The Journal of Head Trauma Rehabilitation最新文献

{"title":"Opioid and Sedative-Hypnotic Prescriptions Among Post-9/11 Veteran VA Users Nationwide With Traumatic Brain Injury, 2012-2020.","authors":"Haley K Holmer,&nbsp;Tess A Gilbert,&nbsp;Alexandria J Ashraf,&nbsp;Maya E O'Neil,&nbsp;Kathleen F Carlson","doi":"10.1097/HTR.0000000000000712","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000712","url":null,"abstract":"<p><strong>Objective: </strong>Many post-9/11 Veterans have received Department of Veterans Affairs (VA) healthcare for traumatic brain injury (TBI). Pain conditions are prevalent among these patients and are often managed with opioid analgesics. Opioids may impose unique risks to Veterans with a history of TBI, especially when combined with other psychotropic medications. We examined receipt of opioid and sedative-hypnotic prescriptions among post-9/11 Veterans with TBI who received VA care nationally between 2012 and 2020.</p><p><strong>Setting: </strong>Nationwide VA outpatient care.</p><p><strong>Participants: </strong>Veterans with, versus without, clinician-confirmed TBI based on the VA's Comprehensive TBI Evaluation (CTBIE) were followed up for subsequent years in which they received VA care.</p><p><strong>Design: </strong>A historical cohort study.</p><p><strong>Main measures: </strong>Proportions of Veterans who received opioid, benzodiazepine, and nonbenzodiazepine sedative-hypnotic prescriptions were compared by CTBIE outcome (TBI yes/no) and by year; overlaps between medication classes, long-term opioid therapy, and high-dose opioid therapy were also examined. Among those with confirmed TBI, logistic regression was used to examine associations between veteran characteristics and likelihood of these potentially high-risk opioid use outcomes.</p><p><strong>Results: </strong>Among 69 752 Veterans with clinician-confirmed TBI, 26.9% subsequently received opioids. The prevalence receiving opioids each year increased from 2012 (16.7%) to 2014 (17.7%), and then decreased each of the following years through 2020 (5.8%). Among Veterans with TBI who received opioids, large proportions also received benzodiazepine (30.1%) and nonbenzodiazepine (36.0%) sedative-hypnotic prescriptions; these proportions also decreased in recent years. In both bivariable and multivariable regression models, Veterans' demographic, TBI, and clinical characteristics were associated with likelihood of potentially high-risk opioid use.</p><p><strong>Conclusions: </strong>VA opioid prescribing to Veterans with TBI has decreased in recent years but remains an important source of risk, particularly when considering coprescriptions of sedative-hypnotic medication. Understanding patterns of psychotropic prescription use among Veterans with TBI can highlight important healthcare and rehabilitation needs in this large patient cohort.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"354-363"},"PeriodicalIF":2.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39392484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Lifetime History of Traumatic Brain Injury With Prescription Opioid Use and Misuse Among Adults.","authors":"Rachel Sayko Adams,&nbsp;John D Corrigan,&nbsp;Grant A Ritter,&nbsp;Abby Hagemeyer,&nbsp;Madeline B Pliskin,&nbsp;Sharon Reif","doi":"10.1097/HTR.0000000000000729","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000729","url":null,"abstract":"<p><strong>Objective: </strong>To investigate associations of lifetime history of traumatic brain injury (TBI) with prescription opioid use and misuse among noninstitutionalized adults.</p><p><strong>Participants: </strong>Ohio Behavioral Risk Factor Surveillance System (BRFSS) participants in the 2018 cohort who completed the prescription opioid and lifetime history of TBI modules (n = 3448).</p><p><strong>Design: </strong>Secondary analyses of a statewide population-based cross-sectional survey.</p><p><strong>Main measures: </strong>Self-report of a lifetime history of TBI using an adaptation of the Ohio State University TBI-Identification Method. Self-report of past year: (1) prescription pain medication use (ie, prescription opioid use); and (2) prescription opioid misuse, defined as using opioids more frequently or in higher doses than prescribed and/or using a prescription opioid not prescribed to the respondent.</p><p><strong>Results: </strong>In total, 22.8% of adults in the sample screened positive for a lifetime history of TBI. A quarter (25.5%) reported past year prescription opioid use, and 3.1% met criteria for prescription opioid misuse. A lifetime history of TBI was associated with increased odds of both past year prescription opioid use (adjusted odds ratio [AOR] = 1.52; 95% CI, 1.27-1.83; P < .01) and prescription opioid misuse (AOR = 1.65; 95% CI, 1.08-2.52; P < .05), controlling for sex, age, race/ethnicity, and marital status.</p><p><strong>Conclusion: </strong>Results from this study support the \"perfect storm\" hypothesis-that persons with a history of TBI are at an increased risk for exposure to prescription opioids and advancing to prescription opioid misuse compared with those without a history of TBI. Routine screening for a lifetime history of TBI may help target efforts to prevent opioid misuse among adults.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"328-337"},"PeriodicalIF":2.