masthead image image map with link to the tbindc.org home page image map with a link to Kessler Medical Rehabilitation Research and Education Corporation
Projects of the TBINDC Registry by Research Center
Long-Term Survival after traumatic brain injury: A population-based analysis
Abstract: This population-based retrospective cohort study identified all Olmsted County, MN residents with any diagnosis indicative of potential traumatic brain injury (TBI) during the years 1985-2000. The complete community-based medical records of a random sample (n=7,175) were reviewed to confirm and characterize the event, and to determine vital status through 2002. The review identified 1, 448 confirmed incident cases; 164 (11%) were moderate to severe; 1,284 were mild. The estimated 30-day fatality rate was 29% for moderate to severe cases and 0.2% for mild cases. Comparison of observed mortality over the full period of follow-up with that expected revealed a risk ratio (95 % CI) of 5.29 (4.11-6.71) for moderate to severe cases and 1.33... more
Investigators: Brown A, Leibson C, Malec J, Diehl N view full
details
Lead Center: Mayo Medical Center
Apolipoprotein E and Cognitive Outcome Following Moderate and Severe Traumatic Brain Injury
Abstract: Objective: To examine the relationship between the Apolipoprotein E (APOE) 4 allele and cognitive outcome in traumatic brain injured (TBI) patients. It was predicted that the carriers would exhibit significantly poorer cognitive outcomes.

Participants: Seventy-four TBI patients 16-59 years old were examined at discharge from inpatient rehabilitation programs. Thirty-nine patients were reassessed at one year follow-up.

Settings: Rehabilitation programs at Emory University School of Medicine and Shepherd Center in Atlanta, Georgia, and the Mayo Clinic College of Medicine in Rochester, Minnesota.

Methods: Neuropsychological assessments of attention, language, memory, visuoanalytic skills, and executive functioning were... more
Investigators: Goldstein F, Stringer A, Malec J, Gearing M, Moessner A, Greenspan A, Macciocchi S view full
details
Lead Center: Mayo Medical Center
Is APOE Status Predictive of Functional Outcome Following Moderate-Severe Traumatic Brain Injury?
Abstract: The predictive power of apolipoprotein E (APOE) genotype (E2 and E4 status) on traumatic brain injury (TBI) outcome was examined in the largest study of this association to-date. One hundred forty-six individuals with moderate to severe TBI underwent APOE genotyping. Functional outcome was assessed with the Disability Rating Scale, the Functional Independence Measure, and the Living and Vocational Independence Scale. Injury severity predicted outcome at discharge and follow-up. Neither E2 nor E4 status predicted additional variance in outcome at either recoverytime-point. Contrary to previously reported findings, results do not suggest a directassociation between APOE genotype and acute or long-term functional outcomes following TBI. ... more
Investigators: Malec J, Goldstein F, Stringer A, Greenspan A, Macciocchi S, Gearing M, Brown A, Moessner A view full
details
Lead Center: Mayo Medical Center
The Mayo-Portland Participation Index (M2PI):A Brief and Psychometrically-sound Measure of Brain Injury Outcome
Abstract: Objectives: To evaluate the internal consistency, inter-rater agreement, concurrent validity and floor/ceiling effects of the 8-item Participation Index (M2PI) of the Mayo-Portland Adaptability Inventory (MPAI).

Design: M2PI data derived from MPAIs completed independently by the people with ABI undergoing evaluation, significant others (SO), and rehabilitation staff were submitted to Rasch Facets analysis to determine the internal consistency of each independent rater group and of composite measures that combined rater groups. Correlations with the Full Scale MPAI were examined to assess concurrent validity, as was inter-rater agreement.

Setting: Outpatient rehabilitation in academic PM&R Department.

Participants: 134 people... more
Investigators: Malec J view full
details
Lead Center: Mayo Medical Center
Comparability of Mayo-Portland Adaptability Inventory Ratings by Staff, Significant Others and People with Acquired Brain Injury
Abstract: Objectives: Determine the internal consistency, reliability, and comparability of the Mayo-Portland Adaptability Inventory (MPAI-4) and subscales completed by people with acquired brain injury (ABI), family and significant others (SO), and rehabilitation staff.

Subjects: 134 people with ABI consecutively seen for outpatient rehabilitation evaluation.

Method: MPAI-4 protocols based on independent ratings by the people with ABI undergoing evaluation, SO, and rehabilitation staff were submitted to Rasch Facets analysis to determine the internal consistency of the overall measure and subscales (Ability, Adjustment, and Participation Indices) for each rater group and for a composite measure based on all rater groups. Rater agreement... more
Investigators: Malec J view full
details
Lead Center: Mayo Medical Center
Further Psychometric Evaluation and Revision of the Mayo-Portland Adaptability Inventory in a National Sample
Abstract: Objectives: To evaluate the internal consistency of the Mayo-Portland Adaptability Inventory (MPAI), further refine the instrument, and provide reference data based on a large, geographically diverse sample of persons with acquired brain injury (ABI).

Participants: 386 persons with generally moderate-severe ABI.

Settings: Outpatient, community-based, and residential rehabilitation facilities for persons with ABI located in the U. S. West, Midwest and Southeast.

Methods: Rasch, item cluster, principal components, and traditional psychometric analyses for internal consistency of MPAI data and subscales.

Results: With rescoring of rating scales for four items, a 29-item version of the MPAI
showed satisfactory internal... more
Investigators: Malec J, Kragness M, Lezak M view full
details
Lead Center: Mayo Medical Center
Characteristics of Successful and Unsuccessful Completers of Three Postacute Brain Injury Rehabilitation Pathways
Abstract: Objective: To determine if successful participants along different postacute brain injury (BI) rehabilitation pathways differ on demographic, injury-related, disability, and outcomes variables.

Design: Secondary analysis of pre-, post-, and 1-year follow-up data obtained in a previous study of specialized vocational services for persons with BI.

Setting: Outpatient BI rehabilitation clinic.

Participants: 114 persons with acquired BI.

Outcome Measures: Demographic and injury-related variables; Mayo-Portland Adaptability Inventory (MPAI); Vocational Independence Scale; .success. as defined by community-based employment (CBE) at 1-year follow-up. Interventions: Participants in three distinct rehabilitation pathways were... more
Investigators: Malec J, Degiorgio L view full
details
Lead Center: Mayo Medical Center
Increased Societal Participation Following Comprehensive Day Treatment For Survivors Treated Within One Year To Over Ten Years After Brain Injury
Abstract: OBJECTIVES: Evaluate a Comprehensive Day Treatment (CDT) program for survivors of brain injury (BI) by time since injury; identify outcome predictors.

PARTICIPANTS: 96 program graduates; 17 dropouts with acquired BI.

OUTCOME MEASURES: Outcome: Independent Living Status, Vocational Independence Scale at program end and 1-year follow-up; Rasch-analyzed Mayo-Portland Adaptability Inventory (MPAI-22) and Goal Attainment Scaling (GAS) at program end; Predictor: age, education, severity of initial injury, time since injury, preadmission MPAI-22.

