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Long-term therapeutic services usage among people with moderate-to-severe traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. People who survive a moderate to severe TBI typically experience impairments to physical, cognitive, and emotional functioning. As a result, they often rely on rehabilitation services (including physical therapy, occupational therapy, and speech therapy) to improve their capacity to move independently, carry out daily tasks, maintain employment, and communicate effectively.

Timely access to services—starting within a few days or weeks of injury—remains essential for a fast, effective recovery after TBI. Yet many people with TBI only engage in rehabilitation services during the acute recovery period, despite the positive outcomes associated with long-term services use.

A recent study examined long-term rehabilitation services usage among people with moderate-to-severe TBI. They wanted to determine patients’ service engagement in the years following injury and to identify characteristics associated with service usage. To this end, they collected data from 97 patients who were admitted to a trauma center with moderate-to-severe TBI between 2005 and 2007. The researchers conducted follow-up surveys with each patient at 1 year, 2 years, 5 years, and 10 years after injury. They found that:

  • At one year after injury, only 42% of patients received any kind of rehabilitation service.
  • At 10 years after injury, only 1% of patients received at least one service, and only 1% still received all three services (occupational therapy, physical therapy, and speech therapy).
  • Patients who continued to use services in the years following TBI were more likely to be female, to have severe injuries, or to have been employed prior to the injury.

These findings indicate that therapeutic services usage is low among individuals with moderate-to-severe TBI. Despite reported ongoing functional impairments, the rate of services access continues to decrease in the years following injury, dropping off almost entirely by the 10-year mark. As a result, researchers believe that TBI patients face insufficient long-term access to traditional TBI rehabilitation services. Further research is necessary to identify barriers that may limit their ability to access the therapeutic rehabilitation services they need to return to a full quality of life.

Andelic N, Forslund MV, Perrin PB, et al. Long-term follow-up of use of therapy services for patients with moderate-to-severe traumatic brain injury. Rehabilitation Medicine. (2020).

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