Article

OBJECTIVE: To determine the impact of co-occurring traumatic brain injury (TBI)
on functional motor outcome and cognition during acute spinal cord injury (SCI) rehabilitation. DESIGN: Prospective, longitudinal cohort. SETTING: Single-center
National Institute of Disability and Rehabilitation Research SCI Model System.
PARTICIPANTS: Persons aged 16 to 59 years (N=189) admitted for acute SCI
rehabilitation during the 18-month recruitment window who met inclusion criteria.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: FIM Motor Scale (Rasch
transformed) and acute rehabilitation length of stay (LOS). RESULTS: In the
tetraplegia sample, co-occurring TBI was not related to FIM Motor Scale scores or
acute rehabilitation LOS despite having negative impacts on memory and problem
solving. Persons with paraplegia who sustained co-occurring severe TBI had lower
admission and discharge FIM Motor Scale scores and longer acute rehabilitation
LOS than did persons with paraplegia and either no TBI or mild TBI. Persons with
paraplegia and severe TBI had lower functional comprehension, problem solving,
and memory and impairments on tests of processing speed compared with persons
with paraplegia and no TBI, mild TBI, and moderate TBI. Persons with paraplegia
and co-occurring mild and moderate TBI had equivalent acute rehabilitation motor
outcomes and cognitive functioning compared with persons with paraplegia and no
TBI. CONCLUSIONS: This study provides evidence that persons aged 16 to 59 years
with paraplegia and co-occurring severe TBI had worse motor outcomes and longer
acute rehabilitation LOS than did persons with paraplegia and no TBI. Impairments
in processing speed, comprehension, memory, and problem solving may explain
suboptimal motor skill acquisition. Research with larger samples is required to
determine whether mild and moderate TBI impact acute rehabilitation motor
outcomes and LOS.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS