Cognitive Recovery and its Correlation with Functional Status One Year After Traumatic Brain Injury
American Journal of Nursing Science
Volume 4, Issue 3, June 2015, Pages: 113-118
Received: Sep. 29, 2014; Accepted: May 5, 2015; Published: May 13, 2015
Views 3866      Downloads 136
Mahima Agrawal, Department of Physical Medicine and Rehabilitation, S.M.S.M.C and hospital, Jaipur, Rajasthan, India
Mrinal Joshi, Department of Physical Medicine and Rehabilitation, S.M.S.M.C and hospital, Jaipur, Rajasthan, India
Article Tools
Follow on us
Objectives: To examine the impact of multi faceted rehabilitation services on functional outcomes after traumatic brain injury (TBI) for individuals with moderate and severe TBI. Design: Cohort, non-randomized, interventional study, pre-test, post-test design. Setting: Community integrated post acute rehabilitation centre. Main outcome measures: Galvenston Orientation and Amnesia Test (GOAT), Mini Mental Status Examination (MMSE), Functional Independence Measure (FIM), Glasgow outcome scale extended (GOSE). Results: Mean change in MMSE scores from admission to twelve months was 23.48 in moderate injury group and 21.26 in severe injury group. This change was significant in both the severity groups. Mean change in GOAT scores from admission to twelve months was 74.85 in moderate injury group and 70.71 in the severe injury group which also was significant. Predictors such as Length of stay (LOS) in acute care (B=-0.913), GCS at the time of acute admission (B=0.402), FIM at the time of discharge (B=.241), injury severity (B=0.221) and LOS in rehabilitation (B=0.168) explained 85.7% of the variation in the value of FIM at 12 months after injury. Conclusion: Impairment of cognitive function and its socio-economic impact is vast such that it affects the socio economic status of a community and country as a whole. Cognitive rehabilitation remains central to the management of persons with TBI.
FIM, GOSE, MMSE, GOAT, Cognitive, Rehabilitation, PTA (Post Traumatic Amnesia)
To cite this article
Mahima Agrawal, Mrinal Joshi, Cognitive Recovery and its Correlation with Functional Status One Year After Traumatic Brain Injury, American Journal of Nursing Science. Vol. 4, No. 3, 2015, pp. 113-118. doi: 10.11648/j.ajns.20150403.20
G. Eason, B. Noble, and I. N. Sneddon, “On certain integrals of Cognitive rehabilitation for traumatic brain injury and stroke, updated review of literature from 1998 through 2002 with recommendation for clinical practice.
Cognitive rehabilitation therapy may assist in treating traumatic brain injury. Medical news today. 13 Oct 2011. 10.00 PDT
Institute of medicine. Gulf war and health: Volume 7: long term consequences of TBI. Washington (DC): National academy Pr; 2009
Ruff RM, Iverson GL, Barth JT, Bush SS, Broshek DK. Recommendations for diagnosing a mild traumatic brain injury: a National Academy of Neuropsychology education paper. Arch Clin Neuropsychol 2009; 24(1):3-10
Dick JP, Guiloff RJ, Stewart A, Blackstock J, Bielawska C, Paul EA, Marsden CD. Mini-mental state examination in neurological patients. J Neurol Neurosurg Psychiatry. 1984 May;47(5):496-9
Levin HS, O'Donnell VM, Grossman RG. The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis. 1979 Nov;167(11):675-84
Grimby G, Gudjonsson G, Rodhe M, Sunnerhagen KS, Sundh V, Ostensson ML. The functional independence measure in Sweden: experience for outcome measurement in rehabilitation medicine. Scand J Rehabil Med. 1996 May;28(2):51-62
Katz, DI; Ashley MJ, O’Shanick GJ, Connors, SH. Cognitive rehabilitation: the evidence, funding and case for advocacy in brain injury. McLean, VA: Brain Injury Association of America, 2006
[9] e business/ provider/ medical policies/ cognitive rehab. htm
Bethesda MD. National institute of health. Report of the consensus development conference on rehabilitation of persons with traumatic brain injury. Sep. 2009
Carney N, Chestnut RM, Maynard H, mann NC, Patterson P, Helfand M. Effect of cognitive rehabilitation on outcomes for persons with traumatic brain injury: A systematic review. J Head Trauma Rehabil. 1999 Jun;14(3):277-307
Christensen BK, Collela B, Inness E, Herbert D. Recovery of cognitive function after traumatic brain injury: a multilevel modeling analysis of Canadian outcomes. Arch Phys Med Rehabil. 2008. Dec; 89(12 suppl):S3-15.
