Research Reports - Predictors of outcome after treatment of mild traumatic brain injury

J Head Trauma Rehabil. 2013 Mar 7

Leininger S, Strong CA, Donders J

OBJECTIVE:: To determine factors affecting outcome of comprehensive outpatient
rehabilitation of individuals who sustained a mild traumatic brain injury.
PARTICIPANTS:: From a 4-year series of referrals, 49 nonconsecutive participants
met criteria for mild traumatic brain injury (ie, loss of consciousness <30
minutes, Glasgow Coma Scale score >12). SETTING:: Outpatient, community-based
postconcussion clinic at a rehabilitation hospital. MAIN MEASURES:: Participants
and therapy staff completed the Mayo-Portland Adaptability Inventory-Fourth
Edition (MPAI-4) at the initiation and conclusion of treatment. Participants were
also administered the Trail Making Test at the start of treatment. RESULTS::
Participants generally gave poorer adaptability ratings than staff at the
beginning and discharge of treatment. Regression analyses revealed that after
controlling for baseline ratings, psychiatric history was associated with worse
participant-rated MPAI-4 Adjustment scores at treatment discharge, whereas better
Trail Making Test Part B performance at initiation of treatment predicted better
participant-rated MPAI-4 Ability at treatment discharge. CONCLUSIONS:: Premorbid
demographic and baseline neurocognitive factors should be taken into account
prior to comprehensive treatment of mild traumatic brain injury, as they can
influence long-term outcomes. Adaptability ratings from both staff and
participants can be useful in gaining different perspectives and assessing
factors affecting recovery.

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