Journal of Head Trauma Rehabilitation最新文献

{"title":"No Differences in Outcomes Between Male and Female Adolescent Athletes Who Receive Vestibular Rehabilitation.","authors":"Morgan O'Neil, Brittany Davis, Kendall Hammonds, Taylor Gilliland, Nicholas Douville, Kayla Covert, Simon Driver","doi":"10.1097/HTR.0000000000001113","DOIUrl":"10.1097/HTR.0000000000001113","url":null,"abstract":"<p><strong>Objective: </strong>With enhancements in standard of care for sport-related concussion (SRC), there is a need to examine sex differences within the context of specific targeted treatments, like vestibular rehabilitation (VR). The primary purpose was to compare symptom severity and vestibular and ocular motor impairment between male and female adolescent athletes with SRC who received VR. The secondary purpose was to compare VR treatment time and recovery time between male and female adolescent athletes with SRC.</p><p><strong>Setting: </strong>Specialty concussion clinic in a metropolitan area in Texas.</p><p><strong>Participants: </strong>Male ( n = 14, 30.4%) and female ( n = 32, 69.6%) adolescent athletes (15.39 ± 1.11 years) in sex-comparable sports were referred to VR within 30 days after SRC.</p><p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Main measures: </strong>Symptom severity was measured using the Post-Concussion Symptom Scale, and vestibular and ocular motor impairment was assessed using the Vestibular Ocular Motor Screening at the first clinic visit and the VR discharge visit. The VR treatment time was the number of days from the first VR visit to the VR discharge visit. Recovery time was the number of days from injury to medical clearance from the clinic.</p><p><strong>Results: </strong>There were no sex differences in symptom severity ( P = 0.12) or vestibular ocular motor impairment at the first clinic visit. There were no sex differences in the change in symptom severity ( P = 0.71) or vestibular ocular motor impairment during VR. There were no sex differences in VR treatment time ( P = 0.52) or recovery time ( P = 0.17).</p><p><strong>Conclusions: </strong>There were no observed sex differences in symptom severity or vestibular and ocular motor impairment at the first clinic visit. Male and female adolescent athletes demonstrated similar benefit from, and length of, VR.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E320-E328"},"PeriodicalIF":3.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitions in Independent Living, Productivity, and Social Relationships Among Individuals Sustaining Traumatic Brain Injury in Adolescence: A TBI Model Systems Investigation.","authors":"Angelle M Sander, Shannon B Juengst, Abdulaziz Bako, Xuan Jesson, Juliet Haarbauer-Krupa, Therese M O'Neil-Pirozzi, Umesh M Venkatesan, Kelli Gary Talley, Brittany Wright","doi":"10.1097/HTR.0000000000001128","DOIUrl":"10.1097/HTR.0000000000001128","url":null,"abstract":"<p><strong>Objective: </strong>To characterize transitions in independent living, productivity, and social relationships over the first 5 years postinjury among adolescents sustaining complicated mild to severe traumatic brain injury (TBI) between ages 16 and 18.</p><p><strong>Setting: </strong>Community following discharge from inpatient rehabilitation. Participants: 584 individuals ages 16 to 18 in the traumatic brain injury model systems (TBIMS) national database who completed follow-up at 1, 2, and/or 5 years postinjury.</p><p><strong>Design: </strong>Multicenter longitudinal observational study.</p><p><strong>Main measures: </strong>Independent living, employment/school/homemaking, having a close friend/confidant, and involvement in a romantic relationship.</p><p><strong>Results: </strong>Hidden Markov models were used to identify trajectories of participation, with the optimal number of hidden states (groups) selected using the Bayesian information criterion (BIC). Three states/groups were the best fit for the data and were labeled as: At Risk, On Track , and Partially Transitioned . About 57.5% of participants started as Partially Transitioned , 30% started as At Risk , and 12.5% were On Track . Most in the On Track group had a close friend/confidant and were involved in a romantic relationship. Most in the Partially Transitioned group had a close friend/confidant but were not involved in a romantic relationship. Around 16.7% of individuals in the Partially Transitioned group and only 6.5% of the At Risk group transitioned to On Track , and 98.5% of those in the On Track group remained in the same status. Factors associated with transition to the On Track group included female sex and problem alcohol/substance use. However, further analysis showed that the significant effect of problem alcohol/substance use became nonsignificant after accounting for within-person correlation. Conclusions : Many who sustain a TBI in late adolescence transition to independent living and employment/school/homemaking activity over the first 5 years postinjury; however, a subset remain At Risk or Partially Transitioned in major life roles. Rehabilitation services, beyond the acute period, are needed to ensure maximal independence, social relationships, and community participation.