Posts Tagged Traumatic Brain Injury

[WEB SITE] A Brief Program May Help People Build Resilience After a Traumatic Brain Injury – National Rehabilitation Information Center


study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

A traumatic brain injury (TBI) is lasting brain damage resulting from an external force, such as a fall or a car accident. People with TBI may have challenges managing stress, thinking and remembering things, or communicating with others. Resilience is the ability to adapt positively to traumatic events and being resilient can help people manage these challenges and adjust to life changes after a TBI. Past research has found that people can become more resilient by learning and practicing coping skills.

In a recent NIDILRR-funded study, researchers tested a new program called the Resilience and Adjustment Intervention (RAI). The RAI program is designed to help build resilience for people with TBI. They wanted to find out if the program would lead to higher resilience, fewer emotional challenges, or lower stress for people with TBI. They also wanted to find out if the benefits of the program could last over a 3-month period.

Researchers at the Virginia Commonwealth University Traumatic Brain Injury Model System Center enrolled 160 people with TBI in a study. The participants were adults over the age of 18, and all had their TBI for at least three months before beginning the study. The participants were randomly divided into two groups: an experimental group who participated in the RAI Program and a comparison group who did not receive any services during the study (but were given the opportunity to receive the intervention after the study was complete).

Each participant in the experimental group had 7 one-hour sessions with a therapist in an outpatient clinic over a five-week period. Participants were also given worksheets and reading materials to complete at home between sessions and were asked to discuss these materials with family and friends. Each session covered a different topic related to resilience and TBI as follows:

  1. Learning about common life changes after a TBI;
  2. Discussing how to take an active role in TBI recovery;
  3. Goal setting and defining success in a flexible way;
  4. Learning how to solve problems and overcome challenges;
  5. Managing stress and difficult emotions;
  6. Communication skills, building relationships, and talking to others about TBI; and
  7. Having a positive outlook on life and overcoming negative thinking.

The participants in both the experimental and comparison groups completed questionnaires at the beginning of the study and either after the final session (experimental group) or about five weeks after starting the study (comparison group). The participants in the experimental group completed the questionnaires a third time about three months after the end of the program. The questionnaire included questions asking how often the participants felt resilient (e.g., “coping with stress can strengthen me”); how they rated themselves on problem-solving and communication skills; and how much they experienced emotional challenges (such as anxiety or depression) or feelings of being stressed or overwhelmed.

The researchers found that the participants in the experimental group reported feeling more resilient, improving their communication and problem-solving skills, and feeling fewer emotional challenges and less stress at the end of the study than at the beginning of the study. For example, the participants’ resilience scores increased by an average of 35%, and their stress scores decreased by an average of 33%. These improvements were maintained three months after the end of the study. In contrast, the participants in the comparison group showed only very small changes in their resilience, skills, emotional challenges, and stress levels.

The authors noted that resilience may play a key role in helping people adjust to challenges after a TBI. Although the stresses of having a TBI can challenge resilience, people can improve their resilience by learning and practicing specific skills. The participants in this study showed improvements in their emotional health and problem-solving skills after only seven brief sessions. Future research may be useful to explore other ways for people with TBI to build their resilience, including long-distance or group-based programs.

To Learn More

The Model Systems Knowledge Translation Center (MSKTC) develops and curates TBI resources from the Model Systems, including factsheets, video modules, and the innovative TBI InfoComics series. offers a wealth of resources on TBI for survivors, family members and caregivers, military personnel, and professionals, including articles from researchers, survivors, and supportive organizations. These include:

For professionals who work with individuals with TBI, the Resilience and Adjustment Intervention (RAI) is available through the National Resource Center for TBI. Learn more about its development and frequently asked questions, including how to receive training on using the RAI with clients with TBI.

