Recovery of automatic and cognitive functions in traumatic brain injury using the functional independence measure.
Automatic tasks are performed with minimal attentional guidance. Neural pathways subserving attention are often impaired in traumatic brain injury (TBI). Therefore, the process of automatization is crucial in skill development, due to the fact that it allows attention to be directed towards the more abstruse components of task [1]. Automatic and cognitive categories were created by aggregating three of the motor items and three of the cognitive items respectively of the Functional Independence Measure (FIM). The averages of these categories were calculated for every evaluation of the FIM, and their relationship to each other was examined. Over a 9-month period 24 patients were selected from a TBI population with a major component of diffuse axonal injury (DAI). Eighty-eight per cent (n = 21) of the patients reached independence for the automatic category, but only 29% (v = 7) reached this level for the cognitive category. When independence was achieved, the average time to do so for the automatic category 6.7 weeks) was not significantly different from the time it took to reach cognitive independence (6.9 weeks). It was found that there were significant statistical differences in the scores between the two categories. Premorbid IQ had no effect on these categories. However, the rate which these two categories increased, from the time of admission to discharge, was not significantly different.
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Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, USA.
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D000203:Activities of Daily Living / Q000145:classification*; D000328:Adult; D001288:Attention; D001925:Brain Damage, Chronic / Q000534:rehabilitation*; D001930:Brain Injuries / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000534:rehabilitation*; D005260:Female; D016489:Head Injuries, Closed / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011446:Prospective Studies; D011594:Psychometrics; D012047:Rehabilitation Centers