Article

Sleep problems and disorders are prevalent in patients with traumatic
brain injury (TBI) and are associated with negative outcomes. Incidence varies
because of challenges including differences in assessment methods, particularly
in the acute stages of recovery when patients are cognitively impaired and unable
to complete traditional self-report methods. Actigraphy (ACG) recently has been
validated in the acute TBI rehabilitation setting and may serve as a superior
method of assessing sleep-wake patterns at this stage of recovery. Although a few
studies with small sample sizes have described the use of ACG, none have
described feasibility and implementation protocols. OBJECTIVE: To describe the
feasibility and implementation protocol of ACG to evaluate sleep-wake patterns
and white-light exposure data in patients with acute TBI during inpatient
rehabilitation. Sleep-wake patterns and light exposure data are presented to
characterize the sample using these methods to inform future research. DESIGN:
Retrospective study. SETTING: Acute inpatient rehabilitation unit at a Veterans'
Affairs Polytrauma Rehabilitation Center. PARTICIPANTS: Veterans (age >/=18
years) admitted to inpatient rehabilitation and enrolled in the Traumatic Brain
Injury Model Systems study who were admitted and discharged in the calendar year
2013. METHODS: Veterans underwent actigraph watch placement as soon as possible
after admission. Records from the calendar year 2013 were reviewed to determine
the number of admissions that met study criteria and what percentage of those
patients had 3 days of continuous ACG data collected. The barriers to successful
watch placement in this population were reviewed. Average sleep, light, and wake
data from available records were collected for the study sample. MAIN OUTCOME
MEASUREMENTS: Percentage of patients who met study criteria and who had 72 hours
of continuous ACG data collected. The barriers to successful watch placement in
this population were reviewed. Average sleep, light, and wake data from available
records were collected. RESULTS: Of 22 eligible Traumatic Brain Injury Model
Systems admissions, 3 consecutive nights of ACG data were successfully obtained
for 86% (n = 19) of the sample. Barriers to data collection included patient
access due to abbreviated lengths of stay, staff availability for ACG placement,
and data collection protocols to prevent loss of data in Veterans' Affairs
computing systems. CONCLUSIONS: ACG is feasible for collecting data about sleep,
wake, and light exposure in patients who are in acute TBI inpatient
rehabilitation settings. LEVEL OF EVIDENCE: III.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS