title: Self-report of extent of recovery and barriers to recovery after traumatic brain injury: a longitudinal study.
abstract: OBJECTIVE
  To examine the perspective of survivors of traumatic brain injury (TBI) regarding the extent and nature of their recovery over time.
  
  
  METHODS
  Inception cohort, longitudinal study.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  One hundred fifty-seven consecutively hospitalized individuals with TBI (mean age, 36.1 yr; 80% men) with a broad range of injury severity.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Participants reported the extent of their recovery and barriers to full recovery at 1, 6, and 12 months.
  
  
  RESULTS
  Participants reported a median return to normal at the 3 follow-up times of 65%, 80%, and 85%. After 1 month, self-reported extent of recovery correlated well with performance on the Glasgow Outcome Scale (p <.001 at 6 and 12 mo) and Wechsler Adult Intelligence Scale Performance IQ (p =.001 at 12 mo). The major reported barrier to recovery was physical difficulties, which constituted over half of the concerns at all time periods. Report of physical-related concerns decreased significantly (p =.002) over time whereas cognition-related concerns increased significantly (p =.02).
  
  
  CONCLUSIONS
  Brain injury survivors consider themselves to have greater recovery than previously reported by clinicians or family members, consider physical problems a significant factor in their recovery, and appear to become more aware of cognitive impairments over time.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98195-6490, USA. jmpowell@u.washington.edu
authors.forename: J M
authors.initials: JM
authors.lastname: Powell
authors.forename: J E
authors.initials: JE
authors.lastname: Machamer
authors.forename: N R
authors.initials: NR
authors.lastname: Temkin
authors.forename: S S
authors.initials: SS
authors.lastname: Dikmen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001364:Awareness; D001930:Brain Injuries / Q000145:classification / Q000534:rehabilitation*; D003071:Cognition; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D012720:Severity of Illness Index; D014193:Trauma Centers