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Projects of the TBINDC Registry by Research Center
Use of Injury Severity Variables in Determining Disability and and Community Integration after Traumatic Brain Injury
Abstract: Much is known about the short-term outcome of individuals acutely hospitalized for traumatic brain injury (TBI) but little is known about the longer-term outcomes and the variables that may predict these outcomes. This study describes the relationship of injury severity measures to one-year outcome for 120 patients hospitalized with TBI at a Level I Trauma Center, as measured by the Disability Rating Scale (DRS) and Community Integration Questionnaire (CIQ). The Glasgow Coma Scale, Revised Trauma Score, Injury Severity Score and The Combined Trauma Score Injury Severity Score (TRISSRTS) were predictive of one-year outcome in this cohort. ... more
Investigators: Wagner A, Hammond F, Sasser H, Wiercisiewski D, Norton H view full
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Lead Center: Carolinas Rehabilitation
Duration of Post-traumatic Amnesia as a Functional Outcome Predictor in Traumatic Brain Injury
Abstract: Levin, et al. studied the relationship of post-traumatic amnesia (PTA) to outcome, and reported that those with PTA > 2 weeks had severe disability based on the Glasgow Outcome Scale (GOS). This study investigated the relationship of coma and PTA duration (as measured by serial administration of the Galveston Orientation Amnesia Test) to the GOS and Disability Rating Scale... more
Investigators: Nguyen V, Wiercisiewski D, Hammond F, Norton H view full
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Lead Center: Carolinas Rehabilitation
Illicit Drug Use Over Time Following Traumatic Brain Injury
Abstract: Reported drug use at Years 1 and 2 following traumatic brain injury (TBI) is 6 to 8%, compared to 29% premorbidly. How drug use responses change over time in the same group is not known. This study investigates patterns of reported drug use and follow-up for individuals with TBI who received inpatient rehabilitation, and who were questioned annually about illicit drug use. The TBI Model System Database (n=1160) was used to perform a cross-sectional analysis on all successfully contacted and screened over a 10 year period. Responses to drug use at Year 1 were 37 yes, and 333 no, with no significant difference in yes/no responses across the years. However, analysis of the positive responses revealed those reporting drug use in Year 1 had... more
Investigators: Hammond F, Grattan K, Sasser H, Corrigan J, Bogner J, Kreutzer J, Weintraub R, Berry J view full
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Lead Center: Carolinas Rehabilitation
Collaborating Centers: Ohio State University, Virginia Commonwealth University/Medical College of Virginia
The Efficacy and Utility of a Community Transition Coordinator in Improving Community Integration, Quality of Life, and Return to Work: A Randomized, Controlled Clinical Trial.
Abstract: Survivors of TBI and their families are confronted with many new challenges. After being guided through many sudden life changes by trained professionals during inpatient rehabilitation, the transition to the community inevitably poses numerous obstacles that must often be faced with minimal outside assistance. This study investigates the utility of a community transition coordinator (CTC) assigned to adults with TBI in a randomized, controlled trial with the goal of developing a replicable model of community reintegration that provides linkages to services after discharge from comprehensive acute rehabilitation inpatient services. The comparison group receives standard post-rehabilitation services without a CTC.... more