To Learn More About This Study

Kreutzer, J.S., Marwitz, J.H., Sima, A.P., Mills, A., Hsu, N.H. & Lukow II, H.R., (2018) Efficacy of the resilience and adjustment intervention after traumatic brain injury: A randomized controlled trial. Brain Injury, 32(8), 963-971. This article is available from the NARIC collection under accession number J79743.

Date published:

via A Brief Program May Help People Build Resilience After a Traumatic Brain Injury | National Rehabilitation Information Center

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[WEB SITE] Top 30 Traumatic Brain Injury Blogs and Websites To Follow in 2018

Traumatic Brain Injury Blogs List.
The Best Traumatic Brain Injury blogs from thousands of Traumatic Brain Injury blogs in our index using search and social metrics. We’ve carefully selected these websites because they are actively working to educate, inspire, and empower their readers with frequent updates and high-quality information.

Traumatic Brain Injury Blogs

1. Traumatic Brain Injury and Head Trauma Blog

Traumatic Brain Injury and Head Trauma BlogAbout Blog Discover the latest news, treatment, and concerns for individuals suffering from traumatic brain and head injuries.
Frequency about 1 post per week.
Since Jul 2005
Facebook fans 374. Twitter followers 818.View Latest Posts ▸


2. Broken Brain – Brilliant Mind

Broken Brain – Brilliant MindAbout Blog This blog is written by TBI blogger who is a multiple-concussion survivor, now living large, living well, and sharing info about how to restore your life and sense of self after brain injury.
Frequency about 3 posts per week.
Since Dec 2007
Facebook fans n/a. Twitter followers 1,193.View Latest Posts ▸


3. Traumatic Brain Injury Law Blog | Brain Injury Lawyer & Attorney | Stark & Stark Law Firm

Traumatic Brain Injury Law Blog | Brain Injury Lawyer & Attorney | Stark & Stark Law FirmPrinceton, New JerseyAbout Blog This law blog provides news & commentary on brain injury legal developments. Topics include personal injury claims, concussions and compensation for brain injuries.
Frequency about 1 post per month.
Since Feb 2003
Facebook fans 2,112. Twitter followers 1,145.View Latest Posts ▸


4. Brain Injury Blog With Free TBI Information

Brain Injury Blog With Free TBI InformationYoungsville, North CarolinaAbout Blog Leading publisher of brain injury books, resources and information about traumatic brain injury, concussions, and post traumatic stress disorder PTSD.
Frequency about 1 post per month.
Since Jul 2008
Facebook fans 1,047. Twitter followers 180.View Latest Posts ▸


5. Kara Swanson’s Brain Injury Blog | Rock This Life!

Kara Swanson's Brain Injury Blog | Rock This Life!About Blog Get all information about brain injury from Kara Swanson’s Brain Injury Blog.
Frequency about 1 post per month.
Since Dec 2008
Facebook fans n/a. Twitter followers n/a.View Latest Posts ▸


6. Brain Injury Law Center | Brain Injury Blog – Stephen Smith

Brain Injury Law Center | Brain Injury Blog - Stephen SmithHampton, VAAbout Blog The Brain Injury Law Center are the brain injury lawyers dedicated exclusively to representing brain injury victims, survivors and their families. This blog talks about experienced attorney who helps you to seek compensation to alleviate the emotional and financial burdens this unwanted injury has placed on your family.
Frequency about 1 post per month.
Since Feb 2000
Facebook fans 1,433. Twitter followers 513.View Latest Posts ▸


7. Traumatic Brain Injury Blog

Traumatic Brain Injury BlogAbout Blog Helping people better understand the impact of brain injury and the remarkable work being done every day to improve our ability to diagnose brain injury, to treat brain injury, to prevent brain injury and to obtain compensation for brain injury caused by negligence.
Frequency about 1 post per month.
Since May 2013
Facebook fans n/a. Twitter followers n/a.View Latest Posts ▸


