Impairment at rehabilitation admission and 1 year after moderate-to-severe traumatic brain injury: A prospective multi-centre analysis

Primary objective: Describe physical impairment at rehabilitation admission and 1-year after moderate-to-severe traumatic brain injury. Research design: Prospective longitudinal multi-centre descriptive analysis. Methods and procedures: Physical examination variables were analysed for all subjects in the Traumatic Brain Injury Model Systems database from 1988-2002 that had data both at rehabilitation admission and at 1 year. Main results: Standing balance was more commonly and severely impaired at admission (82% of sample impaired) and 1 year (24% impaired) compared to other examination variables. Sitting balance was impaired in 52% of the sample at admission, largely resolving (5% abnormal) by 1 year. The profile of impaired strength, coordination and tone was similar among the four limbs. Impaired limb strength was most common and persistent over the study period compared to coordination and tone, but strength was normal in greater than 80% of subjects at 1 year. Dysphagia present at admission (40% of sample) largely resolved by 1 year (0.4% unable to swallow). Impairment in audition and vision was uncommon and changed little during the study period. Conclusions: Acute impairment was present in all variables. A minority of the sample had detectable impairment at 1 year. Standing balance was most severely and persistently impaired.