Trauma & Critical Care

Biography

Biography: Linda L. Herrmann

Abstract

This study describes the impact of modifiable variables (discharge destination and intensity of rehabilitation) on early functional recovery of adults 65 and older following mild and moderate traumatic brain injury (TBI). Previous studies demonstrate that greater intensity of inpatient rehabilitation in TBI patients contribute to improved rates of functional recovery; however, studies are limited by exclusion of/limited number of adults over age 65, and inclusion of patients who only received rehabilitation in the inpatient setting. Functional recovery was measured by clinician rated functional independence measure (FIM^TM) and by participant self-report using the river mead head injury follow up questionnaire (RHFUQ). The sample consisted of 70 community dwelling adults aged 65 and older hospitalized for a mild or moderate TBI. A descriptive longitudinal cohort design was used to explore discharge destination and trajectory of early functional recovery; intensity of rehabilitative services and their relative contribution to early functional recovery at two and six weeks post discharge. Correlations, regression, and repeated measures analysis of covariance (ANCOVA) were used. Major findings from this study indicate that intensity of rehabilitation significantly and positively affected the trajectory of recovery of motor function over time; greater improvement in motor and cognitive function was noted in the high intensity group; and, patterns of self-reported difficulties varied by intensity of rehabilitation. Severity of TBI and presence of co-morbidities were significant predictors of discharge destination to home or skilled nursing facility. The trajectory of recovery of motor function and self-reported difficulties in older adults following mild and moderate TBI is significantly affected by intensity of rehabilitation. Additional research is necessary to examine rehabilitation intensity as it occurs in all settings and its longitudinal effect on the trajectory of motor, cognitive and psychosocial recovery and are essential if losses are to be integrated meaningfully into a person’s daily life.