Investigators: Hammond F, Coghill J, Norton H view full
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Lead Center: Carolinas Rehabilitation
Impact and Efficacy of Electronic Personal Organizer versus Standard Memory Notebook on Memory, Daily function and Quality of Life
Abstract: Memory impairment is one of the most common complications of TBI, posing significant barriers to the everyday life, work, school, and quality of life. Standard practice involves memory strategies incorporating the use of a memory notebook. Increasingly, the general public has been using electronic personal organizers (EPOÂ’s). The EPO has all the features of the standard notebook as well as offering alarms and backup options, are compact, require no extra supplies, and are easy to update. This randomized, controlled study compares an EPO to the standard memory notebook in terms daily function.... more
Investigators: Hammond F, Grattan K, Norton H, Gosney G, Baker G, Hill J view full
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Lead Center: Carolinas Rehabilitation
The Value of Trauma Scores: Predicting Discharge after Traumatic Brain Injury
Abstract: The relationship of acute injury severity measures to discharge disposition was studies for 378 adults consecutively hospitalized with TBI at a Level I Trauma Center. The Combined Trauma Score Injury Severity Score (TRISSRTS) was predictive of discharge to home or acute rehabilitation versus nursing home or death. Excluding those who died or discharge to a nursing home, the Revised Trauma Score and Injury severity Score were predictive of discharge to home versus inpatient rehabilitation. Testing these 2 predictive models on a sample of 4,625 patients with TBI treated at the same facility revealed sensitivities of 98% and 94% respectively... more
Investigators: Wagner A, Hammond F, Grigsby G view full
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Lead Center: Carolinas Rehabilitation
Return to Productive Activity After Traumatic Brain Injury: Relationship with Measures of Disability, Handicap, and Community Integration
Abstract: Return to productive activity (RTPA) is considered a major outcome marker for TBI. One hundred and five respondents from a cohort of 378 adults hospitalized at a Level I Trauma Center with TBI were studied to describe the rate of RTPA and associated factors. There was 67% RTPA. Factors found to be associated with successful RTPA were educational level, psychiatric history, violent mechanism of injury, discharge status after acute hospitalization, prior alcohol and drug use, and injury severity, as well as the Disability Rating Scale and the Community Integration Questionnaire at one year post-injury... more
Investigators: , Hammond F, Sasser H, Wiercisiewski D view full
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Lead Center: Carolinas Rehabilitation
The Prognosis Utility of Pre-Injury, Injury-Related, and Post-Injury Factors in Predicting Outcome in terms of Function, Community Integration, and Quality of Life
Abstract: Abstract: Recovery from TBI involves multiple processes occurring at different times post-injury. Outcome studies have been performed extensively, predominately utilizing the Glasgow Outcome Scale (GOS). The GOS is limited in its measure of outcome by its broad categories; included within a single category may be a wide differential in burden of care, cost, functional level, and social interaction. Studies assessing the relationship of potentially predictive factors to functional outcomes and quality of life are lacking. This study investigates the relationship of premorbid, injury-related and post-injury related factors to function and quality of life.

