The Journal of Head Trauma Rehabilitation最新文献

{"title":"Estimated Life-Time Savings in the Cost of Ongoing Care Following Specialist Rehabilitation for Severe Traumatic Brain Injury in the United Kingdom.","authors":"Lynne Turner-Stokes, Mendwas Dzingina, Robert Shavelle, Alan Bill, Heather Williams, Keith Sephton","doi":"10.1097/HTR.0000000000000473","DOIUrl":"10.1097/HTR.0000000000000473","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate cost-efficiency of rehabilitation following severe traumatic brain injury (TBI) and estimate the life-time savings in costs of care.</p><p><strong>Setting/participants: </strong>TBI patients (n = 3578/6043) admitted to all 75 specialist rehabilitation services in England 2010-2018.</p><p><strong>Design: </strong>A multicenter cohort analysis of prospectively collated clinical data from the UK Rehabilitation Outcomes Collaborative national clinical database.</p><p><strong>Main measures: </strong>Primary outcomes: (a) reduction in dependency (UK Functional Assessment Measure), (b) cost-efficiency, measured in time taken to offset rehabilitation costs by savings in costs of ongoing care estimated by the Northwick Park Dependency Scale/Care Needs Assessment (NPDS/NPCNA), and (c) estimated life-time savings.</p><p><strong>Results: </strong>The mean age was 49 years (74% males). Including patients who remained in persistent vegetative state on discharge, the mean episode cost of rehabilitation was £42 894 (95% CI: £41 512, £44 235), which was offset within 18.2 months by NPCNA-estimated savings in ongoing care costs. The mean period life expectancy adjusted for TBI severity was 21.6 years, giving mean net life-time savings in care costs of £679 776/patient (95% CI: £635 972, £722 786).</p><p><strong>Conclusions: </strong>Specialist rehabilitation proved highly cost-efficient for severely disabled patients with TBI, despite their reduced life-span, potentially generating over £4 billion savings in the cost of ongoing care for this 8-year national cohort.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"205-214"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/c5/jhetr-34-205.PMC6687405.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37171066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Contribution of Social Support, Professional Support, and Financial Hardship to Family Caregiver Life Satisfaction After Traumatic Brain Injury.","authors":"Scott A Sabella,&nbsp;Christopher S Suchan","doi":"10.1097/HTR.0000000000000471","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000471","url":null,"abstract":"<p><strong>Objectives: </strong>(a) To assess whether 3 changeable environmental variables (social support, professional support, and financial hardship) contribute to explaining differences in well-being of family caregivers after traumatic brain injury (TBI), above and beyond the influence of neurobehavioral functioning. (b) To assess the unique and relative contribution of social support, professional support, and financial hardship to life satisfaction of family caregivers.</p><p><strong>Participants: </strong>Adult family caregivers (n = 136) of individuals who received inpatient rehabilitation following a TBI.</p><p><strong>Measures: </strong>The Social Provisions Scale; Brief Scale of Financial Hardship after Brain Injury; Satisfaction with Life Scale; and adapted scales measuring professional support and neurobehavioral functioning.</p><p><strong>Design: </strong>Cross-sectional study using survey methodology.</p><p><strong>Results: </strong>Social support, professional support, and financial hardship explained a significant amount of variance in life satisfaction after controlling for neurobehavioral functioning (R change = 0.34, considered a large effect size). Social support and financial hardship were significant unique predictors within the model, but professional support was not.</p><p><strong>Conclusion: </strong>Social support and financial hardship are prominent environmental variables that may hold promise for targeted intervention development and testing designed to support family adaptation after TBI.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"233-240"},"PeriodicalIF":2.4,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000471","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37020224","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":"A Cross-Sectional Study of Treatments for Behavioral Disorders Following Traumatic Brain Injury: Comparison With French Recommendations.","authors":"Tiphaine Bourseau,&nbsp;Virginie Saoût,&nbsp;Pauline Ali,&nbsp;Uriell Pouliquen-Loriferne,&nbsp;Philippe Allain,&nbsp;Mickaël Dinomais","doi":"10.1097/HTR.0000000000000452","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000452","url":null,"abstract":"<p><strong>Objective: </strong>To give a cross-sectional overview of ongoing management of behavioral disorders following traumatic brain injury (TBI) in a region of France, to compare this with recent recommendations from the French Society of Physical Medicine and Rehabilitation (SOFMER), and to evaluate associations between treatments and participant characteristics.</p><p><strong>Setting: </strong>Outpatients referred to medical or community-based facilities in a region of France.</p><p><strong>Participants: </strong>One hundred twenty-nine adults with moderate to severe TBI, in the postacute period (over 3 months postinjury).</p><p><strong>Design: </strong>Cross-sectional cohort study.