RESULTS: Significant goal achievement on GAS and improvement on MPAI-22; increased societal participation at 1 year follow-up for both those treated postacutely and many years after... more
Investigators: Malec J view full
details
Lead Center: Mayo Medical Center
Characterizing and testing the relative efficacy of vocational rehabilitation interventions after TBI - Phase 1: Characterizing and measuring variations in vocational treatments across the TBIMS
Abstract: The ability to work is important to many persons with TBI for maximizing financial independence, achieving social re-integration and maintaining quality of life. Vocational re-entry is frequently addressed in post-acute rehabilitation of TBI, but employment remains a goal that is difficult to attain. We need ways of evaluating what the most critical elements of the treatment are, or at what intensity or duration they must be delivered. The objectives of Phase 1 are: (1) to develop definitions for content and process parameters for characterizing specific vocational interventions for TBI; (2) to use these definitions to survey the types and variations in vocational services across the TBIMS; (3) to develop testable hypotheses about... more
Investigators: Hart T, Dijkers M, Fraser R, Bogner J, Cicerone K, Malec J view full
details
Lead Center: Moss Rehabilitation Research Institute
Collaborating Centers: Mayo Medical Center, Kessler Medical Rehabilitation Research and Education Corporation, Ohio State University, University of Washington, Mount Sinai School of Medicine
A Randomized Controlled Family Intervention Trial
Abstract: Family members will be recruited between 1 and 2 years after injury. Family members who agree to participate will be randomly assigned to either a cognitive-behavioral treatment group, a traditional support group, or a no treatment control group. Pre-test and post-test measures will be administered to assess family systems functioning, emotional distress, perceived burden, coping strategies, and satisfaction with social support... more
Investigators: Sander A, Sherer M, Malec J view full
details
Lead Center: The Institute for Rehabilitation and Research
Collaborating Centers: Mayo Medical Center, Methodist Rehabilitation Center
Prediction of Patients' Progress in Post-Acute Rehabilitation Based on Family Environment at the Time of Admission
Abstract: The purpose of the current study is to determine the relationship of family functioning to patients' ability to complete a post-acute rehabilitation program, and to their outcome following participation in the program. Information on the family systems functioning and caregivers' distress will be collected within 2 weeks of admission to the program. Functional assessment of disability and handicap will take place within 2 weeks of admission and approximately 1 month after discharge. Regression models will be constructed to predict admit to discharge change scores from demographic characteristics, injury characteristics, and the family variables.
... more
Investigators: Sander A, Sherer M, Malec J view full
details
Lead Center: The Institute for Rehabilitation and Research
Collaborating Centers: Mayo Medical Center, Methodist Rehabilitation Center
Prediction of Long-Term Patient Outcome Based on Pre-Injury Family Environment
Abstract: The purpose of the current study is to determine is the pre-injury family environment is predictive of the outcome of persons with TBI at 1 year after injury. Information on the pre-injury family environment, including emotional distress, coping, family systems functioning, and social support, will be collected within 2 weeks of admission to inpatient rehabilitation. Information on the outcome of persons with injury will be collected at 1 year post-injury. Regression models will be constructed to predict outcome from demographic characteristics, injury characteristics, and the pre-injury family environment.... more
Investigators: Sander A, Sherer M, Malec J view full
details
Lead Center: The Institute for Rehabilitation and Research
Collaborating Centers: Mayo Medical Center, Methodist Rehabilitation Center
Prediction of Long-Term Family Functioning Based on Pre-Injury Family Environment
Abstract: The current study will seek to characterize the pre-injury family environment of persons with TBI and to determine if the preinjury family environment can predict family members' response to TBI. Information on emotional distress, family systems functioning, social support, and coping styles in the month prior to injury will be obtained from family members within 2 weeks of admission to inpatient rehabilitation. These variables will be used to predict family adjustment at 1 year, after controlling for demographics and injury-related characteristics... more
Investigators: Sander A, Sherer M, Malec J view full
details
Lead Center: The Institute for Rehabilitation and Research
Collaborating Centers: Mayo Medical Center, Methodist Rehabilitation Center
Validation of a Model for Evaluating Outcome Following Traumatic Brain Injury
Abstract: Structural equation modeling compared the fit of the data from two samples to a path analysis developed through clinical use and prior research. Both samples provide adequate goodness-of-fit measures to the model, supporting the validity of this model. These results show significant relationships between premorbid factors and acute injury severity and subsequent cognitive and functional status. Injury severity significantly affected cognitive and functional status, while cognitive and functional status significantly influenced one year outcome. As predicted, premorbid factors and injury severity did not significantly influence outcome.... more
Investigators: Novack T view full
details
Lead Center: University of Alabama
Collaborating Centers: Mayo Medical Center, Emory University/Shepherd Center, Kessler Medical Rehabilitation Research and Education Corporation
Early Cognitive Status and Productivity Outcome Following Traumatic Brain Injury
