Understanding pain after traumatic brain injury: impact on community participation.
OBJECTIVE
To examine the prevalence of pain 1 yr after moderate to severe traumatic brain injury (TBI) and identify predictors from the time of injury. Additionally, factors related to pain at 1 yr after injury were examined along with the impact of pain on community participation.


METHODS
Prospective cohort study of 146 individuals enrolled during acute inpatient rehabilitation for TBI and community follow-up at 1 yr after injury.


RESULTS
Higher reports of depressive symptoms during inpatient rehabilitation and at 1 yr after injury were significantly related to reports of pain at 1 yr when controlling for demographic and injury characteristics. Being female and nonwhite were also factors related to increased reports of pain. Pain and community participation were significantly related until depression was entered into the model. Depression is a significant factor in the relationship between pain and community participation.


CONCLUSIONS
Whereas pain was frequently reported 1 yr after injury, injury-related factors were surprisingly unrelated. Further evaluation of the role that depression plays in the relationship between pain and community participation will be important to determine appropriate management of pain and depression and to optimize participation in individuals with TBI.
Hoffman
Jeanne M
JM
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington 98195, USA.
Pagulayan
Kathleen F
KF
Zawaideh
Nadya
N
Dikmen
Sureyya
S
Temkin
Nancy
N
Bell
Kathleen R
KR
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000503:physiopathology* / Q000523:psychology; D003256:Community Participation / Q000523:psychology / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D012944:Social Support; D013997:Time Factors