</p><p><strong>Main measures: </strong>Sociodemographic data, ongoing interventions including psychotherapy and medication, behavioral disorders assessed by the Behavioral Dysexecutive Syndrome Inventory (BDSI).</p><p><strong>Results: </strong>Thirty-three percent of participants received ongoing psychotherapy and 43% were on medication. The most prescribed medications were antidepressants (21%), neuroleptics (18%), anxiolytics (16%), and mood stabilizers (14%). Eighty-five participants (71%) presented a current Behavioral Dysexecutive Syndrome (BDS) according to the BDSI. These participants more frequently received treatment (P = .004), psychotherapy (P = .048), medications (often 2 or more) (P = .007), and particularly antiepileptic mood stabilizers (P = .037) compared with those without BDS.</p><p><strong>Conclusion: </strong>Although recommended as first-line treatment, few participants with BDS received psychotherapy. Medications were overused, especially neuroleptics in view of their potential adverse effects. In contrast, recommended medications, such as mood stabilizers and β-blockers, did not appear to be highly prescribed whatever the evolution. Compliance with recommendations seemed insufficient.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E51-E60"},"PeriodicalIF":2.4,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36738811","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":"Factors Influencing Primary Care Follow-Up After Pediatric Mild Traumatic Brain Injury.","authors":"Dustin Currie,&nbsp;Traci Snedden,&nbsp;Lauren Pierpoint,&nbsp;R Dawn Comstock,&nbsp;Joseph A Grubenhoff","doi":"10.1097/HTR.0000000000000461","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000461","url":null,"abstract":"<p><strong>Objective: </strong>To identify socioeconomic, demographic, and caregiver factors associated with children attending primary care provider (PCP) follow-up after emergency department (ED) evaluation for mild traumatic brain injury (mTBI).</p><p><strong>Setting: </strong>Pediatric trauma center ED.</p><p><strong>Participants: </strong>Children 8 to 18 years of age sustaining mTBI less than 48 hours prior to an ED visit. Mean age of the 183 participants was 12 years with no significant differences between those who attended follow-up and those who did not in race, ethnicity, insurance provider, or PCP office setting.</p><p><strong>Design: </strong>Thirty-day longitudinal cohort study.</p><p><strong>Main measures: </strong>Insurance type, PCP practice setting, and a caregiver attitudes survey regarding mTBI recovery and management (5 questions each scored on a 5-point Likert scale). The primary outcome was attending a PCP follow-up visit within 1 month of injury.</p><p><strong>Results: </strong>Females were more likely than males to attend PCP follow-up (adjusted odds ratio: 2.27 [95% confidence interval: 1.00-5.18]). Increasing scores on the caregiver attitudes survey indicating greater concerns about recovery were significantly associated with attending PCP follow-up (adjusted odds ratio: 1.12 per unit increase in composite score [95% confidence interval: 1.02-1.23]). No other socioeconomic, demographic, or injury characteristics were associated with attending PCP follow-up.</p><p><strong>Conclusions: </strong>The ED counseling regarding PCP follow-up of mTBI should stress the importance of follow-up care to monitor recovery and identify presence of lingering symptoms.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E11-E19"},"PeriodicalIF":2.4,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000461","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36833519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Pain Catastrophizing in Cognitive Functioning Among Veterans With a History of Mild Traumatic Brain Injury.","authors":"Samantha N Hoffman,&nbsp;Matthew S Herbert,&nbsp;Laura D Crocker,&nbsp;Nicole E DeFord,&nbsp;Amber V Keller,&nbsp;Sarah M Jurick,&nbsp;Mark Sanderson-Cimino,&nbsp;Amy J Jak","doi":"10.1097/HTR.0000000000000453","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000453","url":null,"abstract":"<p><strong>Objective: </strong>To determine the role of pain catastrophizing (PC) in neuropsychological functioning in veterans with a history of mild traumatic brain injury (TBI).</p><p><strong>Participants: </strong>Thirty-nine Iraq and Afghanistan combat veterans evaluated in the post-acute phase following mild TBI.</p><p><strong>Methods: </strong>Participants underwent psychiatric and TBI clinical interviews, neuropsychological tests, and self-report assessments of PC, pain intensity, depression, and posttraumatic stress disorder symptoms. Cognitive functioning composite scores of executive functioning, processing speed, and learning and memory were created. Composites were entered as dependent variables into separate linear regressions to examine relations with PC.</p><p><strong>Results: </strong>Greater PC was associated with worse executive functioning and processing speed even when controlling for confounding variables.</p><p><strong>Conclusions: </strong>One's interpretation of pain, in addition to pain intensity, has implications for cognitive functioning. Future research is encouraged to determine whether adaptive pain coping mechanisms improve cognitive functioning or, alternatively, whether cognitive rehabilitation strategies reduce PC.