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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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Modified Mouse Model of Repetitive Mild Traumatic Brain Injury Incorporating Thinned-Skull Window and Fluid Percussion
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Discharge Cognitive-Motor Imbalance Patterns and Long-Term Outcomes After Traumatic Brain Injury: A Propensity

Ji Hyun Kim1, Seo Young Kim1, Tae Uk Kim1

  • 1Department of Rehabilitation Medicine, College of Medicine, Dankook University, Cheonan 31116, Republic of Korea.

Journal of Clinical Medicine
|May 13, 2026
PubMed
Summary

Motor-cognitive imbalance after traumatic brain injury (TBI) impacts long-term recovery. Understanding these patterns at discharge can guide targeted rehabilitation and predict functional outcomes in moderate-to-severe TBI patients.

Keywords:
disability rating scalefunctional independence measureparticipationrehabilitationtraumatic brain injury

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Outcomes Research

Background:

  • Traumatic brain injury (TBI) recovery is often uneven across cognitive and motor functions.
  • The prognostic value of motor-cognitive imbalance at rehabilitation discharge for TBI patients is not well understood.
  • This study examines the association between discharge motor-cognitive imbalance and long-term functional outcomes in moderate-to-severe TBI.

Purpose of the Study:

  • To investigate if motor-cognitive imbalance patterns at rehabilitation discharge predict functional outcomes at 1 and 2 years post-injury.
  • To determine if cognitive-dominant or motor-dominant TBI patients have different long-term prognoses compared to balanced patients.
  • To inform post-acute rehabilitation planning by identifying prognostic implications of discharge imbalance.

Main Methods:

  • Retrospective cohort study utilizing the Traumatic Brain Injury Model Systems (TBIMS) National Database.
  • Included 8342 adults with moderate-to-severe TBI discharged from inpatient rehabilitation, classified by FIM motor/cognitive score discrepancies.
  • Propensity score matching created a balanced cohort (n=1310) comparing cognitive-dominant, motor-dominant, and balanced groups.

Main Results:

  • Cognitive-dominant TBI patients showed lower disability severity (DRS) and higher FIM scores at 1 and 2 years compared to balanced patients.
  • Motor-dominant TBI patients had higher FIM motor scores but lower odds of favorable disability status (DRS ≤ 3) at 2 years.
  • No significant differences were observed in Glasgow Outcome Scale-Extended (GOSE) or Participation Assessment with Recombined Tools-Objective (PART-O) outcomes among groups.

Conclusions:

  • Discharge motor-cognitive imbalance in TBI is linked to distinct long-term disability and functional independence differences.
  • The direction of motor-cognitive imbalance provides prognostic information beyond overall functional scores.
  • Tailoring post-acute rehabilitation based on discharge imbalance patterns may improve patient outcomes.