8. Reddit -Traumatic Brain Injury (TBI)

Reddit -Traumatic Brain Injury (TBI)San Francisco, CAAbout Blog This is a subreddit devoted to Traumatic Brain Injury (TBI). TBI’s are life changing injuries that are not fully understood. This is a subreddit to provide support to those who have suffered TBI’s, and to discuss these injuries and the ongoing effort to learn about these injuries.
Frequency about 2 posts per month.
Facebook fans 13. Twitter followers 548,308.View Latest Posts ▸


9. BrainLine | All About Brain Injury and PTSD

BrainLine | All About Brain Injury and PTSDWashington, DCAbout Blog Information and resources about treating and living with traumatic brain injury (TBI) and PTSD: research-based articles, videos, personal stories, expert Q&A, research updates and more for people living with brain injury, caregivers, family, friends, and professionals.
Frequency about 1 post per week.
Since Dec 2017
Facebook fans 59,971. Twitter followers 43,711.View Latest Posts ▸


10. Brain Energy Support Team – BEST Blog

Brain Energy Support Team - BEST BlogAbout Blog The mission of BEST is to provide support, advocacy, public awareness, education and socialization opportunities to individuals with a brain injury and their families.
Frequency about 5 posts per week.
Since Feb 2011
Facebook fans 730. Twitter followers 1,841.View Latest Posts ▸



BrainInjuryStories.orgAbout Blog Find stories of survival, inspiration, determination, and recovery from TBI survivor. In this blog you can also share your story to help others.
Frequency about 1 post per month.
Since Nov 2011
Facebook fans 1,481. Twitter followers n/a.View Latest Posts ▸


12. Pate Rehabilitation

Pate RehabilitationDallas, TXAbout Blog Articles and news updates on the latest in recovery techniques for MTBI and TBI, with a focus on brain injury rehabilitation blog items.
Frequency about 2 posts per week.
Facebook fans 942. Twitter followers 572.View Latest Posts ▸


13. Faces of TBI

Faces of TBISaint Paul, MNAbout Blog Amy Zellmer is a TBI (Traumatic Brain Injury) survivor and advocate. She is a voice for survivors and their caregivers, bringing awareness to the world.
Frequency about 1 post per month.
Since Jul 2015
Facebook fans n/a. Twitter followers 2,282.View Latest Posts ▸


14. Brain Injury Blog TORONTO | The blog of the Brain Injury Society of Toronto (BIST)

Brain Injury Blog TORONTO | The blog of the Brain Injury Society of Toronto (BIST)Toronto, OntarioAbout Blog From this blog one can get knowledge about brain injury and how to live life after brain surgery as people from all around the world share their personal experiences.
Frequency about 3 posts per month.
Since Jan 2011
Facebook fans n/a. Twitter followers 2,796.View Latest Posts ▸


15. No memory of the day that changed my life

No memory of the day that changed my lifeEast, EnglandAbout Blog My name is Michelle Munt and this is my story about surviving a brain injury and what I continue to learn about it. This is for other survivors and their loved ones, but also to raise awareness of what can happen to those in an accident. This invisible injury too often goes undiagnosed and it can be difficult to find information about it. I will talk about things that have helped me as I continue to recover and invite others to see if it works for them too.
Frequency about 2 posts per week.
Since Aug 2016
Facebook fans n/a. Twitter followers 3,384.View Latest Posts ▸


16. Brain Injury Group

Brain Injury GroupNationalAbout Blog A network of dedicated brain injury lawyers & professionals providing a gateway to support, information & advice for brain injured people & their families.
Frequency about 1 post per week.
Facebook fans 1,151. Twitter followers 4,933.View Latest Posts ▸


17. TryMunity

TryMunityMcKinney, TXAbout Blog The purpose of the TryMunity is peer support for those of us who suffered a life-changing tragedy. We are an web-based social networking site supporting TBI survivors and their families.
Frequency about 2 posts per month.
Since Aug 2012
Facebook fans 2,313. Twitter followers 826.View Latest Posts ▸


