Pre-treatment compensation use is a stronger correlate of measures of activity limitations than cognitive impairment

Objectives: This study examined the relationship between baseline compensation use, activity limitations and cognitive impairment in persons who sustained moderate-to-severe acquired brain injury. Design: Randomized controlled clinical trial. Methods: A total of 22 individuals with medically documented brain injury and their family members completed a baseline assessment including measures of cognitive functioning (Repeatable Battery of Neuropsychological Assessment; RBANS), activity limitations (Neurobehavioural Functioning Inventory; NFI) and compensatory strategies use (Compensation Techniques Questionnaire; CTQ). There were no gender differences on measures of cognitive impairment, activity limitations or compensation use. Results: As predicted, cognitive impairment was not significantly associated with frequency of baseline compensation strategy use. Weaker word-list learning on RBANS was associated with greater family-reported memory problems on the NFI. Lower frequency of compensatory strategy use was correlated with greater patient-reported activity limitations on NFI, while it was not related to family ratings of activity limitations. After adjusting for history of depression and anxiety, baseline compensation use uniquely accounted for 16 of variance in predicting greater patient ratings of mood difficulties. Conclusions: Results indicate that, after acquired brain injury, baseline compensation use is more strongly associated with measures of activity limitations than is cognitive impairment.