Primary research hypotheses: 1)Functional outcomes and perceived quality of life at... more
Investigators: Hammond F, Norton H, Phillips V, Johnston M view full
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Lead Center: Carolinas Rehabilitation
Collaborating Centers: Emory University/Shepherd Center, Kessler Medical Rehabilitation Research and Education Corporation
Post-traumatic Depression as a Complication of Violence Induced TBI Versus Non-violence Induced TBI: Implications on treatment, interventions, cost, and long-term outcomes.
Abstract: Depression is a well-established complication of TBI, with reported incidence of less than 10% to 77%. However, previous studies have been limited by small, unrepresentative samples. This study investigates the incidence, time-course, outcome, and measurement of post-traumatic depression in those with TBI who survive and are admitted to acute inpatient rehabilitation.... more
Investigators: Hammond F, Babin P, Grattan K, Norton H, Johnston M, Miller M, Kreutzer J, Black K view full
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Lead Center: Carolinas Rehabilitation
Collaborating Centers: Rehabilitation Institute of Michigan, Kessler Medical Rehabilitation Research and Education Corporation, Emory University/Shepherd Center, Virginia Commonwealth University/Medical College of Virginia
Serial Casting Versus Ultrasound with Weight Bearing for the Treatment of Equinovarus Contractures in the Individual with Acute TBI: Comparison of Efficacy and Cost
Abstract: Plantar flexion contractures are a common complication of TBI. Multiple treatment methods are available for increasing joint range of motion (ROM). Serial casting and ultrasound combined with a static stretch are two conservative methods of treatment for plantar flexion contractures known to increase dorsiflexion ROM. However, studies have not compared the effectiveness and cost of serial casting versus ultrasound/static stretch in increasing dorsiflexion ROM. This is a randomized, controlled study comparing the efficacy and cost associated with these two methods... more
Investigators: Hammond F, Lang E, LaBarbera J, Bucklew S, Norton H, Burke D, Flanagan S, Rupright J view full
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Lead Center: Carolinas Rehabilitation
Collaborating Centers: Spaulding Rehabilitation Hospital, University of Missouri
Factors Influencing Cost of Care and Resource Utilization for Individuals with TBI Participating in Acute Inpatient Rehabilitation: The Relationship to Outcome
Abstract: Difficult decisions regarding the appropriate allocation of services are continually needed in order to control health care costs. In the case of TBI, such decisions must focus on optimizing function and quality of life while minimizing the costs to society and survivors. It is important to demonstrate the efficacy and cost-effectiveness of treatment interventions and service delivery models. Numerous studies have investigated the direct overall cost of acute medical and rehabilitation hospitalization. However, studies regarding the costs and effectiveness of particular treatment strategies utilized in a comprehensive rehabilitation programs and post-acutely are lacking. This study investigates potential predictors of cost... more
Investigators: Hammond F, Grattan K, McDeavitt J, Handy-Williams B, Norton H, Phillips V, Johnston M view full
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Lead Center: Carolinas Rehabilitation
Collaborating Centers: Emory University/Shepherd Center, Kessler Medical Rehabilitation Research and Education Corporation
Utilization of Rehabilitation Resources in Pediatric Trauma Patients With and Without Head Injury
Abstract: Rehabilitation services after pediatric trauma helps reduce morbidity. However, a better understanding of how these services are utilized is needed. Studies of acute care disposition have suggested that, after controlling for injury and impairment severity, there is a correlation between receipt of inpatient rehabilitation and the availability of rehabilitation resources. This prospective study of 2,319 trauma patients under 16 years of age consecutively admitted to a Level I Trauma Center examined rehabilitation service receipt during and after discharge where availability of rehabilitation services remained constant. The sample included 67.4% with minor injuries and 21.7% with major trauma as defined by the Injury Severity Score. Of... more
Investigators: Kolaski K, Sasser H, Grattan K view full
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Lead Center: Carolinas Rehabilitation
Gender Associated Differences in Outcome after Traumatic Brain Injury
Abstract: The sparse literature on gender and TBI suggest reasons to expect gender-based outcome differences. One hundred twenty persons from a cohort of 378 adults admitted with TBI to a Level I trauma Center were studied to examine the relationship between gender and outcome. In this sample, women were predominately older than the men (80% men and 58% women were <50 years old). Factors significantly different by gender included age, payor, arrest history, pre-and post-injury employment, and injury severity. Female gender was a significantly predictive of poorer total DRS and CIQ Productivity even after adjusting for other factors, but not of total CIQ Total, Home and Social scores. This suggests that TBI may be influenced by gender, and that... more
Investigators: Wagner A, Hammond F, Sasser H, Wiercisiewski D view full
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Lead Center: Carolinas Rehabilitation
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
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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
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
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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
Brain injury severity as measured by the Glasgow Coma Scale & its influence on outcome as measured by Disability Rating Scale at acute rehabilitation discharge and long term follow-up after severe TBI
Abstract: This study will compare outcomes among those with severe injuries to determine how they differ at discharge from rehabilitation and at 1, 5 and 10 years after injury. The data from the model system national database will be reviewed to determine how the patterns and ultimate recovery differ by Glasgow Coma Scale (GCS) score. Severity of injury will be measured by GCS scores in the emergency room. Outcome will be measured by the Disability Rating Scale (DRS).... more
Investigators: Burke D, Hammond F, Rosenthal M, Glenn M, Meythaler J, Jacob L view full
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Lead Center: Spaulding Rehabilitation Hospital
Collaborating Centers: Carolinas Rehabilitation, University of Alabama
Subjective Well-being in the First Two Years Following Traumatic Brain Injury
Abstract: Purpose: Examine predictors of life satisfaction one and two years post-injury.

