (n = 66; p < 0.05). Both groups spent a similar amount of time active, number of steps taken, and the number of sessions in the exoskeleton. Both groups also started with similar admission FIM scores. The FIM gain in the TBI group was similar to that of the CVA group (37.5 and 32.0 respectively). The length of stay between groups was not different either. Conclusions The use of exoskeleton rehabilitation in patients with TBI appear to produce similar outcomes as for patients with CVA, prompting further attention of this intervention for this type of injury. Trial registration: Retrospectively registered on 07/09/2020 in clinicaltrials.gov number NCT4465019.

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Outcome in Women with Traumatic Brain Injury Admitted to a Level 1 Trauma Center

International Scholarly Research Notices ◽

10.1155/2014/263241 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9

Author(s):

Elaine de Guise ◽

Joanne LeBlanc ◽

Jehane Dagher ◽

Simon Tinawi ◽

Julie Lamoureux ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Health Centre ◽

Functional Independence Measure ◽

Functional Independence ◽

Discharge Destination ◽

Confounding Variables ◽

Mcgill University ◽

Research Findings ◽

Level 1 Trauma Center

Background. The aim of this study was to compare acute outcome between men and women after sustaining a traumatic brain injury (TBI). Methods. A total of 5,642 patients admitted to the Traumatic Brain Injury Program of the McGill University Health Centre-Montreal General Hospital between 2000 and 2011 and diagnosed with a TBI were included in the study. The overall percentage of women with TBI was 30.6% (n= 1728). Outcome measures included the length of stay (LOS), the Extended Glasgow Outcome Scale (GOSE), the functional independence measure instrument (FIM), discharge destination, and mortality rate. Results. LOS, GOSE, the FIM ratings, and discharge destination did not show significant differences between genders once controlling for several confounding variables and running the appropriate diagnostic tests (P<0.05). However, women had less chance of dying during their acute care hospitalization than men of the same age, with the same TBI severity and following the same mechanism of injury. Although gender was a statistically significant predictor, its contribution in explaining variation in mortality was small. Conclusion. More research is needed to better understand gender differences in mortality; as to date, the research findings remain inconclusive.

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Functional independence measure at rehabilitation admission as a predictor of return to driving after traumatic brain injury

Brain Injury ◽

10.3109/02699052.2013.862738 ◽

2014 ◽

Vol 28 (2) ◽

pp. 189-195 ◽

Cited By ~ 8

Author(s):

Nora Cullen ◽

Aneta Krakowski ◽

Christina Taggart

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Functional Independence Measure ◽

Functional Independence

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A Multidimensional Rasch Analysis of the Functional Independence Measure Based on the National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems National Database

Journal of Neurotrauma ◽

10.1089/neu.2015.4138 ◽

2016 ◽

Vol 33 (14) ◽

pp. 1358-1362 ◽

Cited By ~ 5

Author(s):

Christopher R. Pretz ◽

Jacob Kean ◽

Allen W. Heinemann ◽

Allan J. Kozlowski ◽

Rita K. Bode ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Independent Living ◽

Rasch Analysis ◽

Functional Independence Measure ◽

Functional Independence ◽

Model Systems ◽

National Database ◽

Traumatic Brain Injury Model ◽

Injury Model

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Post-traumatic seizures and antiepileptic therapy as predictors of the functional outcome in patients with traumatic brain injury

Scientific Reports ◽

10.1038/s41598-021-84203-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Valeria Pingue ◽

Chiara Mele ◽

Antonio Nardone

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Negative Impact ◽

Functional Independence Measure ◽

Functional Independence ◽

Prophylactic Therapy ◽

Rehabilitation Outcome ◽

Increased Risk ◽

Post Traumatic ◽

Gcs Score

AbstractPost-traumatic seizures (PTS) are a common and debilitating complication of traumatic brain injury (TBI) and could have a harmful impact on the progress of patient rehabilitation. To assess the effect of PTS and relative therapy on outcome in the initial phase after TBI, during the rehabilitation process when neuroplasticity is at its highest, we retrospectively examined the clinical data of 341 adult patients undergoing rehabilitation for at least 6 months post-TBI in our neurorehabilitation unit between 2008 and 2019. We correlated through logistic regression the occurrence of seizures and use of anti-seizure medication (ASM) with neurological and functional outcomes, respectively assessed with the Glasgow Coma Scale (GCS) and the Functional Independence Measure (FIM). PTS were documented in 19.4% of patients: early PTS (EPTS) in 7.0%; late PTS (LPTS) in 9.4%; both types in 3.0%. Patients who developed EPTS had an increased risk of developing LPTS (OR = 3.90, CI 95% 1.58–9.63, p = 0.003). Patients with LPTS had a significantly higher risk of worse neurological (p < 0.0001) and rehabilitation (p < 0.05) outcome. Overall, 38.7% of patients underwent therapy with ASM; prophylactic therapy was prescribed in 24.0% of patients, of whom 14.6% subsequently developed seizures. Mortality was associated with a lower FIM and GCS score on admission but not significantly with PTS. The use of ASM was associated with a worse rehabilitation outcome, independently of the onset of epilepsy during treatment. LPTS appear to exert a negative impact on rehabilitation outcome and their occurrence is not reduced by prophylactic therapy, whereas EPTS do not influence outcome. Our findings caution against the generic use of prophylactic therapy to prevent post-traumatic epilepsy in patients with TBI.

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