Longitudinal Follow-Up of Patients with Traumatic Brain Injury: Outcome at Two, Five, and Ten Years Post-Injury

Abstract

The deleterious consequences of traumatic brain injury (TBI) impair capacity to return to many avenues of pre-morbid life. However, there has been limited longitudinal research examining outcome beyond five years post-injury. The aim of this study was to examine aspects of function, previously shown to be affected following TBI, over a span of 10 years. One hundred and forty one patients with TBI were assessed at two, five, and 10 years post-injury using the Structured Outcome Questionnaire. Fatigue and balance problems were the most common neurological symptoms, with reported rates decreasing only slightly during the 10-year period. Mobility outcomes were good in more than 75% of patients, with few participants requiring aids for mobility. Changes in cognitive, communication, behavioral, and emotional functions were reported by approximately 60% of the sample at all time points. Levels of independence in activities of daily living were high during the 10-year period, and as many as 70% of subjects returned to driving. Nevertheless, approximately 40% of patients required more support than before their injury. Only half the sample returned to previous leisure activities and fewer than half were employed at each assessment time post-injury. Although marital status remained stable over time, approximately 30% of participants reported difficulties in personal relationships. Older age at injury did not substantially alter the pattern of changes over time, except in employment. Overall, problems that were evident at two years post-injury persisted until 10 years post-injury. The importance of these findings is discussed with reference to rehabilitation programs.

Significant Improvements in Cognitive Performance Post-Transcranial, Red/Near-Infrared Light-Emitting Diode Treatments in Chronic, Mild Traumatic Brain Injury: Open-Protocol Study

“…A recent study, however, with > 140 TBI patients, has reported that the overall problems present at 2 years post-injury (cognitive, communication, behavioral, and emotional problems that were present in 60% of the cases) persisted even at 10 years post-injury. 71 Therefore, in a chronic mTBI group such as ours, where 6/11 were > 2 years post-TBI, significant improvements in cognition would not be expected. (Each of our 11 participants improved by at least + 1 SD, on the Stroop and/or the CVLT, post-LED.)…”

“I’ve never been a yes person”: Decision-making participation and self-conceptualization after severe traumatic brain injury

“…Individuals who have sustained TBI frequently experience changes in their physical, cognitive, behavioral, emotional, and/or psychosocial functioning, leading to longer-term disability. [16][17][18] Decision-making impairment is a common neurobehavioral consequence of severe TBI. [19] Decision-making difficulties primarily relate to damage to the prefrontal areas and frontal systems, which are particularly vulnerable to injury in TBI.…”

Project Career: Perceived benefits of iPad apps among college students with Traumatic Brain Injury (TBI)

“…Approximately 60% of participants reported negative changes in cognition, communication, behavior, and emotional functioning at all three time points. Less than 50% of the sample were employed at each time point and, overall, problems reported at two-years post-injury persisted at 10-years post-injury [9].…”

“…When considering use of campus resources or supports, many participants had never heard of or accessed campus disability services (44.8%), campus counseling services (77.4%), or campus medical services (77.4%) [6]. Ponsford et al (2014), conducted a 10-year longitudinal study to better understand the long-term functional consequences of TBI. One hundred and forty-one patients with a TBI were assessed at two-, five-, and 10-years post-injury using a functional outcome questionnaire.…”