Predictors of ambulation in individuals with disorders of consciousness after traumatic brain injury: a pilot study.

Objective: To identify characteristics predictive of ambulation at discharge from inpatient rehabilitation in individuals with a Disorder of Consciousness (DoC) following traumatic brain injury (TBI).

Design: Prospective cohort pilot study.

Setting: Inpatient Rehabilitation Facility (IRF).

Participants: 15 adults (≥18 years) with a DoC after TBI, admitted to IRF within 6 months of injury.

Main outcome measure(s): 'Ambulate 50 feet' task from Inpatient Rehabilitation Facility - Patient Assessment Instrument.

Results: At discharge, 6 participants (40%) were classified as ambulators and 9 (60%) as wheelchair users. The 'ambulators' group had significantly fewer days between injury and admission to IRF (p < 0.001), higher JFK Coma Recovery Scale-Revised (CRS-R) scores at initial evaluation in IRF (p < 0.001), fewer days in IRF (p < 0.001), and faster rates of progress on the CRS-R in first 10 days at IRF (p = 0.047) compared to the 'wheelchair users' group.Both the rate of progress on the CRS-R in the first 10 days of IRF stay (p = 0.023) and days between injury and admission to IRF (p = 0.023) were significant predictors of ambulation at discharge.

Conclusion(s): This study identifies the rate of progress on the CRS-R in the first 10 days of IRF stay as a potential prognostic indicator for ambulation in individuals with DoC after TBI. Additional research with larger samples is warranted.