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39392482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors Associated With the Prescription of Opioids Among Service Members Following a First Mild Traumatic Brain Injury.","authors":"Peter Hoover,&nbsp;Dara Johnson,&nbsp;Tim Wu,&nbsp;Louis M French,&nbsp;Jesus Caban","doi":"10.1097/HTR.0000000000000711","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000711","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate factors impacting opioid receipt among active-duty service members (SMs) following a first mild traumatic brain injury (mTBI).</p><p><strong>Setting: </strong>Active-duty SMs receiving care within the Military Health System.</p><p><strong>Participants: </strong>In total, 14 757 SMs who have sustained an initial mTBI, as documented within electronic health records (EHRs), between 2016 and 2017.</p><p><strong>Design: </strong>A retrospective analysis of EHR metadata.</p><p><strong>Main measures: </strong>Multivariable logistic regression assessed factors impacting opioid receipt and initiation. Factors include demographics, military characteristics, and preexisting clinical conditions, including prior opioid prescription.</p><p><strong>Results: </strong>Of the sample population, 33.4% (n = 4927) were prescribed opioids after their initial mTBI, of which, 60.6% (n = 2985) received opioids for the first time following injury. Significant risk factors associated with the increased probability of opioid receipt included age, gender, and preexisting behavioral health and musculoskeletal conditions. Military characteristics also exhibited changes in the probability of opioid receipt, both among initiation and new prescription. No changes were observed among race, nor among those with preexisting headaches or migraines.</p><p><strong>Conclusion: </strong>Despite concerns about the negative impact on recovery, the prescribing of opioids is common in this population of active-duty SMs first diagnosed with an mTBI. As several demographic and preexisting health conditions are factors in the receipt of opioids post-mTBI, the entire medical history of these patients should be considered prior to prescription. Understanding these factors may further inform policy for opioid use in the Military Health System.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"345-353"},"PeriodicalIF":2.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39392486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marital Stability Over 10 Years Following Traumatic Brain Injury.","authors":"Flora M Hammond,&nbsp;Mitch Sevigny,&nbsp;Samantha Backhaus,&nbsp;Dawn Neumann,&nbsp;John D Corrigan,&nbsp;SherylKatta Charles,&nbsp;Hannah Gazett","doi":"10.1097/HTR.0000000000000674","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000674","url":null,"abstract":"<p><strong>Objective: </strong>To examine the stability of marriage from the time of traumatic brain injury (TBI) to 10 years postinjury.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>TBI Model Systems centers.</p><p><strong>Participants: </strong>In total, 1423 participants in the TBI Model Systems National Database who experienced TBI 10 years prior and were married at the time of injury.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure: </strong>Remaining married to the same partner from the time of injury to 10-year follow-up.</p><p><strong>Results: </strong>At 10 years, 66% (938) remained married to the same person. Significant associations were found with age at injury (P < .0001), sex (P = .0028), and preinjury problematic substance use (P = .0092). Marital stability over the 10-year period was higher for those who were older, were female, and had no problematic substance use history. Marital instability was greatest in the first year postinjury.</p><p><strong>Conclusions: </strong>Most married adults who received inpatient rehabilitation for TBI remained married to the same individual 10 years later. Those who were younger, were male, and had a history of problematic substance use were at a highest risk for relationship dissolution. Findings have implications for content, timing, and delivery of marital interventions. Substance use education and prevention appear to be important aspects of marital support.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E199-E208"},"PeriodicalIF":2.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39128627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Editors-A Welcome and a THANK YOU!","authors":"John D Corrigan","doi":"10.1097/HTR.0000000000000704","DOIUrl":"10.1097/HTR.0000000000000704","url":null,"abstract":"","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"225"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39128625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Perceived Interactions Between Consequences of Traumatic Brain Injury.","authors":"Brenda van den Broek,&nbsp;Peggy Spauwen,&nbsp;Rudolf Ponds,&nbsp;Caroline van Heugten,&nbsp;Boudewijn Bus","doi":"10.1097/HTR.0000000000000601","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000601","url":null,"abstract":"<p><strong>Objective: </strong>To explore the perceived interactions between consequences of traumatic brain injury (TBI).</p><p><strong>Participants: </strong>Fifteen clinicians experienced in working with patients with TBI.