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E309-E319"},"PeriodicalIF":3.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Tracking Mood on Emotional Quality of Life: A Secondary Analysis of the Randomized Controlled Trial of Mood Tracker.","authors":"Leia Vos, Shannon B Juengst, Luis Leon-Novelo, Xiangyi Liu, Robert Perna, Michael W Williams, Amanda Wisinger, Robiann Broomfield, Ola-Edo Nwana, Caitlin Aguirre, Mark Sherer","doi":"10.1097/HTR.0000000000001118","DOIUrl":"10.1097/HTR.0000000000001118","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of using a smartphone application to track mood on emotional quality of life (QoL) outcomes (positive emotion, negative emotion, and sense of self) in persons with traumatic brain injury (TBI) in the postacute period of recovery.</p><p><strong>Setting: </strong>Community in the southwestern United States.</p><p><strong>Participants: </strong>In total, 127 community-dwelling adults with medically documented complicated mild to severe TBI.</p><p><strong>Design: </strong>Randomized, parallel group, wait-list-controlled trial of Mood Tracker, a 6-week intervention requiring participants to self-report mood using a smartphone application.</p><p><strong>Main measures: </strong>TBI-QoL item banks.</p><p><strong>Results: </strong>Comparing groups using Wilcoxon rank sum tests, analyses revealed a positive change in sense of self ( P = .02) and a marginal positive change in negative emotion ( P = .06) pre-to-post intervention, largely driven by the effect on subjective depressive symptoms. Effect sizes were generally small (Cohen's d = .272-.320). There were no significant effects on positive emotion ( P = .98).</p><p><strong>Conclusions: </strong>Persons with chronic TBI can use smartphone technology for self-reporting mood multiple times per week, which shows some promise for improving emotional QoL. Large variation in outcomes suggests that further research is needed to determine who is most likely to benefit from this type of intervention and what additional intervention components are needed to maximize effects.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E300-E308"},"PeriodicalIF":3.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts of the 6th Annual Meeting of the Canadian Concussion Network-Réseau Canadien des Commotions (CCN-RCC).","authors":"","doi":"10.1097/HTR.0000000000001190","DOIUrl":"10.1097/HTR.0000000000001190","url":null,"abstract":"","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":"41 4","pages":"E424-E475"},"PeriodicalIF":3.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Risk of Low-Level Blast Exposure and Health Outcomes: A Longitudinal Study of Postdeployment Army Enlisted Active Duty Soldiers.","authors":"Rachel Sayko Adams, Nick Huntington, Jenneth Carpenter, Andrea Linton, Natalie Moresco, Kristen Dams-O'Connor, Raj G Kumar, Krista B Highland, Mary Jo Larson","doi":"10.1097/HTR.0000000000001191","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001191","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the relationship between risk of occupational low-level blast (LLB) exposure and health outcomes (ie, substance use disorder, long-term opioid receipt, headaches, and back pain). We integrated 2 established military occupation-based LLB exposure risk classification strategies (Belding and colleagues and Carr and colleagues) to use military service occupation as a proxy for LLB exposure risk.</p><p><strong>Setting: </strong>Records were drawn from the Substance Use and Psychological Injury Combat Study and included Military Health System inpatient and outpatient care data, pharmacy fill records, and military history characteristics.</p><p><strong>Participants: </strong>Enlisted Army soldiers returning from an Afghanistan/Iraq deployment during fiscal years 2008-2014 (n = 477 746).</p><p><strong>Design: </strong>Longitudinal and observational with exposure and outcome periods before and after the date of return from the first deployment ending in the study period, respectively. Belding and Carr classification strategies were integrated to create a 5-level LLB exposure risk framework (ie, High-Belding & Carr, High-Belding Only, Medium-Belding Only, Mixed, Low-Belding Only).