摘要:

Objectives:To determine a set of variables that would reliably predict duration of posttraumatic amnesia (PTA) in patients with traumatic brain injury and to test the efficacy of the model.Design:Simultaneous standard multiple regression analyses.Participants:Two independent samples of patients with traumatic brain injury who were in the early stages of PTA: a test sample (n= 61) and a cross-validation sample (n= 25).Main Outcome Measure:The Modified Oxford PTA Scale (MOPTAS) is a 12-item test measuring orientation (8 items) and anterograde memory (4 items). The Galveston Orientation and Amnesia Test (GOAT) was also used on a subset of the test sample.Procedure:Patients were examined daily until they emerged from PTA.Results:A statistically significant model, using three predictor variables, was derived that reliably predicted duration of PTA, accounting for 89% of the variance. A second model, using two predictor variables readily available to the clinician (day posttrauma on which PTA testing began and aggregate PTA scores over the first 5 days of testing) had comparable predictive accuracy. A third model, using GOAT data, was also statistically significant and successfully accounted for 72% of the variance. The MOPTAS model showed excellent application to an independent (validation) sample, with an intraclass correlation coefficient between observed and predicted durations of PTA of 0.95. Regression equations for all three models are provided to enable calculation of the predicted duration of PTA.Conclusions:These models can be readily applied in clinical practice and will provide clinically useful estimates of the duration of PTA within the first week of testing after admission to rehabilitation. This information will be important in terms of family counseling and planning of rehabilitation programs.

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Objective:To investigate correlates of life satisfaction after traumatic brain injury (TBI).Design:Prospective, longitudinal study of patients with TBI studied 1 and 2 years after injury.Setting:A specialized inpatient TBI rehabilitation unit in a midwestern academic medical center.Subjects:Two hundred eighteen consecutive patients admitted for rehabilitation, at least 14 years of age, with a primary diagnosis of TBI, consented to participate, and interviewed 1 and/or 2 years after injury (112 interviewed both years, 58 at year 1 only, 48 at year 2 only).Main Outcome Measures:Satisfaction With Life Scale.Results:Stepwise multiple regressions accounted for statistically significant, but small, proportions of variance. Not having a preinjury history of substance abuse and having gainful employment at the time of follow-up were associated with higher life satisfaction both 1 and 2 years after injury. Motor independence at rehabilitation discharge was also associated at 1 year. Current social integration and the absence of depressed mood were associated at 2 years. Life satisfaction was relatively stable between years. Change that did occur was associated with marital status and depressed mood 2 years after injury.Conclusions:Life satisfaction after TBI seems to be related to attaining healthy and productive lifestyles. Future research should investigate other factors that affect life satisfaction to increase prediction and appreciate all influences on subjective well being after TBI.

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Objective:To identify social, neuroradiological, medical, and neuropsychological correlates of sexually aberrant behavior (SAB) after traumatic brain injury (TBI).Design:A controlled study using a retrospective file review.Setting:A brain injury unit providing inpatient and outpatient rehabilitation services.Participants:A sample of males (n= 25) exhibiting SABs and a control group (n= 25) matched for gender, severity of injury, age at injury, and time after injury.Main Outcome Measures:A protocol that recorded data on demographic, injury, radiological, medical, and neuropsychological variables.Results:The SAB group had a significantly higher incidence of postinjury psychosocial disturbance in areas of nonsexual crime and failure to return to work than the matched TBI group. There were no significant differences between the two groups in the incidence of premorbid psychosocial disturbance or postinjury radiological, medical, or neuropsychological variables.Conclusions:The study results caution against simplistic explanations of SAB as the product of damage to the frontal-lobe systems or premorbid psychosocial disturbance. Furthermore, the results suggest that a wide-ranging assessment of people with TBI who exhibit SABs is required, because results of neuropsychological examination alone cannot be considered conclusive. Future research into the etiology of SABs could examine additional factors such as lack of insight, lack of empathy, and premorbid history of family dysfunction.

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Objectives:To investigate spontaneous facial behavior during social interaction in children with acquired brain injury (ABI), and to explore possible links between ABI, facial expressivity, and caregiver-reported social competence.Design:Between-group comparisons usingttests, within-group comparisons using correlational analyses, correlational analyses of independent variables and outcome measures.Participants:Sixteen school-aged children with ABI and 32 normally developing children of comparable age and gender.Main Outcome Measure:Aspects of facial expressivity derived from coding scheme designed for this study.Results:Children with ABI were less expressive overall and tended to shift expressions less often than normally developing children. Several measures of expressivity were correlated with measures of social competence.Conclusions:Brain injury inhibits production of some aspects of spontaneous facial expression. Results are suggestive of links between facial behavior and social skills.

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Objective:To assess depressive symptoms, self-concept, and behavior in non-affected siblings of children with severe pediatric traumatic brain injury (TBI).Design:Cross-sectional study with case controls.Setting:Children's hospital tertiary care center.Participants:Twelve siblings of children consecutively admitted to an inpatient rehabilitation unit after a severe TBI. Case controls were randomly selected from the sibling's classmates.Main Outcome Measures:The Child Behavior Checklist (CBCL), the Teacher's Report Form of the CBCL (TRF-CBCL), the Self-Perception Profile for Children and the Children's Depression Inventory (CDI).Results:No statistical differences were found in depressive symptoms, self-concept, or behavior between the siblings and their classmates 3 to 18 months after injury. Poorer functional outcomes in the child with a TBI were found to correlate significantly with lower self-concept and more symptoms of depression in the siblings.Conclusions:Further research is needed to evaluate the potential impact on sibling adjustment after pediatric TBI.

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Objective:This case study reviews the preinjury and postinjury balance performance of an 11-year-old child who sustained a mild head injury.Design:A prospective design was used to document balance 5 days before injury and 1, 4, and 12 weeks after injury.Outcome Measures:The assessments used were the balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency, the Pediatric Clinical Test of Sensory Interaction for Balance, and the Postural Stress Test.Results:One week after the trauma, balance deficits were observed in the three tests. The deficits improved 4 weeks after the injury, and performance remained stable over the following 2 months for two of the evaluations except for the Postural Stress Test performance, which failed to improve in the 3-month period after trauma.Conclusions:The good recovery of balance skills observed over the first month after injury seems to validate the current activity restrictions imposed on children after a mild head injury. However, the persistence of poor performance in the area of reactions to external perturbations indicates that some deficits may persist beyond what is expected with this population.

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2001

数据来源: OVID