Design: Prospective, longitudinal study of patients with TBI followed at one and two years post-injury. Replication of a single center study using data from the TBI Model Systems dataset. Univariate regression models will be calculated first. Those variables
that account for at least 1% of variance will be included in subsequent stepwise linear regression models.

Current status: Data has been compiled.... more
Investigators: Corrigan J, Bogner J, Hammond F, Sander A, Whiteneck G, Kreutzer J view full
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Lead Center: Ohio State University
Collaborating Centers: Carolinas Rehabilitation, The Institute for Rehabilitation and Research, Virginia Commonwealth University/Medical College of Virginia
Responsiveness of the Community Integration Questionnaire (CIQ) and the Supervision Rating Scale (SRS)
Abstract: It is unknown whether the CIQ (or the SRS) is sensitive to change in S.s. This study planned to use data from other studies, where the CIQ (and/or the SRS) is collected both before and after CI-related interventions, to assess whether these instruments are responsive to change. The study was never initiated due to lack of sufficient available data.... more
Investigators: Goldstein R, Hammond F view full
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Lead Center: Spaulding Rehabilitation Hospital
Collaborating Centers: Carolinas Rehabilitation
Family Members' and Caregivers' Emotional Well Being
Abstract: Objectives for this collaborative project include: (1) to examine the frequency and magnitude of emotional distress and depressive symptoms and the level of life satisfaction of family members and non-family caregivers as compared to clinical and non-clinical populations, and (2) to identify the relationships between caregivers' well-being and survivors' injury severity and level of functioning. Six TBI Model System centers are collecting data from family members, significant others, and friends of individuals in the National Database at either 1, 2, or 5 year follow-up. Data is collected from each caregiver only once. Measures include the Neurobehavioral Functioning Inventory (NFI) Depression subscale, the Brief Symptom Inventory-18... more
Investigators: Kreutzer J, Marwitz J, Rapport L, Koviak C, Hammond F, Morita C, Hart T, Selleck E, Glenn M, Harrison-Felix C view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Collaborating Centers: Spaulding Rehabilitation Hospital, Rehabilitation Institute of Michigan, Carolinas Rehabilitation, Moss Rehabilitation Research Institute, Craig Hospital
Depression after traumatic brain injury: A NIDRR model systems multi-center investigation.
Abstract: Objective: To identify the frequency and manifestations of depression after traumatic brain injury (TBI) and the factors that contribute to developing this mood disorder.

Design: A prospective, nationwide, multicenter study; 17 centers supplied data from medical records and patient responses on a standardized criterion instrument.

Setting: Traumatic Brain Injury Model Systems programs.

Participants: A demographically diverse sample of 666 outpatients with TBI was evaluated 10 to 126 months after injury.

Main Outcome Measures: Depressive symptoms were characterized with the Neurobehavioral Functioning Inventory by using the Diagnostic and Statistical Manual of Mental Disorders (4th ed; DSM-IV) diagnostic framework. Analysis of... more
Investigators: Seel R, Kreutzer J, Rosenthal M, Hammond F, Corrigan J, Black K view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Collaborating Centers: Rehabilitation Institute of Michigan, Kessler Medical Rehabilitation Research and Education Corporation, Carolinas Rehabilitation, Ohio State University
Effect of blood alcohol level on neurpsych outcome from TBI
Abstract: 1) To resolve contradictory reports in the literature regarding adverse effects of acute blood alcohol level (BAL) on neuropsychological outcome from traumatic brain injury (TBI). 2) 459 adults with nonpenetrating TBI who were inpatients at one of 6 rehabilitation centers in the TBI Model Systems project, whose BAL had been measured at hospital arrival, and who emerged from post-traumatic amnesia (PTA) and underwent neuropsychological testing before rehabilitation discharge. 3)15 neuropsychological tests were administered after resolution of post-traumatic amnesia and at one year post-injury. 4) BAL was classified as 1) negative vs. positive and 2) intoxicated (BAL > 100 mg/dl) vs. non-intoxicated. The effect of BAL on neuropsychological... more
Investigators: Boake C, High Jr. W, Sander A, Kreutzer J, Macciocchi S, Stringer A, Hammond F, Rosenthal M, Bogner J, Hanks R view full
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Lead Center: The Institute for Rehabilitation and Research
Collaborating Centers: Emory University/Shepherd Center, Ohio State University, Rehabilitation Institute of Michigan, Carolinas Rehabilitation, Kessler Medical Rehabilitation Research and Education Corporation, Virginia Commonwealth University/Medical College of Virginia
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
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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


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