Abstract
BackgroundDelayed recovery in persons after mild traumatic brain injury (mTBI) is poorly understood. Community integration (CI) is endorsed by persons with neurological disorders as an important outcome. We aimed to describe CI and its associated factors in insured Ontario workers with delayed recovery following mTBI.MethodsA cross-sectional study of insured workers in the chronic phase following mTBI was performed at a rehabilitation hospital in Ontario, Canada. Sociodemographic, occupational, injury-related, clinical, and claim-related data were collected from self-reports, medical assessments, and insurers’ referral files. Community Integration Questionnaire (CIQ) scores were compared using analysis of variance or Spearman’s correlation tests. Stepwise multivariable linear regression models were used to evaluate the associations with CI.ResultsNinety-four workers with mTBI (45.2 ± 9.9 years old, 61.2 % male) at 197 days post-injury (interquartile range, 139–416 days) were included. The CIQ total and subscale scores were similar to those reported in more severe TBI samples. The CIQ scores were moderately to strongly correlated with various sociodemographic, claim-related, and clinical variables. In the multivariable regression analysis, several covariates accounted for 36.4 % of the CIQ variance in the final fully adjusted model.DiscussionThis study evaluated CI in workers with mTBI, and analyzed its associated variables. Analysis revealed insomnia, head or neck pain, being married or in a relationship, time since injury, and a diagnosis of possible/probable malingering were independently associated with limited CI.ConclusionsWorkers with delayed recovery from mTBI experience difficulty with CI. Insomnia is a particularly relevant covariate, explaining the greater part of its variance. To enhance participation, care should focus on clinical and non-clinical covariates.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-015-0432-z) contains supplementary material, which is available to authorized users.
Highlights
Delayed recovery in persons after mild traumatic brain injury is poorly understood
Given the complexity of Community integration (CI), we developed a model of CI for persons with Traumatic brain injury (TBI) to investigate the following hypotheses among workers with delayed recovery from mild traumatic brain injury (mTBI) (Fig. 1): (1) CI would be poor; (2) insomnia would be negatively associated with CI; (3) previously reported clinical and claim-related variables [27,28,29,30] would be associated with CI; and (4) previously unexplored psychosocial variables would be associated with CI
In this study of 94 workers with mTBI, we found that insomnia, head or neck pain, being married or in a relationship, Time since injury (TSI), and a diagnosis of possible/probable malingering were independently associated with limited CI
Summary
Delayed recovery in persons after mild traumatic brain injury (mTBI) is poorly understood. Severe, and penetrating TBIs are associated with the most adverse effects [9,10,11,12,13,14], the effects of mild TBI (mTBI) have recently Many of these symptoms are not specific to TBI [22], and while the list is long, insomnia, the inability to sleep adequately at night given the opportunity [23],has been recognized as extremely important for explaining many of these symptoms in the general population, including. Unnecessary clinical and diagnostic investigations may be ordered to assist the parties in their decision making These investigations typically focus on variables that are derived from three predictive models for adverse mTBI outcomes. A focus on identifying more specific outcome measures was suggested for future research [27]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