Bilbao A, Kennedy C, Chatterji Set al. The ICF: Applications of the WHO model of functioning, disability and health to brain injury rehabilitation. Neuro Rehabilitation 2003.18(3):239-250.
Kunik CL, Flowers L, Kazanjian T. Time to rehabilitation admission and associated outcomes for patients with traumatic brain injury. Arch Phys Med Rehab 2006.Dec;87(12):1590-1596
Srivastava A, Rapoport MJ, Leach L, Phillips A, Shammi P, Feinstein A. The utility of the mini-mental status exam in older adults with traumatic brain injury. Brain Inj. 2006 Dec;20(13-14):1377-82
Katz DI, Alexander MP. Traumatic brain injury. Predicting course of recovery and outcome for patients admitted to rehabilitation. Arch Neurol. 1994 Jul;51(7):661-70
Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992 Sep;40(9):922-35
Sandhaug M Andelic N, Bernsten SA, Seiler S, Mygland A. Functional level during the first year after moderate and severe Traumatic Brain Injury: Course and Predictors of Outcome. J Neurol Res 2011.1(2): 48-58
J T L Wilson, L E L Pettigrew, G M Teasdale. Emotional and cognitive consequences of head injury in relation to the Glasgow outcome scale. J Neurol Neurosurg Psychiatry 2000 Aug;69:(2);204-209
Cicerone KD, Dahlberg C, Kalmar K et al. Evidence based cognitive rehabilitation: recommendations for clinical practice. Arch Phys med Rehabil. 2000 Dec;81(12):1596-615
Cicerone KD, Dahlberg C, Malec JF et al. Evidence based cognitive rehabilitation: updated review of literature from 1998 through 2002. Arch Phys med Rehabil. 2005 Aug;86(8):1681-92.
Gordon WA, Zafonite R, Cicerone K, Cantor J, Brown M, Lombard L, Goldsmith R, Chandan T. Traumatic brain injury rehabilitation: state of the science. Amer J Phys Med Rehabil. 2006; 85(4): 345-82
Halligen PW, wade DT, (Eds.). Effectiveness of rehabilitation for cognitive deficits. Oxford university press 2005
Cowen TD, Meythaler JM, DeVivo MJ, Ivie CS 3rd, Lebow J, Novack TA. Influence of early variables in traumatic brain injury on functional independence measure scores and rehabilitation length of stay and charges. Arch Phys Med Rehabil. 1995 Sep;76(9):797-803
The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care. Glasgow coma scale score. J Neurotrauma 2000;17(6-7):563-571
Dikmen SS, Ross BL, Machamer JE, Temkin NR. One year psychosocial outcome in head injury. J Int Neuropsychol Soc 1995;1(1):67-77
Sherer M, Struchen MA, Yablon SA, Wang Y, Nick TG. Comparison of indices of traumatic brain injury severity: Glasgow Coma Scale, length of coma and post-traumatic amnesia. J Neurol Neurosurg Psychiatry 2008;79(6):678-685
Ariza M, Mataro M, Poca MA, Junque C, Garnacho A, Amoros S, Sahuquillo J. Influence of extraneurological insults on ventricular enlargement and neuropsychological functioning after moderate and severe traumatic brain injury. J Neurotrauma 2004;21(7):864-876
Katz DI, Alexander MP. Traumatic brain injury. Predicting course of recovery and outcome for patients admitted to rehabilitation. Arch Neurol 1994;51(7):661-670
Kleim JA, Hogg TM, VandenBerg PM, Cooper NR, Bruneau R, Remple M. Cortical synaptogenesis and motor map reorganization occur during late, but not early, phase of motor skill learning. J Neurosci. 2004 Jan 21;24(3):628-33
Laatsch LK, Thulborn KR, Krisky CM, Shobat DM, Sweeney JA. Investigating the neurobiological basis of cognitive rehabilitation therapy with fMRI. Brain Inj. 2004 Oct;18(10):957-74
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186