Related Experiment Video
Updated: Nov 30, 2025
Detecting Behavioral Deficits in Rats After Traumatic Brain Injury
Published on: January 30, 2018
Rehabilitation Needs at 5 Years Post-Traumatic Brain Injury: A VA TBI Model Systems Study
Elaine J Mahoney1, Marc A Silva, Tea Reljic
1Mental Health and Behavioral Sciences (MHBS) (Drs Mahoney, Silva, and Nakase-Richardson) and Defense and Veterans Brain Injury Center (DVBIC) (Drs Silva and Nakase-Richardson), James A. Haley Veterans' Hospital, Tampa, Florida; Departments of Psychiatry and Behavioral Neurosciences (Dr Silva), Psychology (Dr Silva), Child & Family Studies (Dr Dillahunt-Aspillaga), and Internal Medicine, Division of Pulmonary and Sleep Medicine (Dr Nakase-Richardson), University of South Florida, Tampa; Morsani College of Medicine, University of South Florida, Tampa (Ms Reljic); Departments of Rehabilitation Medicine (Dr Dams-O'Connor) and Neurology (Dr Dams-O'Connor), Icahn School of Medicine at Mount Sinai, New York, New York; Department of Physical Medicine & Rehabilitation, Indiana University School of Medicine, Indianapolis (Dr Hammond); Rehabilitation Hospital of Indiana, Indianapolis (Dr Hammond); Research Department, Craig Hospital, Englewood, Colorado (Dr Monden); Department of Rehabilitation Medicine, University of Minnesota, Minneapolis (Dr Monden); VA Palo Alto Health Care System, Palo Alto, California (Dr Chung); and Research Service, James A. Haley Veterans' Hospital, Tampa, Florida (Dr Dillahunt-Aspillaga).
Objective:
Describe rehabilitation needs and factors associated with unmet needs at 5 years post-traumatic brain injury (TBI).
Setting:
Five Veterans Affairs (VA) polytrauma rehabilitation centers (PRCs).
Participants:
VA TBI Model Systems participants (N = 283; 96% male, 75%, 57% severe TBI).
Design:
Prospective observational cohort.
Main Measures:
Rehabilitation Needs Survey (21-item survey that assesses cognitive, emotional, social, and functional needs); Craig Hospital Inventory of Environmental Factors (25-item survey of potential environmental barriers).
Results:
Participants endorsed a mean of 8 (SD: 6.2) ongoing and 3 (SD: 4.7) unmet rehabilitation needs at 5 years post-TBI. Approximately 65% of participants reported at least 1 rehabilitation need that remained unmet. The number and nature of needs differed across TBI severity groups. In unadjusted and adjusted linear regression models, Black race and environmental barriers (Craig Hospital Inventory of Environmental Factors total score) were predictive of unmet needs (P < .001). Those with greater unmet needs reported the physical environment (54%-63%), informational sources (54%), social attitudes (55%), healthcare access (40%), public policy (32%-37%), transportation availability (33%), and in-home assistance (32%) as the most frequent environmental barriers at 5 years post-TBI.
Conclusion:
Veterans and Service Members continue to have rehabilitation needs at 5 years post-TBI. Veterans Affairs programs to address ongoing needs and policy to support them are needed.
