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Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...

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Comparing Two Models of Transition from Inpatient Rehabilitation Following Traumatic Brain Injury: A Pragmatic

Jeanne M Hoffman1, Taylor Obata1, Marcia A Ciol1

  • 1Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA.

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|September 17, 2025
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Two models for moderate to severe traumatic brain injury (msTBI) transition care showed no significant differences in societal participation or quality of life. Further research is needed to optimize post-discharge support for msTBI patients.

Keywords:
brain injurycase managementinpatient rehabilitationquality of lifetransition of caretraumatic brain injury

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Health Services Research

Background:

  • Moderate to severe traumatic brain injury (msTBI) leads to persistent physical, cognitive, and psychosocial challenges.
  • Patients with msTBI and their families face difficulties accessing information and services post-discharge, highlighting inadequate transitional care.
  • Effective transition support is crucial to mitigate the long-term consequences of msTBI.

Purpose of the Study:

  • To compare the effectiveness of two US-based transitional care models for msTBI patients: the Rehabilitation Discharge Plan (RDP) and the more intensive Rehabilitation Transition Plan (RTP).
  • To evaluate the impact of these models on societal participation and health-related quality of life (HRQoL) at 6 months and 1 year post-discharge.

Main Methods:

  • A six-center, randomized pragmatic clinical trial involving 925 patients with msTBI.
  • Participants received either the standard RDP (pre-discharge planning, instructions, brief follow-up call) or the enhanced RTP (RDP plus up to 12 post-discharge contacts with a care manager over 6 months).
  • Primary outcomes included societal participation and HRQoL, assessed at 6 months and 1 year.

Main Results:

  • No significant differences were found between the RDP and RTP interventions for societal participation or HRQoL at 6 months or 1 year.
  • Analysis of outcome trajectories did not reveal significant differences between the treatment groups.
  • Pre-injury limitations, Medicaid insurance, and lower baseline function were associated with poorer outcomes; interactions with intervention were noted based on clinical site and caregiver presence.

Conclusions:

  • The intensive Rehabilitation Transition Plan (RTP) did not demonstrate superior outcomes compared to the standard Rehabilitation Discharge Plan (RDP) for msTBI patients.
  • The 6-month intervention duration may be insufficient to address the complex, long-term needs following msTBI.
  • Future research should explore longer-term interventions and personalized support strategies, considering factors like caregiver involvement.