Article

OBJECTIVES: To compare high-level mobility in individuals with chronic
moderate-to-severe traumatic brain injury (TBI) with matched healthy controls,
and to investigate whether clinical variables and magnetic resonance imaging
(MRI) findings in the acute phase can predict high-level motor performance in the
chronic phase. DESIGN: A longitudinal follow-up study. SETTING: A level 1 trauma
center. PARTICIPANTS: Individuals (N=136) with chronic TBI (n=65) and healthy
matched peers (n=71). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
High-Level Mobility Assessment Tool (HiMAT) and the revised version of the HiMAT
performed at a mean of 2.8 years (range, 1.5-5.4y) after injury. RESULTS:
Participants with chronic TBI had a mean HiMAT score of 42.7 (95% confidence
interval [CI], 40.2-45.2) compared with 47.7 (95% CI, 46.1-49.2) in the control
group (P<.01). Group differences were also evident using the revised HiMAT
(P<.01). Acute-phase clinical variables and MRI findings explained 58.8% of the
variance in the HiMAT score (P<.001) and 59.9% in the revised HiMAT score
(P<.001). Lower HiMAT scores were associated with female sex (P=.031), higher age
at injury (P<.001), motor vehicle collisions (P=.030), and posttraumatic amnesia
>7 days (P=.048). There was a tendency toward an association between lower scores
and diffuse axonal injury in the brainstem (P=.075). CONCLUSIONS: High-level
mobility was reduced in participants with chronic, either moderate or severe TBI
compared with matched peers. Clinical variables in the acute phase were
significantly associated with high-level mobility performance in participants
with TBI, but the role of early MRI findings needs to be further investigated.
The findings of this study suggest that the clinical variables in the acute phase
may be useful in predicting high-level mobility outcome in the chronic phase.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.
- IRM - RMI

Langue : ANGLAIS