A profile of outcome: 2 years after traumatic brain injury

Abstract

A group of 175 traumatic brain injury (TBI) patients who had undergone intensive rehabilitation at Bethesda Hospital attended a follow-up interview 2 years after injury. The majority of patients had suffered severe TBI. Outcome was documented in ten areas: medical/physical, mobility, activities of daily living (ADLs) accommodation, marital status, leisure and recreation, employment/study, communication, cognition and behaviour. Whilst most patients were physically independent and competent in personal and domestic activities of daily living, a third of the group were still reliant on assistance with community skills and transport, and more than half of those who previously had a job, were not working at 2 years post-injury. Around two-thirds of the sample reported cognitive, behavioural and emotional changes. There is clearly a need for ongoing community-based support and assistance in dealing with practical difficulties and psychological problems as they are experienced after return to the community.

The Covert Orienting of Visual Attention Following Severe Traumatic Brain Injury

“…In fact, a signi®cant proportion of patients with severe TBI still report such dif®culties more than two years post-injury (Ponsford, Olver, & Curran, 1995). These attentional de®cits compromise virtually all other cognitive processes including memory, learning, and reasoning abilities (Schmitter-Edgecombe, 1996) and, as a result, provide a major obstacle to rehabilitation and to the patient's successful reintegration into the community.…”

Motor impairment after severe traumatic brain injury: A longitudinal multicenter study

“…The most commonly used measurement instruments were the Functional Independence Measure (FIM) [7][8], a structured interview, or a symptom survey. For example, Ponsford et al used a structured interview 2 years after TBI and found frequent somatic symptoms, with 36 percent of patients reporting dizziness and 48 percent reporting visual symptoms [9]. Dombovy and Olek interviewed a sample of 48 patients with mildmoderate TBI over the telephone and found that most were physically independent on the FIM at 3 and 6 months postinjury [10].…”

Call for an Integrative and Multi-Disciplinary Approach to Traumatic Brain Injury (TBI)

“…Psychosocial impairments, some of the most disabling consequences of TBI, often do not emerge until after discharge from the hospital, when difficulties in family and community integration become evident (Ponsford et al, 1995;Caetano & Christensen, 1999). A range of community-based TBI rehabilitation programs have been explored and include interdisplinary team rehabilitation (Ponsford et al, 2006;Ponsford, Oliver, & Nelms, 2003;Powell, Heslin, & Greenwood, 2002;Smith et al, 2006), home based behavioral management program (Carnevale, Anselmi, Busichio, & Millis, 2002;Carnevale, Anselmi, Johnston, Busichio, & Walsh, 2006), outdoor experiential education programs (Thomas, 2004;Walker, Onus, Doyle, Clare, & McCarthy 2005), telephone counseling (Bell et al, 2005), client and caregiver educational training program (Sinnakaruppan, Downey, & Morrison, 2005) and community-based peer support (Hibbard et al, 2002).…”

“…Traumatic brain injury (TBI) is a major health concern causing a wide range of cognitive and behavioral impairments (Levin, 1995;Lezak & O'Brian, 1988;Millis et al, 2001;Ponsford, Oliver, & Curran, 1995) that of-ten lead to decades of disability, reduced independence, unemployment and poor social and familial relations (Machamer, Temkin, Fraser, Doctor, & Dikmen, 2005;Sherer et al, 2002). The societal impact of such injuries is alarming.…”