Preliminary Investigation of Predictors of Rehabilitation Needs 10-15 Years After Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study

Research Objectives: To examine the relationship between environmental barriers and rehabilitation needs during the chronic phase of recovery from traumatic brain injury (TBI).

Design: Cohort study of participants enrolled in the Veterans Affairs TBI Model Systems study with a follow up interview at 10 or 15 years post-TBI.

Setting: Five Veterans Affairs Polytrauma Rehabilitation Centers.

Participants: Participants (N = 476) were 95.6% male, 77.5% White, 59.7% married, 72.5% active duty at time of TBI, 54.2% injured while deployed, and 35.3% were special operators. TBI severity per initial Glasgow Coma Score was 18.7% mild, 5.3% moderate, 24.8% severe, and 2.5% intubated (48.7% had unknown GCS or were self-reported TBI with no acute care).

Interventions: N/A

Main Outcome Measures: Rehabilitation Needs Survey (RNS).

Results: Participants reported an average of 4.9 unmet needs (SD = 5.3). The most frequently endorsed needs were Improving Memory (45.6%), Controlling Physical Symptoms (38.7%) and Improving Health (35.9%). Males reported fewer rehabilitation needs than females (B = -2.57, 95% CI -4.89, -0.24). Total score on the Craig Hospital Inventory of Environmental Factors – short form was associated with increased rehabilitation needs (B = 2.54, 95% CI 2.12, 2.96). All subscale scores were also significant, including Policy barriers (B = 0.93, 95% CI 0.68, 1.17). Physical/Structural barriers (B = 0.93, 95% CI 0.69, 1.17), Work- and School-specific barriers (B = 0.90, 95% CI 0.46, 1.33), Attitudinal/Support barriers (B = 1.40, 95% CI 1.07, 1.73), and Assistance- and Service-related barriers (B = 1.78, 95% CI 1.42, 2.15).

Conclusions: Results suggest that environmental barriers are associated with chronic rehabilitation needs. Future research is needed to examine the inter-relationship between environmental barriers and other predictors of rehabilitation needs.

Author(s) Disclosures: The views expressed in this abstract are those of the authors and do not necessarily reflect the official policy or position of the Defense Health Agency, Department of Defense, nor the U.S. Government. For more information, please contact dha.TBICOEinfo@health.mil. UNCLASSIFIED. This work is supported by funding from the Department of Defense [Contract HT0014-22-C-0016] and with resources and use of facilities at the James A Haley Veterans’ Hospital.