18. NR Times magazine | Brain injury news

NR Times magazine | Brain injury newsLondon, EnglandAbout Blog Neuro Rehab Times: News and insight on brain injuries and neurological conditions including stroke and MS.
Frequency about 2 posts per week.
Since Sep 2017
Facebook fans n/a. Twitter followers 179.View Latest Posts ▸


19. TBI Health

TBI HealthAbout Blog TBI Health provides a comprehensive range of physio, pain management and rehabilitation services across New Zealand.
Frequency about 1 post per month.
Since Mar 2016
Facebook fans 1,544. Twitter followers n/a.View Latest Posts ▸


20. The Silverlining Brain Injury Charity – Explore Our Blog

The Silverlining Brain Injury Charity - Explore Our BlogSurreyAbout Blog The Silverlining Charity brain injury blog. Exploring all aspects of our work and living a fulfilled life after brain injury.
Frequency about 1 post per month.
Since Sep 2016
Facebook fans 644. Twitter followers 876.View Latest Posts ▸


21. TBI to 100 Miles – From Crashing to Finishing – My Journey to Recover from Brain Injury

TBI to 100 Miles - From Crashing to Finishing - My Journey to Recover from Brain InjuryAbout Blog I suffered a brain injury on a cycling trip in 2015 and this blog is about my return to running ultramarathons, from 50k to 100 miles, my ongoing mental and physical struggles, my rehab, and my life with mTBI.
Frequency about 1 post per month.
Facebook fans n/a. Twitter followers n/a.View Latest Posts ▸


22. My Brain Injury

My Brain InjuryDenver, COAbout Blog My personal experience living with a TBI including alternative treatments like essential oils, acupuncture, massage and craniosacral therapy.
Frequency about 3 posts per month.
Since Jan 2017
Facebook fans 734. Twitter followers 1,825.View Latest Posts ▸


23. TBI Survivor

TBI SurvivorMaine, USAAbout Blog Blog of Jeff Sebell, Author and TBI Survivor. Committed to helping TBI Survivors acquire the tools and confidence to lead a fulfilled life.
Frequency about 1 post per month.
Since Dec 2013
Facebook fans n/a. Twitter followers 351.View Latest Posts ▸


24. Surviving Traumatic Brain Injury | TBI – Survivors, Caregivers, Family, and Friends

 Surviving Traumatic Brain Injury | TBI – Survivors, Caregivers, Family, and FriendsPhoenix, AZ areaAbout Blog This blog helps to get lot of information about brain injury as people share their real life experiences.
Frequency about 2 posts per month.
Since Mar 2014
Website survivingtraumaticbraininjur..
Facebook fans n/a. Twitter followers 559.View Latest Posts ▸


25. David’s Traumatic Brain Injury Blog

David's Traumatic Brain Injury BlogAbout Blog David is a survivor of traumatic brain injury. In this blog he shares his experiences and gives tips to help other brain injury survivors.
Frequency about 2 posts per week.
Since Aug 2012
Website surviving-brain-injury.blogs..
Facebook fans n/a. Twitter followers n/a.View Latest Posts ▸


26. Movements and Looks | Blog

Movements and Looks | BlogAbout Blog A Movimentos e Olhares is a non-profit association that was born as a result of a misfortune, Trauma Brain Skull Light, lived and told in the first person.Its mission is to support the rehabilitation and integration into the working life of patients who have suffered slight Brain Trauma through a multidisciplinary team. We develop our activity among patients and caregivers, primarily in the areas of Neuropsychological Assessment, Psychological Support, Cognitive Rehabilitation and Legal Support.
Frequency about 2 posts per month.
Facebook fans 883. Twitter followers n/a.View Latest Posts ▸


27. Sharing some Information and Thoughts on Head and Brain Injury

Sharing some Information and Thoughts on Head and Brain InjuryAbout Blog Craig likes to share knowledge and insights from his life experiences to try and help others through simple encouragement. He hopes that by sharing this information, it will help promote awareness of and also make some difference in those lives affected by brain (head) injury, what is often termed “the “silent epidemic”.
Frequency about 6 posts per week.
Since Jan 2011
Facebook fans n/a. Twitter followers n/a.View Latest Posts ▸