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E61-E66"},"PeriodicalIF":2.4,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36738743","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":"A Comparison of 2 Online Parent Skills Training Interventions for Early Childhood Brain Injury: Improvements in Internalizing and Executive Function Behaviors.","authors":"Jessica M Aguilar,&nbsp;Amy E Cassedy,&nbsp;Emily L Shultz,&nbsp;Michael W Kirkwood,&nbsp;Terry Stancin,&nbsp;Keith Owen Yeates,&nbsp;H Gerry Taylor,&nbsp;Shari L Wade","doi":"10.1097/HTR.0000000000000443","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000443","url":null,"abstract":"<p><strong>Objective: </strong>To examine the effectiveness of a web-based parenting intervention (Internet-Based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT]) and an abbreviated version (Express) in reducing executive dysfunction and internalizing problems among young children following traumatic brain injury (TBI).</p><p><strong>Method: </strong>Parents of 113 children (ages 3-9 years) who had sustained a TBI were randomized to 1 of 3 treatment groups: I-InTERACT, Express, or an Internet Resource Comparison (IRC) group. Parents who participated in either I-InTERACT or Express completed self-guided web sessions and received live coaching of their parenting skills via videoconferencing with a therapist. I-InTERACT included additional psychoeducation, stress management, and family communication skills (eg, marriage, grief, pain, and sleep). Analyses of covariance were utilized to compare the groups on parent-reported executive function behaviors (ie, Behavior Rating Inventory of Executive Function) and internalizing symptoms (ie, Child Behavior Checklist) at baseline and 6 months.</p><p><strong>Results: </strong>Parents who participated in Express reported significantly lower levels of executive dysfunction than those in I-InTERACT, β = -0.49; t(2, 73) = -2.47, P = .048, and significantly lower levels of withdrawal than those in the IRC group, β = -0.44; t(2, 74) = -2.22, P = .03. The Express group did not significantly differ from the IRC group on executive function behaviors or the I-InTERACT group on internalizing problems, all P > .05. Children with more problems at baseline, families with lower education levels, and parents with more symptoms of depression benefited most.</p><p><strong>Conclusion: </strong>A brief, online parent training intervention may be efficacious in improving executive dysfunction and internalizing problems following early TBI, particularly among children of lower socioeconomic status or with existing behavioral concerns.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"65-76"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36737304","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":"Preliminary Efficacy of Online Traumatic Brain Injury Professional Development for Educators: An Exploratory Randomized Clinical Trial.","authors":"Ann E Glang,&nbsp;Melissa McCart,&nbsp;Jody Slocumb,&nbsp;Jeff M Gau,&nbsp;Susan C Davies,&nbsp;Doug Gomez,&nbsp;Laura Beck","doi":"10.1097/HTR.0000000000000447","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000447","url":null,"abstract":"<p><strong>Objective: </strong>To examine the efficacy of an online traumatic brain injury (TBI) professional development intervention, In the Classroom After Concussion: Best Practices for Student Success.</p><p><strong>Design: </strong>A randomized controlled trial with a sample of 100 general educators, who were randomly assigned to the In the Classroom Web site (treatment group) or the LEARNet Web site (control group). Participants completed the pretest, accessed the In the Classroom or LEARNet site and the posttest and completed follow-up assessments 60 days after posttest.</p><p><strong>Measures: </strong>(1) Knowledge of effective strategies for working with students with TBI; (2) knowledge application; (3) self-efficacy in handling situations presented in text and video scenarios, and (4) a standardized self-efficacy measure.</p><p><strong>Results: </strong>On the posttest assessment, In the Classroom educators showed significantly greater gains in knowledge (P < .0001, d = 1.36 [large effect]), TBI knowledge application (P = .0261, d = 0.46), and general self-efficacy (P = .0106, d = 0.39) than the LEARNet controls. In the Classroom educators maintained significant gains in knowledge (P = .001, d = 0.82) and general self-efficacy (P = .018, d = 0.38) but not in TBI knowledge application (P = .921, d = 0.02).</p><p><strong>Conclusion: </strong>Given the prevalence of TBI, it is important to develop evidence-based, cost-effective approaches to knowledge transfer and exchange in TBI professional development. In the Classroom is one such approach.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"77-86"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000447","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36738804","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":"A Review of Smartphone Applications for Persons With Traumatic Brain Injury: What Is Available and What Is the Evidence?","authors":"Vivian Kwan,&nbsp;Nicoline Bihelek,&nbsp;Vicki Anderson,&nbsp;Keith Yeates","doi":"10.1097/HTR.0000000000000425","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000425","url":null,"abstract":"<p><strong>Objectives: </strong>To map the number and type of smartphone applications available for persons with traumatic brain injury (TBI), evaluate validity of app content, and investigate evidence for any claims made.</p><p><strong>Methods: </strong>We searched iTunes and Google Play and also completed a web search. The purpose of each app and any claims were extracted, and a search for best available evidence was performed.