</p><p><strong>Methods: </strong>Participating clinicians completed an online questionnaire in which they estimated the degree to which consequences of TBI (taken from the Brief ICF Core Set for Traumatic Brain Injury) causally relate to each other. Based on these perceived interactions, a visual network was constructed and centrality measures for this network were computed.</p><p><strong>Results: </strong>The resulting network demonstrates various strong perceived causal relations between the consequences of TBI. Impairments in consciousness were perceived to most strongly cause other TBI consequences in the network. Difficulties with acquiring, keeping, and terminating a job were perceived to be most strongly caused by other TBI consequences. Difficulties in partaking in complex interpersonal interactions were also perceived to play a central role in the network.</p><p><strong>Conclusion: </strong>In the perception of clinicians, consequences of TBI interact with each other and are thus not solely a direct result of the injury. While more research is needed to map the interactions between consequences of TBI, our results could have important implications for the way we understand and treat the problems patients are faced with after TBI.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E209-E217"},"PeriodicalIF":2.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38353218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Westmead Posttraumatic Amnesia Scale, Galveston Orientation and Amnesia Test, and Confusion Assessment Protocol as Measures of Acute Recovery Following Traumatic Brain Injury.","authors":"Courtney Spiteri,&nbsp;Jennie Ponsford,&nbsp;Harvey Jones,&nbsp;Adam McKay","doi":"10.1097/HTR.0000000000000607","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000607","url":null,"abstract":"<p><strong>Background: </strong>The duration of the acute period of recovery following traumatic brain injury (TBI) remains a widely used criterion for injury severity and clinical management. Consensus regarding its most appropriate definition and assessment method has yet to be established.</p><p><strong>Objective: </strong>The present study compared the trajectory of recovery using 3 measures: the Westmead Post-Traumatic Amnesia Scale (WPTAS), the Galveston Orientation and Amnesia Test (GOAT), and the Confusion Assessment Protocol (CAP). Patterns of symptom recovery using the CAP were explored.</p><p><strong>Participants: </strong>Eighty-two participants with moderate to severe TBI in posttraumatic amnesia (PTA) on admission to an inpatient rehabilitation hospital.</p><p><strong>Design: </strong>Prospective longitudinal study.</p><p><strong>Outcome measures: </strong>Length of PTA (days), agreement between measures (%, κ coefficient), and pattern of symptom recovery.</p><p><strong>Results: </strong>Participants emerged from PTA earliest on the CAP followed the GOAT, and last on the WPTAS. There was good agreement between the CAP and the GOAT as to PTA status, but both tests had poor agreement with the WPTAS. Of patients considered out of PTA on the CAP, the majority exhibited signs of amnesia on the WPTAS and one-third had clinical levels of agitation.</p><p><strong>Conclusion: </strong>The WPTAS identifies a later stage of PTA recovery that requires specialized management due to ongoing amnesia and agitation. The CAP and the GOAT are less sensitive to this extended period of PTA.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"156-163"},"PeriodicalIF":2.4,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38450217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Differences in Concussion Symptom Knowledge and Sources of Information Among Black and White Collegiate-Athletes.","authors":"Jessica Wallace,&nbsp;Erica Beidler,&nbsp;Zachary Y Kerr,&nbsp;Tamaria Hibbler,&nbsp;Morgan Anderson,&nbsp;Johna K Register-Mihalik","doi":"10.1097/HTR.0000000000000672","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000672","url":null,"abstract":"<p><strong>Objective: </strong>Basic concussion symptom knowledge is fundamental to concussion identification; however, racial disparities in concussion knowledge exist in high school and youth sports. It is unknown whether similar differences exist in collegiate-athletes. Identifying racial disparities in concussion knowledge and sources of concussion information is essential to inform equitable approaches to knowledge translation and educational interventions. This study examined how Black and White collegiate-athletes differed in their knowledge of concussion symptoms and use of concussion information sources.</p><p><strong>Setting: </strong>National Collegiate Athletic Association (NCAA) institutions.</p><p><strong>Participants: </strong>Collegiate-athletes.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Main measures: </strong>Collegiate-athletes completed a questionnaire that assessed personal and sports demographics, concussion symptom knowledge, and use of concussion information sources. Fisher's exact tests and Wilcoxon rank-sum tests examined differences in outcome measures between Black and White collegiate-athletes. A multivariable Poisson regression model examined the association between race and concussion symptom knowledge scores while accounting for sex, sports contact level, NCAA division, concussion history, and specific concussion information sources. Incidence rate ratios (IRRs) with 95% CIs excluding 1.00 were deemed significant.