From the Department of Psychology, Virginia Commonwealth University, Richmond, Virginia (JCAL, JDW); Central Virginia Veterans Affairs Health Care System, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia (KM); Escuela de Psicología, Universidad de Las Américas, Quito, Ecuador (GM); Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, New Jersey (AHL); Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, New Jersey (AHL); and Departments of Psychology and Physical Medicine and Rehabilitation, Virginia Commonwealth University, Central Virginia Veterans Affairs Health Care System, Richmond, Virginia (PBP).
Am J Phys Med Rehabil. 2023 Apr 1;102(4):308-315. doi: 10.1097/PHM.0000000000002092. Epub 2022 Sep 7.
This study examined demographic and injury-related predictors of cognitive and motor functional independence in Hispanics with traumatic brain injury at years 1, 2, 5, and 10 after hospital discharge.
Hispanic participants ( n = 1360) from the TBI Model Systems Study were included if they had at least one Functional Independence Measure (FIM) Cognitive and Motor score at any time point (years 1, 2, 5, or 10). Hierarchical linear modeling was used to examine baseline predictors of FIM Cognitive and Motor trajectories across this period.
FIM Cognitive trajectories showed a quadratic movement (initial increase followed by a plateau or slight decrease), whereas FIM Motor trajectories showed a cubic movement (initial increase, followed by a plateau, then another increase). Higher FIM Cognitive trajectories were predicted by younger age, shorter length of posttraumatic amnesia, higher education, and having experienced a nonviolent mechanism of injury. Higher FIM Motor trajectories were predicted by younger age, shorter posttraumatic amnesia, and a nonviolent mechanism of injury.
The baseline predictors of functional trajectories identified may help create tailored, evidence-based rehabilitation interventions along the continuum of recovery during the first 10 yrs for Hispanics with traumatic brain injury at risk for reduced functional outcomes.
本研究旨在探讨创伤性脑损伤后 1 年、2 年、5 年和 10 年,出院后西班牙裔患者认知和运动功能独立的人口统计学和损伤相关预测因素。
如果 TBI 模型系统研究中的西班牙裔参与者(n=1360)在任何时间点(1 年、2 年、5 年或 10 年)至少有一次功能独立性测量(FIM)认知和运动评分,则将其包括在内。使用分层线性模型来检验该期间 FIM 认知和运动轨迹的基线预测因素。
FIM 认知轨迹呈二次运动(先增加后趋于平稳或略有下降),而 FIM 运动轨迹呈三次运动(先增加,然后趋于平稳,然后再次增加)。较高的 FIM 认知轨迹与年龄较小、创伤后遗忘时间较短、较高的教育程度以及经历非暴力损伤机制有关。较高的 FIM 运动轨迹与年龄较小、创伤后遗忘时间较短和非暴力损伤机制有关。
确定的功能轨迹的基线预测因素可能有助于为创伤性脑损伤风险降低功能结局的西班牙裔患者在恢复的最初 10 年期间制定个性化的循证康复干预措施。