STEPPING STONES FOR TRAUMATIC BRAIN INJURYCypress, TXAbout Blog This blog was developed to share the journey of Ben from recovery from TBI.
Frequency about 1 post per month.
Since Jan 2013
Website steppingstonesfortbi.blogspo..
Facebook fans n/a. Twitter followers n/a.View Latest Posts ▸


29. Hope After Brain Injury | Non-Profit Organization

Hope After Brain Injury | Non-Profit OrganizationNew Hampshire, USAAbout Blog Hope after brain injury is a non-profit organization focused on providing hope and guidance for those with brain injuries.
Frequency about 1 post per month.
Since Sep 2012
Facebook fans 592. Twitter followers 38.View Latest Posts ▸


30. Serpe Firm | Virginia Brain Injury Attorney Lawyer

Serpe Firm | Virginia Brain Injury Attorney Lawyer VirginiaAbout Blog Read the latest Virginia brain injury lawsuits ans settlement news. Learn more about traumatic brain injury (TBI).
Frequency about 1 post per month.
Facebook fans 3,635. Twitter followers n/a.View Latest Posts ▸


These blogs are ranked based on following criteria

  • Google reputation and Google search ranking
  • Influence and popularity on Facebook, twitter and other social media sites
  • Quality and consistency of posts.
  • Feedspot’s editorial team and expert review

via Top 30 Traumatic Brain Injury Blogs and Websites To Follow in 2018

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[Abstract + References] Changes in sexual functioning following traumatic brain injury: An overview on a neglected issue


  • Sexuality has a significant impact on interpersonal relationships and psychological well-being.
  • Up to 50% of patients with moderate to severe TBI report sexual problems.
  • Sexual disorders in TBI are closely dependent on the damaged brain area.
  • TBI patients and their caregivers should be provided with information useful to achieve a better sexual health.


Traumatic brain injury (TBI) is any damage to the skull and/or the brain and its frameworks due to an external force. Following TBI, patients may report cognitive, physiological and psychosocial changes with a devastating impact on important aspects of the patient’s life, such as sexual functioning. Although sexual dysfunction (SD) occurs at a significantly greater frequency in individuals with TBI, it is not commonly assessed in the clinical setting and little information is available on this crucial aspect of patients’ quality of life. As the number of people with TBI is on the rise, there is a need for better management of TBI problems, including SD, by providing information to patients and their caregivers to achieve sexual health, with a consequent increase in their quality of life. Discussing and treating sexual problems in TBI patients enters the framework of a holistic approach. The purpose of this narrative review is provide clinicians with information concerning changes in sexual functioning and relationships in individuals with TBI, for a better management of patient’s functional outcomes and quality of life.


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  62. Calabrò, R.S., Furnari, A., Bramanti, P. Treatment and rehabilitation of sexual dysfunction in neurological diseases. in: R.S. Calabrò (Ed.) Male Sexual dysfunction in neurological disorders: From pathophysiology to rehabilitationNovaNY: Hauppauge2010.

via Changes in sexual functioning following traumatic brain injury: An overview on a neglected issue – Journal of Clinical Neuroscience

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[Infographic] TRAUMATIC BRAIN INJURY – Brain Injury Symptoms



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[Infographic] Traumatic Brain Injury


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[Abstract] Psychometric Comparisons of the Quality of Life after Brain Injury between Individuals with Mild and Those with Moderate/Severe Traumatic Brain Injuries