</p><p><strong>Results: </strong>Seventy apps met our inclusion criteria (35 related to assessment, 11 to education, 9 to treatment/management, 8 to impact sensors, and 7 to symptom tracking). To the best of our knowledge, no empirical research has been published to demonstrate that the use of any particular TBI-related app leads to clinically meaningful benefits compared with not using the app. Other problems include potential biases in self-report leading to possible app misuse, lack of references for app content, and inappropriate marketing to laypersons not trained to interpret the findings of tools validated for use by healthcare professionals.</p><p><strong>Conclusions: </strong>The current evidence for benefit from using TBI-related apps is minimal. More collaborative research is needed among clinicians, scientists, and app developers to determine whether, and how, apps may be helpful to individuals at risk for or following TBI.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E45-E51"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36342003","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":"Early Elementary School Outcome in Children With a History of Traumatic Brain Injury Before Age 6 Years.","authors":"Juliet Haarbauer-Krupa,&nbsp;Tricia Z King,&nbsp;Justin Wise,&nbsp;Schauna Gillam,&nbsp;Julie Trapani,&nbsp;Barbara Weissman,&nbsp;Roberta DePompei","doi":"10.1097/HTR.0000000000000414","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000414","url":null,"abstract":"<p><strong>Objective: </strong>To describe elementary school outcomes for children who experienced a traumatic brain injury (TBI) before age 6 years compared with a control group of children with orthopedic injuries.</p><p><strong>Participants: </strong>Children ages 6 to 9 years recruited from community and trauma registries in a large southeastern state.</p><p><strong>Design: </strong>Descriptive findings from the first year of a 3-year longitudinal study.</p><p><strong>Main measures: </strong>Child assessment and parent report measures were administered to capture cognitive, language, reading, and behavior outcomes. Medical record review confirmed injuries and injury severity.</p><p><strong>Results: </strong>The TBI group (n = 39) had a mean age of 7.55 years (standard deviation = 1.29) and was 5.15 (standard deviation = 1.56) years postinjury. The TBI group had primarily classified as mild complicated TBI (63%). On average, children in both groups performed within normal limits on most cognitive, language, and reading measures. Group differences were identified in verbal IQ, receptive language, and reading comprehension, with robust performance differences in pragmatic language, story retell and word fluency, and parent report of executive functions.</p><p><strong>Conclusions: </strong>Findings indicate the importance of in-depth follow-up specialist assessments (eg, neuropsychologist and speech and language pathologists) to identify potential nuanced difficulties in children with mild complicated TBI that may be missed by general evaluations.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"111-121"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000414","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36343023","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":"Balance and Mobility Improvements During Inpatient Rehabilitation Are Similar in Young-Old, Mid-Old, and Old-Old Adults With Traumatic Brain Injury.","authors":"Susan B Perry,&nbsp;Barbara Billek-Sawhney,&nbsp;Jason Woollard,&nbsp;Susan Little,&nbsp;Amy Szalinski","doi":"10.1097/HTR.0000000000000415","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000415","url":null,"abstract":"<p><strong>Objective: </strong>To compare balance, mobility, and functional outcomes across 3 age groups of older adults with traumatic brain injury; to describe differences between those discharged to private residences versus institutional care.</p><p><strong>Setting: </strong>Acute inpatient rehabilitation facility.</p><p><strong>Participants: </strong>One hundred adults, mean age of 78.6 ± 7.9 years (range = 65-95 years), with an admitting diagnosis of traumatic brain injury.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Main measures: </strong>Functional Independence Measure (FIM) for Cognition and Mobility; Berg Balance Scale; Timed Up and Go; and gait speed, at admission to and discharge from an inpatient rehabilitation facility.</p><p><strong>Results: </strong>Statistically significant improvements (P < .01) were made on the Timed Up and Go, Berg Balance Scale, and gait speed for young-old, mid-old, and old-old adults, with no differences among the 3 age groups. Substantial balance and mobility deficits remained. The FIM cognition (P = .013), FIM Walk (P = .009), and FIM Transfer (P = .013) scores were significantly better in individuals discharged home or home with family versus those discharged to an institution.</p><p><strong>Conclusion: </strong>Preliminary outcome data for specific balance and mobility measures are reported in 3 subgroups of older adults following traumatic brain injury, each of which made significant and similar improvements. Some FIM item scores discriminated between those discharged to a private residence versus a higher level of care.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E66-E73"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36343024","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}