Archive for category TBI



“Brain injury can last a lifetime, but it doesn’t have to cost a lifetime.”
– Anonymous person with a brain injury

Living with a brain injury can require a range of resources, strategies and supports. The range of possible supports can be tremendous. This page hopes to offer links to articles and information about the supports and resources that are available to people with brain injury and their families to assist them.

Below is a list of common issues that can arise, with links to publications and/or other website with useful information. If you know of additional information or resources, or find something missing, please feel free to contact us to let us know.  Also look in the BIAA Marketplace for additional resources, including personal accounts, webinars and more.

Alternative Medicines
Challenge Issue on Alternative Medicine
National Insitutes of Health Alternative Medicine Information
Brain Injury Association Caregiver Webinar on Alternative Medicine

Assistive Technology
Assistive Technology Tip Card
Assistive Technology Checklist for PDA’s
Resources for Finding and Funding AT Devices
Family Caregivers article on Assistive Technology
    What Are Your Options to Pay for Assistive Devices?

Behavioral Challenges
Road to Rehabilitation Part 4 – Behavior and Brain Injury
Cognition and Behavior
Behavioral Guidelines
Emotional Issues After Brain Injury

Caregiver/Family Stress
    Family Caregiver Alliance
Brain Injury is a Family Affair
Caregiver Planning Tool
Family News and Views Letting Go
Tips for Dealing with Stress
Changes, Choices, Challenges- A Guide for Families to Brain Injury Rehabilitation
Impact of Brain Injury on the Family and How They Can Help

Children and Brain Injury
    See the Children’s Page
Challenge Issue on Children and Brain Injury
Return to School After Brain Injury

Cognition and Memory
     Road to Rehabilitation Part 3- Cognition and Memory
Family News and Views: Cognition is the Key
Family News and Views Neuropsychological Assessment
Organizing Daily Life After Brain Injury
Cognitive Problems After Brain Injury
Brain Injury Association Cognitive Stimulation Resource Guide

College/Return to School
Young Adults with Brain Injury and College
Life After High School
Return to School After Brain Injury
TBI Model Systems Research: Return to Work After Brain Injury

     Depression and Brain Injury
Overcoming Loneliness
Depression After Brain Injury
TBI Model Systems Research: Depression and Brain Injury

    Driving After Brain Injury
Return to Driving After Brain Injury

Employment After Brain Injury
    Challenge Winter 2011 Issue Return to Work

Falls and Brain Injury

Fatigue and Brain Injury

Financial Issues
    Financial Resources for Students with Brain Injury
College Funding Information for Students with a Disability

    Road to Rehabilitation #2- Headaches
Headaches After Brain Injury

    Navigating The Insurance Maze After Brain Injury

Legal Issues
Guide to Selecting Legal Representation
Legal Glossary
Brain Injury Association webinar on Special Needs Trusts

Road to Rehabilitation #6 – Medications and Brain Injury
Brain Injury Association Webinar on Medication and Brain Injury

Road to Rehabilitation #1- Pain

Research/Clinical Trials
Guide to Participating in Clinical Trials
Abstracts of TBI Model Systems Research
Knowledge Translation Center of TBI Model Systems
    THE Challenge! newsletter issue on research (summer 2009)

Seizures and Brain Injury
Epilepsy Information

Severe Brain Injury
    Facts About Severe Brain Injury
A Physician Talks About Severe Brain Injury
Facts About the Vegetative and Minimally Conscious States After Brain Injury

Family News and Views Sexuality and Brain Injury
Sexuality and Brain Injury

Sleep disturbances after brain injury
Brain Injury Association webinar on Sleep and Brain Injury

Spasticity Alliance: An Educational Website About Spasticity
Spasticity After Brain Injury

    Road to Rehabilitation #5- Speech and Communication
Challenge Spring 2011 issue on Communication

Substance Abuse
Substance Abuse and Brain Injury
Substance Abuse Information from the Ohio Valley Center
TBI Model Systems Research: Substance Abuse and Brain Injury
Model Systems Knowledge Translation Center presentation on Substance Abuse and Brain Injury

Taste and Smell
Taste and Smell issues after brain injury
Taste and Smell Disorders
    Taste and Smell Information

Vestibular Fact Sheet

    Vision and Brain Injury
Vision issues post injury


Source: Brain Injury Resources


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[WEB SITE] TBI Basics – BrainLine

A TBI can happen to anyone, whether it happens while playing sports, at work, or just slipping on an icy sidewalk. Injuries can range from “mild” to “severe”, with a majority of cases being concussions or mild TBI. The good news is that most cases are treatable and there are several ways to help prevent injury.

What You’ll Find Here

You Are Not Alone

You Are Not Alone

See how others are navigating their post-TBI lives. Check out personal stories and “life after TBI” blogs, or join the conversation with our Facebook community.

Source: TBI Basics | BrainLine

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[Dissertation] Perceived Self-Efficacy in Individuals with Moderate-to-Severe Brain Injury: The Effects of Rehabilitation Outcomes and Depression – Full Text PDF


Brain injury represents a major public health issue in the United States, accounting for a largely underestimated figure of 2.5 million cases in 2010. The pervasive effects of this chronic medical condition contribute to a growing economic burden, as the physical, cognitive, behavioral, and emotional sequelae of brain injury demand long-term care for those with moderate-to-severe brain injuries. The Centers for Disease Control and Prevention recently proposed new recommendations for improvements in monitoring the incidence of and research on brain injury. The goals of this public health initiative are to better inform health service delivery and ultimately improve quality of life for those affected, as well as their loved ones.
In addition to improved quality of life, community reintegration is a primary goal
of brain injury rehabilitation. Engagement in rehabilitation is largely dependent upon an individual’s level of impairment, as well as other personal factors. For example, research examining the relationship between targeted interventions and community participation has established support for the protective effects of self-efficacy, or personal belief in one’s abilities to achieve a desired goal. Additional research on the importance of selfefficacy to psychological health has provided further support for the protective effects of this construct against depression and anxiety. Therefore, further research into the relationship between rehabilitation outcomes, psychological health, and self-efficacy is necessary to inform recommendations for improving health service delivery and quality of life for this vulnerable population.

