Co-Occurring Traumatic Brain Injury and Acute Spinal Cord Injury Rehabilitation Outcomes
Co-Occurring Traumatic Brain Injury and Acute Spinal Cord Injury Rehabilitation Outcomes
复制标题
DOI：
10.1016/j.apmr.2012.01.022
复制
发表时间：
2012-10-01
影响因子：
4.3
通讯作者：
Barlow, Kimether
中科院分区：
文献类型：
--
作者：
Macciocchi, Stephen;Seel, Ronald T.;Barlow, Kimether
张文良，张文良.合并创伤性脑损伤和急性脊髓损伤的康复结局。Arch Phys Med Rehabil 2012;93：1788- 94.目的：确定急性脊髓损伤（SCI）康复期间合并创伤性脑损伤（TBI）对功能运动结果和认知的影响。设计：前瞻性纵向队列。设置：国家残疾和康复研究所SCI模型系统的单中心。参与者：在18个月的招募窗口期内，符合入选标准的16至59岁的患者（N = 189）入院接受急性SCI康复治疗。干预措施：不适用。主要结果指标：FIM运动量表（Rasch转换）和急性康复住院时间（LOS）。在四肢瘫痪的样本中，同时发生的TBI与ESTA运动量表评分或急性康复LOS无关，尽管对记忆和解决问题有负面影响。与没有TBI或轻度TBI的截瘫患者相比，持续并发严重TBI的截瘫患者的入院和出院时运动量表评分较低，急性康复LOS较长。与截瘫和无TBI、轻度TBI和中度TBI的人相比，截瘫和重度TBI的人在处理速度测试中的功能理解、解决问题和记忆力以及损伤较低。人与截瘫和并发症的轻度和中度TBI有相当的急性康复运动的结果和认知功能与截瘫和没有TBI.Conclusions的人相比：这项研究提供的证据表明，16至59岁的人与截瘫和并发症的严重TBI有更差的运动结果和更长的急性康复LOS比截瘫和没有TBI的人。处理速度、理解力、记忆力和解决问题能力的损伤可以解释次优运动技能的获得。需要更大样本的研究来确定轻度和中度TBI是否影响急性康复运动结果和LOS。
Macciocchi S, Seel RT, Warshowsky A, Thompson N, Barlow K. Co-occurring traumatic brain injury and acute spinal cord injury rehabilitation outcomes. Arch Phys Med Rehabil 2012;93:1788-94.Objective: To determine the impact of co-occurring traumatic brain injury (TBI) on functional motor outcome and cognition during acute spinal cord injury (SCI) rehabilitation.Design: Prospective, longitudinal cohort.Setting: Single-center National Institute of Disability and Rehabilitation Research SCI Model System.Participants: Persons aged 16 to 59 years (N = 189) admitted for acute SCI rehabilitation during the 18-month recruitment window who met inclusion criteria.Interventions: Not applicable.Main Outcome Measures: FIM Motor Scale (Rasch transformed) and acute rehabilitation length of stay (LOS).Results: In the tetraplegia sample, co-occurring TBI was not related to FIM Motor Scale scores or acute rehabilitation LOS despite having negative impacts on memory and problem solving. Persons with paraplegia who sustained co-occurring severe TBI had lower admission and discharge FIM Motor Scale scores and longer acute rehabilitation LOS than did persons with paraplegia and either no TBI or mild TBI. Persons with paraplegia and severe TBI had lower functional comprehension, problem solving, and memory and impairments on tests of processing speed compared with persons with paraplegia and no TBI, mild TBI, and moderate TBI. Persons with paraplegia and co-occurring mild and moderate TBI had equivalent acute rehabilitation motor outcomes and cognitive functioning compared with persons with paraplegia and no TBI.Conclusions: This study provides evidence that persons aged 16 to 59 years with paraplegia and co-occurring severe TBI had worse motor outcomes and longer acute rehabilitation LOS than did persons with paraplegia and no TBI. Impairments in processing speed, comprehension, memory, and problem solving may explain suboptimal motor skill acquisition. Research with larger samples is required to determine whether mild and moderate TBI impact acute rehabilitation motor outcomes and LOS.