Differences Between Elapsed Time to Employment and Employer Selection in Vocational Outcome Following Severe Traumatic Brain Injury

1995 ◽  
Vol 26 (4) ◽  
pp. 17-20 ◽  
Author(s):  
Robert J. Fabiano ◽  
Nancy Crewe ◽  
David A. Goran
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neuropsychological Testing ◽  
Hourly Wage ◽  
Post Injury ◽  
Severe Injuries ◽  
Telephone Interviews ◽  
Rehabilitation Programs ◽  
Vocational Outcome ◽  
Acute Rehabilitation

Information from medical records and telephone interviews were collected on 94 patients who had enrolled in three post-acute rehabilitation programs for the treatment of traumatic brain injury. Those patients who performed better on neuropsychological testing returned to work sooner (within two years post-injury), had less severe injuries, and were more likely to return to the same employer post-injury. Furthermore, those patients who returned to work with the same employer were more likely to be employed and earned a greater hourly wage than those who returned to a new employer.

Addressing the Sexual Concerns of Persons With Traumatic Brain Injury in Rehabilitation Settings: A Framework for Action

2001 ◽  
Vol 2 (2) ◽  
pp. 97-108 ◽  
Author(s):  
Grahame Simpson
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
World Health Organisation ◽  
World Health ◽  
Post Injury ◽  
Rehabilitation Programs ◽  
Human Functioning ◽  
Sexual Concerns ◽  
Organisational Structures

AbstractTraumatic brain injury (TBI) impacts upon people's sexuality with 50% to 60% of persons reporting some level of disruption post-injury. However, only small proportions of patients/family members report that rehabilitation health professionals made inquiries about whether they had any sexual concerns. Rehabilitation programs have a responsibility to meet the challenge of addressing this important area of human functioning. An agency framework is described that provides a non-threatening, structured way for services to conceptualise, introduce or upgrade sexuality services in a manner that can be maintained over the long term. The framework contains an underlying philosophy of sexuality, five proposed modalities of service provision and detail of the underlying organisational structures that are required to provide sexuality services with consistency and effectiveness over the long term. Finally, organisational strategies that can be employed to implement the framework are discussed as well as suggestions about the sequencing of such strategies. By using the framework, rehabilitation services can put sexuality back onto their treatment agenda, as they seek to restore patients/clients with TBI to the “highest level of adaptation attainable” (World Health Organisation, 1996, p. 1) in all areas of their lives.

scholarly journals Saccadic Eye Movements in Mild Traumatic Brain Injury: A Pilot Study OPEN ACCESS

2014 ◽  
Vol 41 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Sarah J. Mullen ◽  
Yeni H. Yücel ◽  
Michael Cusimano ◽  
Tom A. Schweizer ◽  
Anton Oentoro ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Eye Movements ◽  
Brain Injury ◽  
Pilot Study ◽  
Mild Traumatic Brain Injury ◽  
Neuropsychological Testing ◽  
Saccadic Eye Movements ◽  
Post Injury ◽  
Persistent Symptoms

Objective:To investigate whether repeat saccadic reaction time (SRT) measurements using a portable saccadometer is useful to monitor patients with mild traumatic brain injury (mTBI).Methods:Seven patients with newly-diagnosed mTBI and five agematched controls were prospectively recruited from an emergency Department. Saccadic eye movements, symptom self-reporting and neuropsychological tests were performed within one week of injury and again at follow-up three weeks post-injury. Control patients underwent saccade recordings at similar intervals.Results:Median saccade reaction times were significantly prolonged within one week post-injury in mTBI compared to controls. At follow-up assessment there was no significant between-groups difference. Changes in median SRT between the two assessments were not statistically significant. Four of the seven mTBI patients showed significantly increased SRT at follow-up; three of the mTBI patients and all controls showed no significant change. Among the three mTBI patients with persistent decreased SRT, two experienced loss of consciousness and reported the greatest symptoms, while the third was the only subject with significant decrease in neuropsychological testing scores at both assessments.Conclusion:In three of seven mTBI patients, saccadic eye movements remained delayed within three weeks post-injury. These three patients also showed persistent symptoms or no improvement on neuropsychological testing. This pilot study using a portable saccadometer suggests that comparing SRT from three weeks post-injury to that within one week of injury may be useful for early detection of a subpopulation at risk of persistent disability from mTBI. This finding suggests that further investigation in a large study population is warranted.