</p><p><strong>Main measures: </strong>Outcomes were long-term opioid receipt and diagnoses of substance use disorder, headache (including migraine), and back pain; covariates included demographic and military history characteristics, exposure-period traumatic brain injury diagnosis, exposure-period mental health and self-harm/suicidal behavior, and exposure-period observation of outcomes measures.</p><p><strong>Results: </strong>Approximately 6.0% were classified as high exposure by the High-Belding & Carr classification, and 27.2% were classified as High-Belding Only. Comparing the High-Belding Only and High-Belding & Carr groups, respectively, with the Low-Belding Only group, survival models revealed elevated hazard ratios for long-term opioid receipt (1.29, P < .001; 1.33, P < .001) and substance use diagnoses (1.19, P < .001; 1.27, P < .001), somewhat elevated hazard ratios for headache (1.12, P < .001; 1.08, P < .001), and slightly lowered hazard ratios (0.98, P < .001; 0.98, P < .01) for back pain.</p><p><strong>Conclusion: </strong>Study results add to the existing research underscoring the urgency for advancing knowledge about LLB exposure and potential military health impacts and provide direction for future research.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Associations Between Environmental Exposures and Neurobehavioral Symptoms in Post-9/11 Veterans With a Probable History of TBI.","authors":"Kelsey M Schilling, Leah D Talbert, Elizabeth Valocchi, Francesca V Lopez, Victoria C Merritt","doi":"10.1097/HTR.0000000000001187","DOIUrl":"10.1097/HTR.0000000000001187","url":null,"abstract":"<p><strong>Objective: </strong>Prior research has established several risk factors for poor neurobehavioral outcomes after traumatic brain injury (TBI) in Iraq/Afghanistan-era-Veterans. However, no studies have examined the impact of environmental exposures on neurobehavioral symptoms in this population. The purpose of this study was to examine the relationship between environmental exposures and neurobehavioral symptoms in post-9/11 Veterans with a probable history of TBI.</p><p><strong>Setting: </strong>Veterans Affairs (VA) Million Veteran Program (MVP).</p><p><strong>Participants: </strong>Participants included MVP-enrolled Veterans who completed the Veterans Health Administration's (VHA's) TBI Screening and Evaluation Program. Eligible participants were those who screened positive for TBI on the VHA Clinical Reminder Screen (N = 3370).</p><p><strong>Design: </strong>Retrospective, cross-sectional design using secondary data analysis.</p><p><strong>Main measures: </strong>Primary outcomes were 6 indices derived from the Neurobehavioral Symptom Inventory (NSI): total score (overall symptom severity), positive symptom total (symptom breadth), and 4 system clusters (vestibular, somatic/sensory, cognitive, and affective). Environmental exposures were self-reported by MVP surveys and included an exposure burden score and 7 individual exposure types: chemical or biological warfare agents; solvents/fuels; petroleum/combustion products; lead; other metals; pesticides; and open-air burn pits.</p><p><strong>Results: </strong>The most frequently reported environmental exposures included petroleum combustion products (90.38%), burn pits (87.58%), and solvents/fuels (84.25%). Adjusted linear regression analyses, controlling for age, sex, race/ethnicity, and posttraumatic stress disorder status, showed significant positive associations between exposure burden and most neurobehavioral symptom outcomes (β = 0.13-1.08, all Ps < .001). In addition, there were several significant associations observed between each individual exposure variable and NSI outcomes, with the most consistent effects observed for other metals (β = 0.37-3.14, all Ps = <.001) and solvents/fuels (β = 0.88-2.95, all Ps = <.001).</p><p><strong>Conclusions: </strong>In post-9/11 Veterans with a probable history of TBI, environmental exposure burden and specific exposure types (particularly other metals and solvents/fuels) were associated with greater neurobehavioral symptom severity and breadth, suggesting environmental exposures as an additional, important contributor to chronic symptoms.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Untangling the Confusion: A Scoping Review of Terminology and Assessment Methods for Acute Confusional States Following Traumatic Brain Injury.","authors":"Sophie Du Ruisseau, Catherine Leclerc, Marie-Michèle Briand, Marie-Julie Potvin, Francis Bernard, David Williamson, Caroline Arbour","doi":"10.1097/HTR.0000000000001176","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001176","url":null,"abstract":"<p><strong>Introduction: </strong>Hospitalized adults with traumatic brain injury (TBI) often experience acute confusional states. However, conceptual clarity remains limited because of overlapping terminology, which hinders assessment.