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Dissertation
Functional Outcome in Chronic Traumatic Brain Injury: Goal Attainment in Rehabilitation
Doctor of Philosophy (Ph.D.), Drexel University
Jun 2021
DOI:
https://doi.org/10.17918/00000710
Abstract
Traumatic brain injury (TBI) is a disease process, rather than a single discrete event. Individuals with TBI experience variable sequelae and treatment needs across the acute, post-acute, and chronic stages after injury. It is estimated that 40% of individuals with a moderate to severe TBI will live with long-term disability. The lifetime direct and indirect costs of TBI are estimated to exceed $70 billion. This is a significant public health concern, and the patterns of recovery and decline in chronic TBI are important to study. Thus, the aims of the current study are to identify the predictors of goal attainment in rehabilitation, examine the relationship between goal attainment and other long-term sequelae of TBI in the chronic stage, and examine the trajectory of cognitive function. 70 individuals with chronic TBI participating in day/residential rehabilitation treatment at Bancroft NeuroRehab were examined. The majority had sustained a TBI with loss of consciousness. A subsample of 8 completed behavioral/social measures, and a subsample of 25 had longitudinal cognitive screener data over an 8 year period. Results of the study suggest that Speech Therapy goal attainment is predicted by time since injury, and may be related to attention. Occupational Therapy goal attainment was not predicted by premorbid/injury-related variables, but was predicted by judgment ability. Finally, Physical Therapy was not predicted by premorbid/injury-related variables, but may be related to attention. Small sample size may limit these predictions. Additionally, sleep quality was strongly related to overall goal attainment, which represents an area for additional intervention in chronic TBI. Finally, there were no significant cognitive changes observed over an 8 year period. Future research should replicate these findings, as they can aid in treatment planning for individuals with chronic TBI, inform recommendations made in earlier stages, and help set expectations for individuals with TBI and their caregivers at all stages.
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Details
- Title
- Functional Outcome in Chronic Traumatic Brain Injury
- Creators
- Jillian M. Tessier
- Contributors
- Maria Teresa Schultheis (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- x, 99 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 991015080449304721