Thinking Outside the Box: Maximizing Vocational Outcomes Post-Traumatic Brain Injury through Rehabilitation Counseling and Recreation/Leisure Activities

2015 ◽  
Vol 46 (4) ◽  
pp. 37-44
Author(s):  
Leah Cox Thomas ◽  
Eileen J. Burker ◽  
Kelly A. Kazukauskas
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Rehabilitation Counseling ◽  
Leisure Activities ◽  
Rehabilitation Counselors ◽  
Post Injury ◽  
Rehabilitation Programs ◽  
Vocational Outcomes ◽  
Post Traumatic ◽  
Employment Programs

Traumatic brain injury (TBI) is a disability that is becoming more common and post-injury many individuals with TBI have difficulty returning to employment for extended periods of time. Despite the success of traditional vocational rehabilitation programs, many individuals still struggle to maintain long-term employment. The purpose of this paper is to suggest the use of recreation and leisure activities (RLA) as a complementary treatment modality that can be utilized in conjunction with traditional employment programs to maximize vocational outcomes and increase overall life satisfaction. Benefits and barriers to RLA participation are discussed as well as specific attributes necessary for participation in both vocational pursuits and RLA. Recommendations for rehabilitation counselors are also provided.

Mild Traumatic Brain Injury — the Fife Perspective

1997 ◽  
Vol 42 (2) ◽  
pp. 40-43 ◽  
Author(s):  
C.E. Skelton ◽  
R.M. Walley ◽  
J.B. Chisholm ◽  
R.L. Sloan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Neuropsychological Testing ◽  
Age Group ◽  
Post Injury ◽  
Accident And Emergency ◽  
Brain Injured ◽  
Accident And Emergency Department ◽  
Injured Patients

Results are reported from a study to identify patients residing in Fife with mild traumatic brain injury in the 16–65 year old age group, who attended an accident and emergency department following their brain injury. Over a two month period 161 such patients attended with minor head trauma, of which 33 entered our study. The major cause of mild traumatic brain injury was assault. We found that over two-thirds of patients in the study had persisting post-concussive symptoms six months post injury. Neuropsychological testing showed problems of concentration and memory, but not at a level that was significantly different from that expected in an average population. Other studies have shown that symptom rates are higher when patients get no explanation of their symptoms and we feel that better co-ordination of services for brain injured patients in Fife is required, to provide the necessary information, education and support.

Pre-Injury, Injury and Early Post-Injury Predictors of Long-Term Functional and Psychosocial Recovery After Severe Traumatic Brain Injury

2005 ◽  
Vol 6 (2) ◽  
pp. 75-89 ◽  
Author(s):  
Robyn L. Tate ◽  
G. Anthony Broe ◽  
Ian D. Cameron ◽  
Adeline E. Hodgkinson ◽  
Cheryl A. Soo
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Occupational Status ◽  
Self Care ◽  
Consecutive Series ◽  
Post Injury ◽  
Predictive Capacity ◽  
Rehabilitation Programs ◽  
Living Skills

AbstractBackground: Findings from prognostic studies of functional and psychosocial recovery after traumatic brain injury (TBI) reported to date have been limited by the restricted timeframe for prediction, generally within the first 5 years post-trauma. This investigation examined prediction of functional and psychosocial recovery in the medium-term (6 years post-trauma; Time 1) and long-term (23 years post-trauma; Time 2). Methods: The participants comprised a consecutive series of the first 100 patients with severe TBI receiving their primary rehabilitation at a regionally based unit. At the 23-year follow-up, 91% of the sample was traced: 17 had died, 5 declined participation, and 69 were interviewed, with 68 participating at both Time 1 and Time 2. Five outcome domains were examined: mobility, self-care, employability, relationships and living skills. Results: Very few of seven pre-injury variables were significantly correlated with any of the outcome variables. A series of logistic regression analyses successfully predicted levels of recovery in all domains using four predictor variables: pre-injury occupational status, duration of post-traumatic amnesia, and physical and neuropsychological disability at rehabilitation discharge. At Time 1, 60% or more of the variance was accounted for in four of the five domains, and at Time 2, more than 40% of the variance was accounted for in all domains. Sensitivity ranged from 62% (self-care) to 90% (mobility). With a single exception (employability at Time 2), specificity was also high, ranging from 80% (relationships) to 98% (mobility). Comparable accuracy rates were also found for positive and negative predictive power. Conclusions: These results demonstrate impressive predictive capacity of early post-trauma variables for the very long-term levels of recovery. They provide guidance for the tailoring of individual rehabilitation programs and the identification of people who may require special supports after rehabilitation discharge.

