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Projects of the TBINDC Registry by Research Center
The Effect of Scheduled Telephone Intervention on Outcomes After Traumatic Brain Injury: A Multi-Center Randomized Controlled Trial
Abstract: The University of Washington is the lead center in an innovative, three-site TBI telephone intervention funded by the National Institute on Disability and Rehabilitation Research. The study is being carried out here as well as at two other Model Systems Centers across the country: Moss Rehabilitation Research Institute in Philadelphia, Pennsylvania and Methodist Rehabilitation, in Jackson, Mississippi.

The aim of the study is to evaluate the effect of a low-cost phone intervention for persons with moderate to severe TBI in such areas as community integration and employment at one and two years after injury. Participation in the study will be offered to individuals with TBIs who are receiving inpatient rehabilitation services at... more
Investigators: Bell K, Dikmen S, Temkin N, Fraser R, Brockway J, Hart T, Whyte J, Sherer M view full
Lead Center: University of Washington
Collaborating Centers: Moss Rehabilitation Research Institute, Methodist Rehabilitation Center
Outcome as a Function of Alternate Pathways of Post-acute Medical Treatment
Abstract: This study attempted to determine the effectiveness of
rehabilitation for TBI using a non-randomized design. Participants
consisted of a consecutive series of 365 individuals with TBI who were
discharged from a Level I trauma center either to inpatient
rehabilitation or home (78% follow-up). Outcome measures included
Glasgow Outcome Scale (GOS), Sickness Impact Profile (SIP), Burden
Inventory, and Perceived Quality of Life (PQOL). We found that
discharge to inpatient rehabilitation was associated with significantly
poorer functioning on the GOS, non-significantly poorer functioning on
the SIP, non-significantly increased care-giver burden as measured by
the Burden Inventory, and non-significant improvement on the PQOL.
Similar results... more
Investigators: Powell J, Temkin N, Machamer J, Dikmen S view full
Lead Center: University of Washington
Scheduled telephone interventions for survivors of TBI and caregivers (the experimental arm of the controlled trial)
Abstract: We are developing a training manual based on the experience gained from our scheduled telephone follow up randomized study. The manual will have background information for training phone staff as well as suggested management strategies, and methods of documentation. Sample decision trees and assessment scales will be included. The training manual is aimed at the educated non-medical professional to provide support and information via telephone.... more
Investigators: Bell K, Toshima M, Dalisky R, Esselman P, Doctor J, Bombardier C, Fraser R, Powell J, Temkin N, Dikmen S view full
Lead Center: University of Washington
Acute Care Discharge Destination as Related to Violence
Abstract: Violence related to TBI has enormous impact on the medical system and on society because of the burden of medical, disability and social costs of these injuries. This study will attempt to examine how violence impacts discharge destination following acute medical care. We will compare discharge location and other variables in individuals whose injury was violence related to individuals with non-violence related injuries.
The subjects will be all individuals admitted to the Level I trauma center with a diagnosis of TBI over a 2 year period.

The hypostheses are:
1. Those injured violently are more likely to have focal, severe, and penetrating brain injuries requiring a greater number of neurosurgical interventions. They will be less... more
Investigators: Esselman P, Dikmen S, Temkin N, Bell K view full
Lead Center: University of Washington
The Effect of Community-Based Exercise on Symptoms of Depression in Persons with TBI
Abstract: Depression and associated disorders (such as anxiety, irritability, insomnia, appetite disorders, sadness, and lack of interest) are common after traumatic brain injuries (TBI) or concussions. We are interested in examining whether aerobic exercise would be helpful to improve mood and lessen the severity of these symptoms in persons who have had mild to moderate TBI or concussion. In this study, we will randomize participants into two groups; each participating in 10 supervised exercise sessions at North Seattle Community College Wellness Center. While in the exercise program, each individual will have practice and assistance in planning a home exercise program to be done during the exercise program (and, hopefully, after the study is... more
Investigators: Bell K, Esselman P, Bombardier C, Hoffman J, Powell J view full
Lead Center: University of Washington
Risk of Unemployment after Traumatic Brain Injury
Abstract: This project will be looking at unemployment after traumatic brain injury. It will focus on people who were working before their injury. First, we will find out the unemployment rate for those people one year after injury. We will compare that rate with the unemployment rate for the general population. We will then look at age, gender, and education, to see if those factors make a difference in who is employed and who is not. We will also look at injury severity and cognitive abilities to see how they affect employment status. ... more
Investigators: Doctor J, Castro J, Machamer J, Fraser R, Temkin N, Dikmen S view full
Lead Center: University of Washington
A Change in the Payment Environment: Evaluation of Medicare's Prospective Payment System on Access to Inpatient Rehabilitation for Patients with Traumatic Brain Injury
Abstract: We will be examining if the new Medicare Prospective Payment System (PPS), implemented in January 2002, for inpatient rehabilitation has changed how many people go to inpatient rehabilitation, who those patients are, and where they are discharged after a Traumatic Brain Injury (TBI). We are also interested in describing and comparing the types of patients and how well they have recovered after inpatient rehabilitation for TBI before and after the Medicare Prospective Payment System (PPS) for inpatient rehabilitation was started.

... more
Investigators: Hoffman J, Doctor J, Chan L view full
Lead Center: University of Washington
Blame Attribution in Violent and Non-Violent TBI: Effects on Psychosocial Adjustment
Abstract: Violence is a significant cause of TBI, especially in urban areas. In other populations, violence-related injury has been studied with respect to blame attribution. Previous work suggests that self-blame may be associated with better coping and more favorable outcome compared to blame of other persons. Those with TBI due to violence may therefore be at risk for worse psychological outcomes. In this project we are measuring blame attribution in the acute stages of both violent and non-violent injury and again at 1-year follow-up, along with outcome assessment, to determine the effects of blame attribution on psychosocial outcome. In the first phase of the study we demonstrated that blame attribution is reliable and valid in persons with... more
Investigators: Hart T, Bogner J, Whyte J, Polansky M, Hanks R, Esselman P view full
Lead Center: Moss Rehabilitation Research Institute
Collaborating Centers: Ohio State University, University of Washington, Rehabilitation Institute of Michigan
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
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
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
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

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