Abstract: To evaluate the contribution of early cognitive assessment to prediction of productivity outcome after traumatic brain injury (TBI) adjusted for severity of injury, demographic factors, and pre-injury employment status. Design: Inception cohort. Setting: Six inpatient brain injury rehabilitation programs. Participants: 388 adults with TBI whose post-traumatic amnesia resolved prior to discharge from inpatient rehabilitation. Results: Multiple logistic regression analysis revealed that pre-injury productivity status, duration of post-traumatic amnesia, education level, and early cognitive status each made significant, independent contributions to prediction of productivity status at follow-up. Conclusions: Findings support the... more
Investigators: Sherer M, Sander A, Nick T, High Jr. W, Malec J, Rosenthal M view full
details
Lead Center: Methodist Rehabilitation Center
Collaborating Centers: The Institute for Rehabilitation and Research, Mayo Medical Center, Kessler Medical Rehabilitation Research and Education Corporation
Mortality and Life Expectancy After TBI Rehabilitation
Abstract: Abstract from Project Phase I - Objective: To investigate mortality, life expectancy, risk factors for death, and causes of death in individuals with traumatic brain injury (TBI). Methods: Retrospective cohort study utilizing data from the TBI Model Systems National Database, the Social Security Death Index and death certificates. Participants: 2,178 individuals with TBI completing inpatient rehabilitation in one of 15 National Institute on Disability and Rehabilitation Research-funded TBI Model Systems of care between 1988 and 2001. Results: Individuals with TBI were twice as likely to die compared to individuals in the general population of similar age, gender and race, resulting in an estimated average life expectancy reduction of 7... more
Investigators: Harrison-Felix C, Whiteneck G, Devivo M, Hammond F, Jha A view full
details
Lead Center: Craig Hospital
Collaborating Centers: Carolinas Rehabilitation, Emory University/Shepherd Center, Mayo Medical Center, Ohio State University, University of Alabama, Oregon Health Sciences University, University of Missouri, Moss Rehabilitation Research Institute, Rehabilitation Institute of Michigan, Spaulding Rehabilitation Hospital, Virginia Commonwealth University/Medical College of Virginia, Santa Clara Valley Medical Center, University of Washington
Development of Participation Measures for People with Traumatic Brain Injury
Abstract: There is no general agreement in the field regarding a reliable and valid objective measure of community participation after TBI. This study will use a multi-center, prospective, cohort design to evaluate participation items pooled from four currently used tools: the Craig Handicap Assessment and Reporting Technique Short Form (CHART-SF); the Community Integration Questionnaire Version 2 (CIQ-2); the Participation Objective-Participation Subjective (PO-PS) section of the Living Life After TBI (LLATBI); and the Mayo-Portland Participation Index (M2PI). The primary objectives of this study are to: 1) evaluate internal consistency, concurrent validity, and item/scale structure of current measures of community participation after TBI; and 2)... more
Investigators: Whiteneck G, Bushnik T, Cicerone K, Corrigan J, Bogner J, Dijkers M, Gordon W, Hart T, Malec J, Novack T view full
details
Lead Center: Craig Hospital
Collaborating Centers: University of Alabama, Santa Clara Valley Medical Center, Mayo Medical Center, Kessler Medical Rehabilitation Research and Education Corporation, Mount Sinai School of Medicine, Ohio State University, Moss Rehabilitation Research Institute
A Prospective Observational Study of Screening and Prophylaxis for Deep Vein Thrombosis in Survivors of Traumatic Brain Injury During Inpatient Rehabilitation
Abstract: During the period of acute rehabilitation for traumatic brain injury (TBI), the development of deep vein thrombosis (DVT) is a significant complication that increases morbidity and mortality. Pulmonary embolism (PE) is one of the most ominous, and frequently life-threatening, complications that occur during TBI rehabilitation. TBI patients often sustain concomitant multiple trauma and have cumulative risk factors for DVT. Because these TBI patients are usually maintained at bed rest during their acute hospitalization, they are at increased risk for existing DVT to embolize when they enter the rehabilitation setting and resume mobility. Prior to initiating this study, a practice survey was distributed to the 16 rehabilitation centers of... more
Investigators: Carlile M, Diaz-Arrastia R, Mysiw W view full
details
Lead Center: North Texas Traumatic Brain Injury Model System
Collaborating Centers: Carolinas Rehabilitation, JFK Johnson Rehabilitation Institute, Mayo Medical Center, Mount Sinai School of Medicine, Santa Clara Valley Medical Center, Methodist Rehabilitation Center, Ohio State University, University of Alabama, University of Pittsburgh
A Collaborative National Information Center on Outcome Measurement in Brain Injury
Abstract: In order to better serve the rehabilitation community, the Center on Outcome Measurement in Brain Injury (COMBI) website and newsletter are proposed. The COMBI provides information on measures in a format that is easily accessed and understood, free of charge, objective, and comprehensive. Each measure will have online syllabi, training and testing materials (including the measure's rating form), information on scale properties, a reference listing of published studies using the measure, and a section for "Frequently Asked Questions."... more
Investigators: Bushnik T, Wright J, Mellick D, Harrison-Felix C, Boake C, Sander A, Malec J, Sherer M, Thompson R, Novack T, Dijkers M, Bogner J, Corrigan J, Hammond F, Kreutzer J, Marwitz J, Millis S, O'Neil-Pirozzi T view full
details
Lead Center: Santa Clara Valley Medical Center
Collaborating Centers: Craig Hospital, The Institute for Rehabilitation and Research, Mayo Medical Center, Methodist Rehabilitation Center, University of Alabama, Rehabilitation Institute of Michigan, Ohio State University, Carolinas Rehabilitation, Virginia Commonwealth University/Medical College of Virginia, Moss Rehabilitation Research Institute, Kessler Medical Rehabilitation Research and Education Corporation, Spaulding Rehabilitation Hospital, Mount Sinai School of Medicine


Kessler Medical Rehabilitation Research and Education Corporation image link NIDRR image link
National Traumatic Brain Injury Live Syllabus v2.00.00
Registry Dataset accessed Monday, September 25, 2006 5:51am
© 2006, All rights reserved || .  KMRREC
contact: tbindc@kmrrec.org

Bobby approved image
accessibilty and the TBINDC