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Citation
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Togher L, Elbourn E, Kenny B, Honan C, Power E, Tate R, McDonald S, MacWhinney B. Arch. Phys. Med. Rehabil. 2023; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: To examine predictive factors underlying communication and psychosocial outcomes at 2-years post-injury. Prognosis of communication and psychosocial outcomes following severe traumatic brain injury (TBI) is largely unknown yet is relevant for clinical service provision, resource allocation and managing patient and family expectations for recovery.
DESIGN: A prospective longitudinal inception design was employed with assessments at 3 months, 6 months, and 2-years. PARTICIPANTS: The cohort included 57 participants with severe TBI. SETTING: Subacute and post-acute rehabilitation. MAIN OUTCOME MEASURES: Preinjury/Injury measures included age, gender, education years, GCS & PTA. The 3-month and 6-month data points included speech, language and communication measures across the ICF domains and measures of cognition. The 2-year outcome measures included conversation, perceived communication skills and psychosocial functioning. Predictors were examined using multiple regression. INTERVENTIONS: Not applicable.
RESULTS: The cognitive and communication measures at 6 months significantly predicted conversation measures at 2 years and psychosocial functioning as reported by others at 2 years. At 6 months, 69% of participants presented with a cognitive-communication disorder (FAVRES). The unique variance accounted for by the FAVRES measure was 7% for conversation measures and 9% for psychosocial functioning. Psychosocial functioning at 2 years was also predicted by pre-injury/injury factors and 3-month communication measures. Pre-injury education level was a unique predictor accounting for 17% of the variance and processing speed/memory at 3 months uniquely accounted for 14% of the variance.
CONCLUSION: Cognitive-communication skills at 6 months are a potent predictor of persisting communication challenges and poor psychosocial outcomes up to 2 years after a severe TBI.
FINDINGS emphasise the importance of addressing modifiable cognitive and communication outcomes variables during the first 2 years following severe TBI to maximise functional patient outcomes.
Language: en |