</p><p><strong>Objectives: </strong>This study aimed to map the terminology and assessment of acute confusional states in hospitalized TBI adults and examine their alignment with established definitions.</p><p><strong>Methods: </strong>We conducted a scoping review (2013-2025) in 4 databases (MEDLINE, PsycInfo, CINAHL, and Google Scholar) following the Arksey and O'Malley framework. Peer-reviewed studies and clinical guidelines addressing acute confusional states in hospitalized TBI adults were included. Data extraction focused on terminology, assessment practices, and correspondence with definitions.</p><p><strong>Results: </strong>Thirty-four studies were included. The most frequently reported terms were post-traumatic amnesia (PTA; n = 18), agitation (n = 11), delirium (n = 5), and post-traumatic confusional state (PTCS; n = 2). PTA was described as a transient state, reflecting daily assessment using unimodal cognitive screening tools rather than a broader recovery phase. It was characterized by amnesia and disorientation after sedation, aligning with international cognitive rehabilitation guidelines (INCOG 2.0), although additional features were reported. Agitation, also described as a state, involved fluctuating motor restlessness, impulsivity, aggression, and intense emotions, often without significant cognitive impairment, partially aligning with Cohen-Mansfield definition. Delirium was conceptualized as a syndrome encompassing disturbances across cognitive, attentional, behavioral, psycho-affective, and perceptual domains, and was assessed using multicomponent instruments, consistent with Diagnostic & Statistical Manual of Mental Disorders (DSM-5). PTCS was described as a transitional period during early recovery of consciousness, assessed using a multidimensional observational tool, and characterized by attentional and executive disturbances, such as disorientation, slowed processing, attention deficits, as well as fluctuating emotional and behavioral responses, consistent with the case definition.</p><p><strong>Conclusion: </strong>Although overlapping features exist, PTA, agitation, delirium, and PTCS differ in underlying constructs and temporal framing. Refining definitions to better integrate behavioral and psycho-affective features and clarify transitional phases may improve conceptual and diagnostic clarity in acute TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Physical Activity on Clinical Outcomes in Veterans Completing the VA's Traumatic Brain Injury Screening and Evaluation Program.","authors":"Erin D Ozturk, Catherine Chanfreau-Coffinier, Victoria C Merritt","doi":"10.1097/HTR.0000000000001182","DOIUrl":"10.1097/HTR.0000000000001182","url":null,"abstract":"<p><strong>Objective: </strong>Although the relationship between physical activity (PA) and clinical outcomes after traumatic brain injury (TBI) has been evaluated in the civilian TBI literature, few studies have examined these relationships in Veterans. We evaluated whether PA moderates the relationship between probable TBI and clinical outcomes in post-9/11 Veterans.</p><p><strong>Setting: </strong>This study used electronic health record data sourced from the VA's Corporate Data Warehouse through the VA Million Veteran Program (MVP) and MVP surveys.</p><p><strong>Participants: </strong>Participants included MVP-enrolled Veterans (n = 7217; 77.35% male) who were screened for possible deployment-related TBI through the TBI Screening and Evaluation Program.</p><p><strong>Design: </strong>Observational, cross-sectional, retrospective design using secondary data analysis.</p><p><strong>Main measures: </strong>The TBI Screen was used to classify Veterans into 2 groups: \"TBI Screen-\" (n = 4921) or \"TBI Screen+\" (n = 2296). PA was assessed using self-reported frequency of engagement in vigorous exercise on an MVP survey and categorized as None (\"No-PA\"; n = 1373), Below Recommended (\"Below Recommended-PA\"; n = 2118), or Meets/Exceeds Recommended (\"Meets/Exceeds Recommended-PA\"; n = 3726). Clinical outcomes included self-reported assessments of posttraumatic stress disorder symptoms, depression/anxiety symptoms, subjective cognition, and health-related quality of life.