@article{ref1,
title="Trajectories of fatigue, psychological distress and coping styles after mild traumatic brain injury: a six-month prospective cohort study",
journal="Archives of physical medicine and rehabilitation",
year="2021",
author="Rakers, Sandra E. and Timmerman, Marieke E. and Scheenen, Myrthe E. and de Koning, Myrthe E. and van der Horn, Harm J. and van der Naalt, Joukje and Spikman, Jacoba M.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To analyse fatigue after mild traumatic brain injury (TBI) with latent class growth analysis (LCGA) to determine distinct recovery trajectories and investigate influencing factors, including emotional distress and coping styles. <br><br>DESIGN: An observational cohort study design with validated questionnaires assessing fatigue, anxiety, depression, post-traumatic stress and coping at 2 weeks, 3 and 6 months post-injury. SETTING: Three level-1 trauma-centers. PARTICIPANTS: Mild TBI patients (n=456). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Fatigue was measured with the fatigue severity subscale of the Checklist Individual Strength, including 8 items (sum scores 8-56). Subsequently, three clinical categories were created: high (40-56), moderate (26-38) and low (8-25). <br><br>RESULTS: From the entire mild TBI group, four patient clusters with distinct patterns for fatigue, emotional distress and coping styles were found with LCGA. Clusters 1 and 2 showed favourable recovery from fatigue over time, with low emotional distress and the predominant use of active coping in cluster 1 (30%), and low emotional distress and decreasing passive coping in cluster 2 (25%). Clusters 3 and 4 showed unfavourable recovery, with persistent high fatigue and increasing passive coping together with low emotional distress in cluster 3 (27%), and high emotional distress in cluster 4 (18%). Patients with adverse trajectories were more often female, suffering more often from sleep disturbances and pain. <br><br>CONCLUSION: The prognosis for recovery from posttraumatic fatigue is favourable for 55% of the mild TBI patients. Patients at risk for chronic fatigue can be signalled in the acute phase post-injury based on the presence of high fatigue, high passive coping and, for a subgroup of patients, high emotional distress. LCGA proved to be a highly valuable and multipurpose statistical method to map distinct courses of disease-related processes over time.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2021.06.004",
url="http://dx.doi.org/10.1016/j.apmr.2021.06.004"
}