The aim of the present study is to examine factors that may be related to self
efficacy in persons with moderate-to-severe brain injury who receive treatment at along term post acute brain injury program. The implications of this research include baseline assessment of self-efficacy in this sample that could potentially inform future staff training and overall clinical practice geared towards cultivating self-efficacy in persons with brain injury. The primary limitations of this study are its small sample size and constrained external validity. Despite these limitations, more research is necessary to understand the role of psychological protective factors in brain injury rehabilitation and to inform strategies for improved health service delivery and increased quality of life.

Full Text PDF 


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[ARTICLE] Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review – Full Text



Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians.


In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time.


Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included.


In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus.


The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke.

Continue —> PLOS ONE: Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

Fig 2. Frequency of use of different upper limb outcome measures (in % of studies). Frequency of use varies widely, between 36% and 1%. Only 15 measures were used in more than 5% of studies (dotted line). The 48 outcome measures are in alphabetic order: AMAT = Arm Motor Ability Test, ARAT = Action Research Arm Test, Ashworth = Ashworth scale, BBT = Box and Blocks Test, CAHAI = Chedoke Arm Hand Inventory, CMSA = Chedoke McMaster Stroke Assessment, COPM = Canadian Occupational Performance Measure, DAS = Disability Assessment Scale, DTI = Diffusion Tensor Imaging, EMG = Electromyography, FAT = Frenchay Arm Test, FC = Force Control, fMRI = Functional Magnetic Resonance Imaging, FMT = Fugl-Meyer Test, FTHUE = Functional Test for the Hemiplegic Upper Extremity, FTT = Finger Tapping Test, GOT = Grating Orientation Task, GRT = Grasp Release Test, HFS = Hand Function Survey, HFT = Hand Function Test, JTHT = Jebsen Taylor Hand Test, KIN = Kinematics, MAL = Motor Activity Log, MAM36 = Manual Ability Measurement 36, MAS = Motor Assessment Scale, MHS = Mini Hand Score, MI = Motricity Index, MMDT = Minnesota Manual Dexterity Test, NHPT = Nine Hole Peg Test, NSA = Nottingham Sensory Assessment, PT = Pegboard Test, RELHFT = Rehabilitation Engineering Laboratory Hand Function Test, RMA = Rivermead Motor Assessment, ROM = Range of Movement, SHFT = Shollerman Hand Function Test, SHPT = Sixteen Hole Peg Test, SIAS = Stroke Impairment Assessment Set, SMES = Sodring Motor Evaluation Scale, SSDI = Standardized Somatosensory Deficit Index, STEF = Simple Test for Hand Function, TDT = Tactile Discrimination Test, TMS = Transcranial Magnetic Stimulation, TS = Tardieu Scale, UEFT = Upper Extremity Function Test, ULIS = Upper Limb Impairment Scale, VAS = Visual Analogue Scale, VFHT = Von-Frey Hair Test, WMFT = Wolf Motor Function Test.


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[WEB SITE] Research Reports – Psychotropic medication use during rehabilitation for traumatic brain injury

Research Reports – Psychotropic medication use during rehabilitation for traumatic brain injury


OBJECTIVE: To describe psychotropic medication administration patterns during
inpatient rehabilitation for traumatic brain injury (TBI) and their relation to
patient preinjury and injury characteristics.

DESIGN: Prospective observational cohort.

SETTING: Multiple acute inpatient rehabilitation units or hospitals.

PARTICIPANTS: Individuals with TBI (N=2130; complicated mild, moderate, or
severe) admitted for inpatient rehabilitation.

INTERVENTIONS: Not applicable.


RESULTS: Most frequently administered were narcotic analgesics (72% of sample),
followed by antidepressants (67%), anticonvulsants (47%), anxiolytics (33%),
hypnotics (30%), stimulants (28%), antipsychotics (25%), antiparkinson agents
(25%), and miscellaneous psychotropics (18%). The psychotropic agents studied
were administered to 95% of the sample, with 8.5% receiving only 1 and 31.8%
receiving ≥6. Degree of psychotropic medication administration varied widely
between sites. Univariate analyses indicated younger patients were more likely to
receive anxiolytics, antidepressants, antiparkinson agents, stimulants,
antipsychotics, and narcotic analgesics, whereas those older were more likely to
receive anticonvulsants and miscellaneous psychotropics. Men were more likely to
receive antipsychotics. All medication classes were less likely administered to
Asians and more likely administered to those with more severe functional
impairment. Use of anticonvulsants was associated with having seizures at some
point during acute care or rehabilitation stays. Narcotic analgesics were more
likely for those with history of drug abuse, history of anxiety and depression
(premorbid or during acute care), and severe pain during rehabilitation.
Psychotropic medication administration increased rather than decreased during the
course of inpatient rehabilitation in each of the medication categories except
for narcotics. This observation was also true for medication administration
within admission functional levels (defined by cognitive FIM scores), except for
those with higher admission FIM cognitive scores.

CONCLUSIONS: Many psychotropic medications are used during inpatient
rehabilitation. In general, lower admission FIM cognitive score groups were
administered more of the medications under investigation compared with those with
higher cognitive function at admission. Considerable site variation existed
regarding medications administered. The current investigation provides baseline
data for future studies of effectiveness.

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