Therese M O'Neil-Pirozzi1, Anthony H Lequerica, Nancy D Chiaravalloti, Shannon B Juengst, Jody K Newman. 1. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts (Dr O'Neil-Pirozzi); Department of Communication Sciences and Disorders, Northeastern University, Boston, Massachusetts (Dr O'Neil-Pirozzi); Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, New Jersey (Drs Lequerica and Chiaravalloti); Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark (Drs Lequerica and Chiaravalloti); Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas (Dr Juengst); and Research Department, Craig Hospital, Englewood, Colorado (Ms Newman).
Abstract
OBJECTIVE: To examine changes in functional memory, problem solving, comprehension, expression, and social communication over the first 2 years posttraumatic brain injury (TBI) and the ability of each to predict return to work (RTW) outcomes at 1 year and 5 years postinjury. DESIGN: Secondary analysis of data from a multicenter longitudinal cohort study. SETTING: Acute inpatient rehabilitation facilities and community follow-up. PARTICIPANTS: A total of 3543 individuals between 16 and 60 years of age who were competitively employed at the time of TBI and had completed year 1, year 2, and year 5 postinjury follow-ups. MAIN OUTCOME MEASURES: Year 1 and year 5 RTW status (± competitively employed) at the time of study completion. RESULTS: Greater function across each of the 5 cognitive-communication abilities was associated with RTW success at 1 year and 5 years post-TBI. At discharge, these 5 abilities showed comparable odds of predicting later employment. At year 1 and year 2 follow-ups, independence with problem solving was the most predictive of employment 5 years post-TBI, followed by social interaction, memory, expression, and comprehension. CONCLUSIONS: An increased rehabilitation focus on functional memory, problem solving, comprehension, expression, and social interaction post-TBI has the potential to improve RTW outcomes.
OBJECTIVE: To examine changes in functional memory, problem solving, comprehension, expression, and social communication over the first 2 years posttraumatic brain injury (TBI) and the ability of each to predict return to work (RTW) outcomes at 1 year and 5 years postinjury. DESIGN: Secondary analysis of data from a multicenter longitudinal cohort study. SETTING: Acute inpatient rehabilitation facilities and community follow-up. PARTICIPANTS: A total of 3543 individuals between 16 and 60 years of age who were competitively employed at the time of TBI and had completed year 1, year 2, and year 5 postinjury follow-ups. MAIN OUTCOME MEASURES: Year 1 and year 5 RTW status (± competitively employed) at the time of study completion. RESULTS: Greater function across each of the 5 cognitive-communication abilities was associated with RTW success at 1 year and 5 years post-TBI. At discharge, these 5 abilities showed comparable odds of predicting later employment. At year 1 and year 2 follow-ups, independence with problem solving was the most predictive of employment 5 years post-TBI, followed by social interaction, memory, expression, and comprehension. CONCLUSIONS: An increased rehabilitation focus on functional memory, problem solving, comprehension, expression, and social interaction post-TBI has the potential to improve RTW outcomes.
Authors: Bruce K Christensen; Brenda Colella; Elizabeth Inness; Deborah Hebert; Georges Monette; Mark Bayley; Robin E Green Journal: Arch Phys Med Rehabil Date: 2008-12 Impact factor: 3.966
Authors: Margaret A Struchen; Allison N Clark; Angelle M Sander; Monique R Mills; Gina Evans; Diana Kurtz Journal: NeuroRehabilitation Date: 2008 Impact factor: 2.138