NEUROPSYCHOLOGICAL CHANGES IN PATIENTS WITH A CONSEQUENCE OF TRAUMATIC BRAIN INJURY

2020 ◽  
Vol 3 (1) ◽  
pp. 44-46
Author(s):  
Istatillo Shodjalilov ◽  
◽  
Saoda Igamova ◽  
Aziza Djurabekova
Keyword(s):  
Traumatic Brain Injury ◽  
Cognitive Impairment ◽  
Brain Injury ◽  
Neuropsychological Testing ◽  
Anxiety And Depression ◽  
Psychopathological Symptoms ◽  
Neuropsychological Changes ◽  
The Relationship

The incidence of cognitive impairment in TBI is high, depending on the severity. At the same time, psychopathological symptoms in the form of asthenia, increased anxiety and depression are encountered among patients with TBI. The work studied the relationship between cognitive and psychopathological symptoms in patients with TBI using neuropsychological testing on scales.

scholarly journals A-126 Clinical Utility of Risk Factors to Predict Self-reported Neurobehavioral Outcome Following Traumatic Brain Injury: PTSD, Sleep, Resilience, and Lifetime Blast Exposure

2020 ◽  
Vol 35 (6) ◽  
pp. 919-919
Author(s):  
Lange R ◽  
Lippa S ◽  
Hungerford L ◽  
Bailie J ◽  
French L ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Clinical Utility ◽  
Poor Sleep ◽  
Post Injury ◽  
Poor Outcome ◽  
Blast Exposure ◽  
Neurobehavioral Outcome

Abstract Objective To examine the clinical utility of PTSD, Sleep, Resilience, and Lifetime Blast Exposure as ‘Risk Factors’ for predicting poor neurobehavioral outcome following traumatic brain injury (TBI). Methods Participants were 993 service members/veterans evaluated following an uncomplicated mild TBI (MTBI), moderate–severe TBI (ModSevTBI), or injury without TBI (Injured Controls; IC); divided into three cohorts: (1) < 12 months post-injury, n = 237 [107 MTBI, 71 ModSevTBI, 59 IC]; (2) 3-years post-injury, n = 370 [162 MTBI, 80 ModSevTBI, 128 IC]; and (3) 10-years post-injury, n = 386 [182 MTBI, 85 ModSevTBI, 119 IC]. Participants completed a 2-hour neurobehavioral test battery. Odds Ratios (OR) were calculated to determine whether the ‘Risk Factors’ could predict ‘Poor Outcome’ in each cohort separately. Sixteen Risk Factors were examined using all possible combinations of the four risk factor variables. Poor Outcome was defined as three or more low scores (< 1SD) on five TBI-QOL scales (e.g., Fatigue, Depression). Results In all cohorts, the vast majority of risk factor combinations resulted in ORs that were ‘clinically meaningful’ (ORs > 3.00; range = 3.15 to 32.63, all p’s < .001). Risk factor combinations with the highest ORs in each cohort were PTSD (Cohort 1 & 2, ORs = 17.76 and 25.31), PTSD+Sleep (Cohort 1 & 2, ORs = 18.44 and 21.18), PTSD+Sleep+Resilience (Cohort 1, 2, & 3, ORs = 13.56, 14.04, and 20.08), Resilience (Cohort 3, OR = 32.63), and PTSD+Resilience (Cohort 3, OR = 24.74). Conclusions Singularly, or in combination, PTSD, Poor Sleep, and Low Resilience were strong predictors of poor outcome following TBI of all severities and injury without TBI. These variables may be valuable risk factors for targeted early interventions following injury.

scholarly journals The Challenge of Managing Patients Suffering from TBI: The Utility of Multiparametric MRI

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 178-179
Author(s):  
John L. Sherman ◽  
Laurence J. Adams ◽  
Christen F. Kutz ◽  
Deborah York ◽  
Mitchell S. Szymczak
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family History ◽  
Diffusion Tensor ◽  
Multiparametric Mri ◽  
Psychiatric History ◽  
Post Injury ◽  
Negative Family History ◽  
Imaging Result ◽  
The Brain