This study compared psychometric properties of the Taiwanese version of the Quality of Life after Brain Injury (QOLIBRI) between patients with mild and those with moderate/severe traumatic brain injury (TBI). Of 683 participants, 548 had sustained a mild injury with Glasgow Coma Scale (GCS) scores of 13–15, and 135 had a moderate/severe injury with GCS scores of 3–12. The QOLIBRI comprises six domains: Cognition, Self, Daily Life and Autonomy, Social Relationships, Emotions, and Physical Problems. Results of the Rasch analysis showed that two items of “Problems with seeing/hearing” and “Finding one’s way about” were underfitting in the mild TBI group while the item “Problems with seeing/hearing” was underfitting and the item “TBI effects” was overfitting in the moderate/severe TBI group. The largest differential item functioning (DIF) between the mild and moderate/severe TBI groups appeared in the item “Energy,” followed by those of “Being slow/clumsy” and “Problems with seeing/hearing.” For both the mild and moderate/severe TBI groups, the two domains of Emotions and Physical Problems displayed strong ceiling effects, low person reliability and separation, and an incomplete range of the person measure covered by the item difficulty, while the remaining four domains had acceptable performances. While the psychometric performance of the QOLIBRI at the domain level was similar between the mild and moderate/severe TBI groups, certain items exhibited different functioning between the two groups. The reason why the two domains of the Emotions and Physical Problems performed poorly in the two TBI severity groups could be due to cross-cultural effects. The meanings of these DIF items, particularly for patients with a mild TBI, and factors contributing to the ceiling effect of the Emotions and Physical Problems domains in other ethnic Chinese populations need to be investigated further.


via Psychometric Comparisons of the Quality of Life after Brain Injury between Individuals with Mild and Those with Moderate/Severe Traumatic Brain Injuries | Journal of Neurotrauma

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[Abstract] Efficacy of Telerehabilitation for Adults With Traumatic Brain Injury: A Systematic Review


Objective: To identify and appraise studies evaluating the efficacy of telerehabilitation for adults with traumatic brain injury (TBI).

Methods: A systematic search of Cochrane Library, MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO databases was conducted from January 1980 to April 23, 2017, for studies evaluating the efficacy of telerehabilitation for adults with TBI. Two reviewers independently assessed articles for eligibility and rated methodological quality using 16 criteria related to internal validity, descriptive, and statistical characteristics.

Results: The review yielded 13 eligible studies, including 10 randomized controlled trials and 3 pre-/postgroup studies (n ≥ 10). These evaluated the feasibility and/or efficacy of telephone-based (10 studies) and Internet-based (3 studies) interventions. Overall, the evidence of efficacy was somewhat mixed. The most common study design evaluated the efficacy of telephone-based interventions relative to usual care, for which 4 of 5 randomized controlled trials reported positive effects at postintervention (d = 0.28-0.51). For these studies, improvements in global functioning, posttraumatic symptoms and sleep quality, and depressive symptoms were reported. The feasibility of Internet-based interventions was generally supported; however, the efficacy could not be determined because of insufficient studies.

Conclusions: Structured telephone interventions were found to be effective for improving particular outcomes following TBI. Controlled studies of Internet-based therapy and comparisons of the clinical and cost-effectiveness of in-person and telerehabilitation formats are recommended for future research.

via Efficacy of Telerehabilitation for Adults With Traumatic Bra… : The Journal of Head Trauma Rehabilitation

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[Abstract] Employment stability in the first 5 years after moderate to severe traumatic brain injury



To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate to severe traumatic brain injury (TBI) that may be clinically addressed.


Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI.


Inpatient rehabilitation centers with telephone follow-up.


Individuals enrolled in the TBIMS-NDB since 2001, aged 18 to 59, with employment data at two or more follow-up interviews at years 1, 2, and 5 (N=5,683).


Not applicable.

Main Outcome Measure

Employment stability, categorized using post-TBI employment data as no paid employment (53.25%), stably (27.20%), delayed (10.24%), or unstably (9.31%) employed.


Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, pre-injury employment, higher annual earnings, male sex, higher education, transportation independence post-injury, and no anxiety or depression at 1-year post-TBI.


Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.

via Employment stability in the first 5 years after moderate to severe traumatic brain injury – Archives of Physical Medicine and Rehabilitation

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[ARTICLE] Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury – Full Text

Traumatic brain injury (TBI) causes physical and cognitive-behavioral impairments that reduce participation in employment, leisure, and social relationships. Demographic and injury-related factors account for a small proportion of variance in participation post-injury. Personal factors such as resilience may also impact outcomes. This study aimed to examine the association of resilience alongside demographic, injury-related, cognitive, emotional, and family factors with participation following TBI. It was hypothesized that resilience would make an independent contribution to participation outcomes after TBI. Participants included 245 individuals with mild-severe TBI [Mage = 44.41, SDage = 16.09; post traumatic amnesia (PTA) duration M 24.95 days, SD 45.99] who completed the Participation Assessment with Recombined Tools-Objective (PART-O), TBI Quality of Life Resilience scale, Family Assessment Device General Functioning Scale, Rey Auditory Verbal Learning Test, National Adult Reading Test, and Hospital Anxiety and Depression Scale an average 4.63 years post-injury (SD3.02, R 0.5–13). Multiple regression analyses were used to examine predictors of PART-O scores as the participation measure. Variables in the model accounted for a significant 38% of the variability in participation outcomes, F(13, 211) = 9.93, p < 0.05, R2 = 0.38, adjusted R2 = 0.34. Resilience was a significant predictor of higher participation, along with shorter PTA duration, more years since injury, higher education and IQ, and younger age. Mediation analyses revealed depression mediated the relationship between resilience and participation. As greater resilience may protect against depression and enhance participation this may be a focus of intervention.


Following traumatic brain injury (TBI), participation in employment, education, leisure, and relationships is often significantly reduced, leaving individuals substantially less integrated in their communities (14). As a result, many individuals spend increased time at home, straining family and other relationships (5). Given that TBI occurs commonly during young adulthood (6), participation deficits coincide with a critical period of development in which individuals are completing education, establishing a vocation, leaving home, and forming important lifelong relationships. Failure to attain these goals may profoundly impact their sense of self, mental health and general well-being. Reduced participation often extends beyond the acute recovery period and continues to be associated with poorer quality of life up to two decades after injury (7). Arguably participation in these life roles, including employment, education, leisure and relationships, represents one of the most important and objective indicators of injury outcomes.

Numerous variables have been associated with participation outcomes post-TBI, including injury-related and demographic variables as well as post-injury environmental and personal factors. Injury severity, cognitive difficulties, and limb injuries with related pain and impact on mood, affect an individual’s ability to engage socially and often present significant barriers to education and employment (816). Injury severity is a particularly well-researched predictor of participation outcomes, with duration of post traumatic amnesia (PTA) having the most robust association (1721). With respect to demographic factors, younger age, higher premorbid education level, higher premorbid IQ, and being employed prior to injury have all been associated with better participation outcomes (102229). Notably, older age at injury has been found to predict both worse participation overall as well as progressively worsening participation over time (10). Although gender does not appear to be directly associated with participation (30), it may have an indirect association, for example through mood and pre-injury education (14). Post-injury psychological functioning, particularly depression and anxiety, are also important predictors of participation outcomes (10123133). The impact of family functioning on participation is thought to be both direct, and through association with emotional well-being (3435).

Due to this broad range of factors influencing outcome, research has moved toward a multivariate approach to prediction of participation outcomes following TBI (24363738). These models contribute to a more comprehensive understanding of participation outcomes; however, the average amount of variance accounted for by predictive models is around 30% (21). This suggests there are additional predictive factors yet to be identified. One such factor that has increasingly gained scholarly recognition, due its positive association with quality of life and well-being outcomes among different clinical populations, is resilience.