</p><p><strong>Results: </strong>Linear regressions, adjusting for sociodemographics, evaluated interactions between TBI Screen status and PA on all outcomes. We observed significant main effects of TBI Screen (P's < .001) and PA (P's ≤ .001 to .003), and significant TBI Screen × PA interactions (P's = .001 to .016) on all outcomes except 1 health-related quality of life measure. Among both TBI Screen groups, a dose-response effect of PA frequency was observed, such that the \"Meets/Exceeds Recommended-PA\" group fared the best, followed by the \"Below Recommended-PA\" and then \"No-PA\" groups; however, this pattern was more pronounced among TBI Screen+ Veterans.</p><p><strong>Conclusions: </strong>Findings suggest a buffering effect of PA on clinical outcomes, particularly among Veterans with a probable TBI history. These results underscore the potential of PA as an accessible intervention for post-9/11 Veterans.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Access to Traumatic Brain Injury Care Through Learning Health Systems Change: Community-Based Participatory Research Through Human-Centered Design.","authors":"Jolie N Haun, Risa Nakase-Richardson, Megan Moore, Natalie Gilmore, April Ingram, Jessica L Ryan, Cassandra Decker, Jill Coulter, Rebecca Campbell-Montalvo","doi":"10.1097/HTR.0000000000001184","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001184","url":null,"abstract":"<p><p>This special communications piece responds to previous calls from the field of physical medicine and rehabilitation to incorporate methodological diversity in our work, specifically community-based participatory research (CBPR). Our team reports on our CBPR efforts and use of Human-Centered Design (HCD) within the context of executing a multidisciplinary Department of Defense-funded award on improving access to care for those with traumatic brain injury (TBI). First, we situate the context for our program, \"Improving Health Care Access and Engagement for Veterans and Service Members with TBI Morbidity\". Second, we review the use of CBPR and HCD methods to interact with project partners, including persons with lived-experience, professional society representatives, clinicians, and policymakers. Third, we conclude with practical recommendations to support CBPR and HCD efforts in this context. Given the complexity of eliciting and understanding community perspectives across lived experiences (eg, patients, clinicians, care partners), the primary contributions of this piece are: (1) the provision of exemplar adaptive HCD activities; and (2) the identification of practices that foster both HCD and CBPR, and (3) strengthen community partnerships and authentic engagement through a tailored approach, specifically with persons with TBI lived experience.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience and Quality of Life in Mild Traumatic Brain Injury: Serial Mediating Role of Sleep Quality and Depression.","authors":"Ya-Wen Hsiao, Hsiang-Yun Lan, Ching-Yuan Ma, Dueng-Yuan Hueng, Yun-Cune Chang, Hui-Hsun Chiang","doi":"10.1097/HTR.0000000000001177","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001177","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the influence of resilience on quality of life (QoL) in patients with mild traumatic brain injury (mTBI), and to evaluate the mediating roles of sleep quality and depression in the relationship. Setting: Emergency and neurosurgical outpatient departments in regional medical center in northern Taiwan.</p><p><strong>Participants: </strong>A total of 310 adults patients diagnosed with mTBI were recruited between 3 and 12 months postinjury.</p><p><strong>Design: </strong>A cross-sectional observational study using self-report measures and serial-mediation analysis.</p><p><strong>Main measures: </strong>Participants completed the Resilience Scale for Adults, Pittsburgh Sleep Quality Index, Beck Depression Inventory-II, and the WHO Quality of Life-BREF. Data were analyzed using PROCESS Model 6 with 5000 bootstrap resamples.</p><p><strong>Results: </strong>Resilience was associated with improved QoL, both directly and indirectly through sleep quality and depression. In particular, resilience predicted higher sleep quality and fewer depressive symptoms. Poor sleep quality was associated with greater depressive symptoms, which in turn predicted lower QoL. All direct and indirect pathways in the serial mediation model were significant (P < 0.001), and the model explained 54% of the variance in QoL.</p><p><strong>Conclusion: </strong>Our findings suggest that resilience influences QoL through sleep quality and depression. Enhancing resilience and sleep quality may reduce depressive symptoms and improve overall well-being in patients recovering from mTBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}