title: Modeling of Community Integration Trajectories in the First Five Years after Traumatic Brain Injury.
abstract: The aims of this study were to assess the trajectories of community integration in individuals with traumatic brain injury (TBI) through one, two, and five years post-injury and to examine whether those trajectories could be predicted by demographic and injury characteristics. A longitudinal cohort study was conducted with 105 individuals with moderate-to-severe TBI admitted to a trauma referral center in 2005-2007. Demographics and injury-related factors were extracted from medical records. At the one-, two- and five-year follow-ups, community integration was measured by the Community Integration Questionnaire (CIQ). A hierarchical linear model (HLM) examined whether longitudinal trajectories of community integration could be predicted by: time, sex, age, relationship status, education, employment status, occupation, acute Glasgow Coma Scale score, cause of injury, days in post-traumatic amnesia (PTA), computed tomography Marshall Score, and Injury Severity Score. CIQ scores improved across the three time-points (p<0.001). Additionally, higher trajectories of community integration were predicted by being single at the time of injury (p<.001), higher level of education (p=0.006), employment (p<0.001), and a shorter length of PTA (p<0.001). In a follow-up HLM with interaction terms, time*PTA was statistically significant (p<0.001), suggesting that participants with longer PTA increased in community integration more rapidly than those with shorter PTA. The longitudinal course of community integration described in this study may help rehabilitation professionals to plan more extensive follow-ups and targeted rehabilitation programs in the early stage of recovery for patients with specific demographic and injury characteristics.
authors.affiliation: 1 Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ulleval , Oslo, Norway .|2 Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services, Faculty of Medicine, University of Oslo , Oslo, Norway .
authors.forename: Nada
authors.initials: N
authors.lastname: Andelic
authors.affiliation: 3 University of Deusto . IKERBASQUE, Basque Foundation for Science. Bilbao, Spain .
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Arango-Lasprilla
authors.affiliation: 4 Department of Psychology, Virginia Commonwealth University , Richmond, Virginia.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Perrin
authors.affiliation: 2 Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services, Faculty of Medicine, University of Oslo , Oslo, Norway .|5 Sunnaas Rehabilitation Hospital Trust , Akershus, Norway .
authors.forename: Solrun
authors.initials: S
authors.lastname: Sigurdardottir
authors.affiliation: 6 Department of Epidemiology and Community Health, Virginia Commonwealth University , Richmond, Virginia.
authors.forename: Juan
authors.initials: J
authors.lastname: Lu
authors.affiliation: 7 Department of Psychology, University of Deusto , Bilbao, Spain .
authors.forename: Laiene Olabarrieta
authors.initials: LO
authors.lastname: Landa
authors.affiliation: 1 Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ulleval , Oslo, Norway .|8 Faculty of Medicine, University of Oslo , Oslo, Norway .
authors.forename: Marit V
authors.initials: MV
authors.lastname: Forslund
authors.affiliation: 1 Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ulleval , Oslo, Norway .|8 Faculty of Medicine, University of Oslo , Oslo, Norway .
authors.forename: Cecilie
authors.initials: C
authors.lastname: Roe
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D062309:Community Integration / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015233:Models, Statistical; D009664:Norway; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*
keywords: outcome measures; recovery; rehabilitation; traumatic brain injury