AbstractTraumatic brain injury (TBI) is a complex phenomenon affecting multiple areas of the brain in multiple ways. Both right and left hemispheres are affected as well as supratentorial and infratentorial compartments. These multifocal injuries are caused by many factors including acute mechanical injury, focal intracranial hemorrhage, blunt and rotational forces, epidural and subdural hematoma, hypoxemia, hypotension, edema, axonal damage, neuronal death, gliosis and blood brain barrier disruption. Clinicians and patients benefit by precise information about the neuroanatomical areas that are affected macroscopically, microscopically and biochemically in an individual patient.Standard imaging studies are frequently negative or grossly underestimate the severity of TBI and may exacerbate and prolong patient suffering with an imaging result of “no significant abnormality”. Specifically, sophisticated imaging tools have been developed which reveal significant damage to the brain structure including atrophy, MRI spectroscopy showing variations in neuronal metabolite N-acetyl-aspartate, elevations of membrane related Choline, and the glial metabolite myo-inositol is often observed to be increased post injury. In addition, susceptibility weighted imaging (SWI) has been shown to be more reliable for detecting microbleeds versus calcifications.We have selected two TBI patients with diffuse traumatic brain injury.The first patient is a 43-year-old male who suffered severe traumatic brain injury from a motorcycle accident in 2016. Following the accident, the patient was diagnosed with seizures, major depression, and intermittent explosive disorder. He has attempted suicide and has neurobehavioral disinhibition including severe anger, agitation and irritability. He denies psychiatric history prior to TBI and has negative family history. Following the TBI, he became physically aggressive and assaultive in public with minimal provocation. He denies symptoms of thought disorder and mania. He is negative for symptoms of  cognitive decline or encephalopathy.The second patient is a 49-year-old male who suffered at least 3 concussive blasts in the Army and a parachute injury. Following the last accident, the patient was diagnosed with major depressive disorder, panic disorder, PTSD and generalized anxiety disorder. He denies any psychiatric history prior to TBI including negative family history of psychiatric illness. In addition, he now suffers from nervousness, irritability, anger, emotional lability and concurrent concentration issues, problems completing tasks and alterations in memory.Both patients underwent 1.5T multiparametric MRI using standard T2, FLAIR, DWI and T1 sequences, and specialized sequences including susceptibility weighted (SWAN/SWI), 3D FLAIR, single voxel MRI spectroscopy (MRS), diffusion tensor imaging (DTI), arterial spin labeling perfusion (ASL) and volumetric MRI (NeuroQuant). Importantly, this exam can be performed in 30–45 minutes and requires no injections other than gadolinium in some patients. We will discuss the insights derived from the MRI which detail the injured areas, validate the severity of the brain damage, and provide insight into the psychological, motivational and physical disabilities that afflict these patients. It is our expectation that this kind of imaging study will grow in value as we link specific patterns of injury to specific symptoms and syndromes resulting in more targeted therapies in the future.

The effect of phototherapy on sleep during acute rehabilitation after traumatic brain injury: a randomized controlled trial

Brain Injury ◽  
2021 ◽  
pp. 1-9
Author(s):  
Kathleen R. Bell ◽  
Donald Fogelberg ◽  
Jason Barber ◽  
Risa Nakase-Richardson ◽  
Jennifer M. Zumsteg ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Randomized Controlled Trial ◽  
Brain Injury ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Acute Rehabilitation

Blood Biomarkers Relate to Cognitive Performance Years after Traumatic Brain Injury in Service Members and Veterans

2020 ◽  
pp. 1-7
Author(s):  
Sara M. Lippa ◽  
Jessica Gill ◽  
Tracey A. Brickell ◽  
Louis M. French ◽  
Rael T. Lange
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Outcome ◽  
Service Members ◽  
Neurocognitive Performance ◽  
Blood Biomarkers ◽  
Post Injury ◽  
Blood Draw ◽  
Neurofilament Light ◽  
History Of

Abstract Objective: This study examines the relationship of serum total tau, neurofilament light (NFL), ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), and glial fibrillary acidic protein (GFAP) with neurocognitive performance in service members and veterans with a history of traumatic brain injury (TBI). Method: Service members (n = 488) with a history of uncomplicated mild (n = 172), complicated mild, moderate, severe, or penetrating TBI (sTBI; n = 126), injured controls (n = 116), and non-injured controls (n = 74) prospectively enrolled from Military Treatment Facilities. Participants completed a blood draw and neuropsychological assessment a year or more post-injury. Six neuropsychological composite scores and presence/absence of mild neurocognitive disorder (MNCD) were evaluated. Within each group, stepwise hierarchical regression models were conducted. Results: Within the sTBI group, increased serum UCH-L1 was related to worse immediate memory and delayed memory (R2Δ = .065–.084, ps < .05) performance, while increased GFAP was related to worse perceptual reasoning (R2Δ = .030, p = .036). Unexpectedly, within injured controls, UCH-L1 and GFAP were inversely related to working memory (R2Δ = .052–.071, ps < .05), and NFL was related to executive functioning (R2Δ = .039, p = .021) and MNCD (Exp(B) = 1.119, p = .029). Conclusions: Results suggest GFAP and UCH-L1 could play a role in predicting poor cognitive outcome following complicated mild and more severe TBI. Further investigation of blood biomarkers and cognition is warranted.

Sign in / Sign up

Export Citation Format

Share Document