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Predictors of Multidimensional Profiles of Participation After Traumatic Brain Injury: A TBI Model Systems Study
Shannon B Juengst1, Raj G Kumar, Umesh M Venkatesan
1Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas (Drs Juengst and Sander); Department of Physical Medicine & Rehabilitation, UT Health Science Center at Houston, Houston (Dr Juengst); Department of Physical Medicine & Rehabilitation, UT Southwestern Medical Center, Dallas (Dr Juengst); Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York (Dr Kumar); Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Drs Venkatesan and Rabinowitz); Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania (Drs Venkatesan and Rabinowitz); Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts (Dr O'Neil-Pirozzi); Department of Communication Sciences and Disorders, Northeastern University, Boston, Massachusetts (Dr O'Neil-Pirozzi); Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts (Dr Evans); H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (Dr Sander); Richmond Veterans Affairs Medical Center, Richmond, Virginia (Dr Klyce); Virginia Commonwealth University Health System, Richmond (Dr Klyce); Sheltering Arms Institute, Richmond, Virginia (Dr Klyce); Research Department, Craig Hospital, Englewood, Colorado (Drs Agtarap and Whiteneck); Department of Occupational Therapy, MGH Institute of Health Professions, Boston, Massachusetts (Dr Erler); Rusk Rehabilitation, NYU Langone Health, New York City, New York (Dr Bushnik); Rehabilitation Outcomes Center (ROC), Spaulding Hospital, Charlestown, Massachusetts (Dr Kazis); Department of Health Law, Policy & Management, School of Public Health, Boston University, Boston, Massachusetts (Dr Kazis); and Harvard Medical School, Boston, Massachusetts (Dr Kazis).
Personal, clinical, and environmental factors influence participation profiles after traumatic brain injury (TBI). Education, employment, and cognitive function are key predictors of these distinct TBI recovery patterns.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Public Health
Background:
- Traumatic brain injury (TBI) significantly impacts an individual's ability to participate in daily life.
- Previous research has identified distinct multidimensional participation profiles among individuals with TBI.
- Understanding the factors associated with these profiles is crucial for effective rehabilitation.
Purpose of the Study:
- To identify personal, clinical, and environmental factors associated with four previously identified distinct multidimensional participation profiles in individuals following TBI.
- To inform personalized rehabilitation strategies by understanding the drivers of different participation outcomes.
Main Methods:
- Secondary data analysis of cross-sectional data from 408 participants in the TBI Model Systems (TBIMS) Participation Module, 1 year or more post-TBI.
- Utilized questionnaires assessing personal, clinical, and environmental factors, alongside participation measures (frequency, importance, satisfaction, enfranchisement).
- Employed multinomial regression to determine factors distinguishing the four participation profile groups.
Main Results:
- Multinomial regression revealed that education, current employment, current illicit drug use, current driving status, community type, and Functional Independence Measure (FIM) Cognitive scores at follow-up significantly differentiated participation profile groups.
- A trend towards differences in participation profiles based on race/Hispanic ethnicity was observed.
- These findings highlight the complex interplay of individual and environmental factors in TBI recovery.
Conclusions:
- Distinct participation profiles following TBI are associated with specific personal, clinical, and environmental factors.
- Identifying these factors can lead to more personalized and nuanced guidance for rehabilitation intervention planning.
- This understanding supports ongoing clinical monitoring and tailored support for individuals with TBI.
