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Function after motor vehicle accidents: a prospective study of mild head injury and posttraumatic stress
1Department of Occupational Therapy, Faculty of Medicine, University of Toronto, Ontario, Canada.
Abstract:
Relationships among mild traumatic brain injury (MTBI), posttraumatic stress (PTS), and function were examined in 99 motor vehicle accident (MVA) admissions: 64 in an MTBI group and 35 in a no-MTBI comparison group. Assessments occurred within the first month and at 6 to 9 months. At follow-up, the sample was moderately disabled on the Sickness Impact Profile (SIP), 71% satisfied on the Reintegration of Normal Living Index (RNL), and 42% had returned to work. Only the SIP Psychosocial score was significantly different for MTBI groups; 24% of the sample showed definite symptoms of PTS. This group was significantly more disabled on the SIP, less satisfied on the RNL, and less likely to return to work. The proportion of variance in outcome explained in each model ranged from 32% (Physical SIP) to 44% (RNL). Results suggest the need for clinicians to be more aware of the strong influence of PTS on functional outcomes.
Insights
Mild traumatic brain injury (MTBI) and posttraumatic stress (PTS) significantly impact recovery after motor vehicle accidents (MVAs). PTS strongly influences disability, life satisfaction, and return to work, highlighting the need for clinical awareness.
Area of Science:
- Neuroscience
- Psychology
- Rehabilitation Medicine
Background:
- Mild traumatic brain injury (MTBI) is common after motor vehicle accidents (MVAs).
- The long-term functional consequences of MTBI, particularly in relation to posttraumatic stress (PTS), require further investigation.
- Understanding these relationships is crucial for effective patient management and rehabilitation.
Purpose of the Study:
- To examine the relationships among MTBI, PTS, and functional outcomes in MVA admissions.
- To assess the impact of PTS symptoms on disability, life satisfaction, and return to work.
- To identify factors influencing recovery trajectories post-MVA.
Main Methods:
- A cohort of 99 MVA admissions was studied, with 64 in an MTBI group and 35 in a comparison group.
- Assessments were conducted within one month and again at 6 to 9 months post-injury.
- Standardized measures including the Sickness Impact Profile (SIP) and Reintegration of Normal Living Index (RNL) were utilized.
Main Results:
- At follow-up, the sample exhibited moderate disability (SIP), 71% life satisfaction (RNL), and 42% return to work.
- A significant difference in SIP Psychosocial scores was observed between MTBI groups.
- Twenty-four percent of the sample displayed definite PTS symptoms, correlating with greater disability, lower life satisfaction, and reduced likelihood of returning to work.
Conclusions:
- Posttraumatic stress significantly influences functional outcomes following motor vehicle accidents.
- Clinicians should be aware of the substantial impact of PTS on recovery.
- Targeting PTS symptoms may improve rehabilitation success and functional reintegration after MTBI.