Resilience has been conceptualized as a process of adaptation to adversity or the ability to bounce back after trauma or adversity. Resilience arguably influences the extent to which a person is able to resume important life roles after an injury. Resilience may impact participation outcomes directly through facilitating or promoting return to normal life or the development and achievement of new life goals (39), and indirectly through its effects on improved well-being, quality of life and psychological adjustment. Participating in employment, education, leisure, and relationships represent fundamental areas of participation. Resilience has been positively associated with physical and emotional well-being in individuals with cancer (40), Parkinson’s disease (41), diabetes (42), chronic spinal cord injury (43), multiple sclerosis, spina bifida, stroke, and posttraumatic stress disorder (4445). There has been less resilience research in TBI, with only one study to date examining the association between resilience and participation. Notably, it has been suggested that the study of resilience after TBI poses a distinct challenge, in that the skills characteristically associated with resilience are typically impaired after TBI (4547). For example, resilience requires emotional stability, a positive outlook, good problem-solving skills and social perception (47); however, TBI is commonly associated with impaired executive functioning (4849), irritability and aggression (5051), depression (3345), and difficulties with social perception (52).

The little research that has focused on resilience after TBI has been largely limited to patients with mild TBI, in whom no studies have examined impact on participation. In this group, greater resilience has been associated with less reporting of post-concussional and post-traumatic stress symptoms (5355), reduced fatigue, insomnia, stress, and depressive symptoms, as well as better quality of life (56). One study found that greater pre-injury resilience was significantly associated with greater post-concussion symptom severity 1 month post-injury (57), perhaps reflecting insufficient time for participants to “bounce back” (44), or overrating of pre-injury resilience levels, a phenomenon known as the “Good Old Days”(58).

Only three studies have examined resilience in individuals with moderate to severe TBI, of which one examined an association with participation. Marwitz et al. (39), conducted a large (n = 195) longitudinal study and found that resilience was significantly associated with participation over the first 12 months post-injury (39). Other studies have associated higher resilience in individuals with moderate to severe TBI with fewer depressive and anxiety symptoms, better emotional adjustment, use of task oriented coping and greater social support (4445). However, one of these studies used a sample of individuals who were actively seeking help with adjusting to changes post-injury, possibly biasing the sample toward those experiencing greater adjustment problems (45).

The aim of the present study was to examine the relative association of resilience, as well as demographic, injury-related, cognitive, emotional, and family factors with participation (productivity, social relations and leisure) following mild to severe TBI. To the best of our knowledge, this is the first study to examine the association between resilience and participation outcomes more than 12 months after mild to severe TBI. This critically extends previous research by examining the impact of resilience across the spectrum of TBI severity, from mild to severe, and how this association influences outcomes beyond the acute post-injury period. It was hypothesized that resilience would make an independent contribution to participation after TBI, in a model that would include demographic variables (gender, age, pre-morbid IQ, education, pre-injury employment), injury variables (injury severity, cognitive functioning, limb injury, time since injury) and post-injury personal and environmental factors (depression, anxiety, family support).[…]


Continue —> Frontiers | Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury | Neurology

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[Abstract] Monitoring the injured brain



Traumatic brain injury can be defined as the most complex disease in the most complex organ. When an acute brain injury occurs, several pathophysiological cascades are triggered, leading to further exacerbation of the primary damage. A number of events potentially occurring after TBI can compromise the availability or utilization of energy substrates in the brain, ultimately leading to brain energy crisis. The frequent occurrence of secondary insults in the acute phase after TBI, such as intracranial hypertension, hypotension, hypoxia, hypercapnia, hyperthermia, seizures, can then increase cerebral damage, and adversely affect outcome. Neuromonitoring techniques provide clinicians and researchers with a mean to detect and reverse those processes that lead to this energy crisis, especially ischemic processes, and have become a critical component of modern neurocritical care. Which is the best way to monitoring the brain after an acute injury has been a matter of debate for decades. This review will discuss how monitoring the injured brain can reduce secondary brain damage and ameliorate outcome after acute brain injury.


Journal of Neurosurgical Sciences 2018 Apr 18 – Minerva Medica – Journals

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