Article

The study objective was to examine postacute changes in bowel and bladder
continence and cognition after severe traumatic brain injury (TBI) in persons
with long-term functional recovery to full independence. This case series
included nine patients initially admitted to inpatient rehabilitation (IR) with
severe TBI who had returned to prior responsibilities and functional independence
by 8 to 15 mo. Patients had initial Glasgow Coma Scale scores of 3 to 6,
posttraumatic amnesia durations of 18 to 70 d, time-to-follow-commands of 16 to
56 d, initial abnormal brain computed tomography scans, and initial pupil
abnormalities. IR Functional Independence Measure (FIM) cognitive and sphincter
score improvements were compared with national TBI FIM data from Uniform Data
Systems for Medical Rehabilitation (UDSMR) for 2010 (n = 16,368). All patients
had IR improvements in cognitive and sphincter FIM scores approximately twice the
national UDSMR data for 2010. All patients had combined IR discharge sphincter
FIM scores that were 12 or greater, indicating independence to modified
independence with bowel and bladder function with no incontinence. Five
participants (55%) were admitted to IR with sphincter FIM scores of 11 to 12,
indicating recovery of continence during acute care. These findings suggest
potential usefulness of IR cognitive FIM score changes and of the recovery of
bowel and bladder continence for predicting favorable functional outcomes
following severe TBI.

Langue : ANGLAIS