</p><p><strong>Results: </strong>A total of 768 (82.6% White, 17.4% Black) collegiate-athletes completed the questionnaire. Black athletes were more likely to have lower concussion symptom knowledge scores than White athletes (P < .001). In the multivariable Poisson regression model controlling for covariates, this finding was retained (IRR = 0.97; 95% CI, 0.94-0.997). White athletes were more likely to report school-based professional (P < .001), online medical sources (P = .02), and the NCAA (P = .008) as sources of concussion information. Black athletes were more likely to report referees (P = .03) as a source of concussion knowledge.</p><p><strong>Conclusion: </strong>Despite NCAA concussion education requirements for athletes, Black collegiate-athletes were found to have lower concussion knowledge than White collegiate-athletes. The findings highlight the need for equitable strategies to disseminate concussion information to diverse populations by improving the physician-patient relationship and investing in culturally appropriate educational materials.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"139-148"},"PeriodicalIF":2.4,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38951860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Atypical Antipsychotics for Managing Agitation After Traumatic Brain Injury.","authors":"Adam McKay,&nbsp;Jessica Trevena-Peters,&nbsp;Jennie Ponsford","doi":"10.1097/HTR.0000000000000614","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000614","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the use of antipsychotics for managing agitation during posttraumatic amnesia (PTA) after traumatic brain injury (TBI) and its relationship with agitated behavior.</p><p><strong>Design: </strong>Observational prospective study with correlational design.</p><p><strong>Setting: </strong>Inpatient rehabilitation hospital for TBI.</p><p><strong>Participants: </strong>A total of 125 consecutive admissions who were in PTA and had moderate-severe TBI.</p><p><strong>Measures: </strong>Antipsychotic use was compared with agitation levels as measured by the total scores on the Agitated Behavior Scale (ABS).</p><p><strong>Results: </strong>Atypical antipsychotics were used in one-third of participants to manage agitation. Antipsychotic use was more common in participants with high levels of global agitation; however, there were many on antipsychotics who had mild or even no agitation according to the ABS. Uncontrolled observational data found no reduction in agitation after antipsychotic commencement or dose increase.</p><p><strong>Conclusions: </strong>Antipsychotics are commonly used to manage agitation after TBI despite limited evidence of efficacy. Agitation should be formally monitored in PTA to ensure antipsychotics are used to manage more severe agitation and for evaluating treatment response. Research is needed to understand why prescribers are using antipsychotics when agitation is mild or below clinical thresholds.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"149-155"},"PeriodicalIF":2.4,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38450214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Negative Attributions in Persons With Brain Injury: A Comparison of 2 Measures.","authors":"Dawn Neumann,&nbsp;Angelle M Sander,&nbsp;Noelle Witwer,&nbsp;Jeong Hoon Jang,&nbsp;Surya Sruthi Bhamidipalli,&nbsp;Flora M Hammond","doi":"10.1097/HTR.0000000000000635","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000635","url":null,"abstract":"<p><strong>Objectives: </strong>To compare construct and predictive validity, readability, and time-to-administer of 2 negative attribution measures in participants with traumatic brain injury (TBI).</p><p><strong>Setting: </strong>Two TBI rehabilitation hospitals.</p><p><strong>Participants: </strong>Eighty-five adults with complicated mild to severe TBI.</p><p><strong>Main measures: </strong>Negative attributions (intent, hostility, and blame) and anger responses to hypothetical scenarios were measured with the Epps scenarios and the Ambiguous Intention Hostility Questionnaire (AIHQ). Trait aggression was measured with the Buss-Perry Aggression Questionnaire (BPAQ).</p><p><strong>Results: </strong>Associations between attributions and anger responses (ie, construct validity) within each measure were significant (Epps: r = 0.61-0.74; AIHQ: r = 0.39-0.71); however, associations were stronger for Epps (Ps < .001). Receiver operating characteristics (ROC) revealed attributions from both measures predicted BPAQ scores (area under the ROC curves = 0.6-0.8); predictive validity did not statistically differ between the 2 measures. Both had comparable readability (fifth- to sixth-grade levels), but Epps required longer administration times.</p><p><strong>Conclusion: </strong>Negative attributions affect anger and aggression after TBI, making it important to identify suitable assessments for the TBI population. While psychometric properties of the AIHQ and Epps scenarios should be further explored, this study offers early support for the use of either instrument in persons with TBI. Advantages and disadvantages of the AIHQ and Epps scenarios are highlighted.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E170-E177"},"PeriodicalIF":2.4,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38706444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}