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Published on: September 23, 2018
Combining cognition and motor functioning to predict outcomes 1 year after inpatient rehabilitation for traumatic
Emily Dudek1, Michael W Williams1, Shannon B Juengst2,3,4
1Department of Psychology, University of Houston, Houston, TX, USA.
Abstract:
Objective: To examine the interaction between early cognition and motor functioning when predicting functional independence, community participation, homeboundness, and return-to-work 1 year after traumatic brain injury (TBI). Method: Data from 101 adults (M age = 39.6 years) across two TBI Model Systems sites. Cognitive performance (Brief Test of Adult Cognition by Telephone) and motor functioning (FIM-Motor score/Continuity Assessment Record and Evaluation) were collected at inpatient rehabilitation discharge. Functional independence (Glasgow Outcome Scale-Extended, GOS-E), community participation (Participation Assessment with Recombined Tools-Objective-17, PART-O-17), homeboundness, and return-to-work were collected at 12-month follow-up. Motor functioning was hypothesized to moderate the relationship between cognition and 1-year outcomes. Results: Using multiple regression, early cognitive performance significantly predicted community participation, whereas motor functioning significantly predicted functional independence. Surprisingly, neither cognition nor motor functioning significantly predicted later employment or homeboundness. Rehabilitation length of stay and higher income were the only relevant predictors of return to work. The interaction between cognition and motor functioning did not meaningfully contribute to predicting outcomes at 1 year post-injury. Conclusions: Cognition and motor functioning offer distinct and independent contributions to rehabilitation outcomes among people with TBI. These findings underscore the importance of interventions that address post-TBI cognitive impairments as an avenue to improve participation after TBI. Critically, this study demonstrates that such interventions may be equally important for people with TBI across varying levels of motor functioning. Future studies should examine the impact of outpatient rehabilitation interventions on the predictive relationship between early cognition and post-TBI functional outcomes.
