174 results on '"Bushnik, Tamara"'
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2. Menopause and Traumatic Brain Injury: A NIDILRR Collaborative Traumatic Brain Injury Model Systems Study
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Rapport, Lisa J., Kalpakjian, Claire Z., Sander, Angelle M., Lequerica, Anthony H., Bushnik, Tamara, Quint, Elisabeth H., and Hanks, Robin A.
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- 2024
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3. Societal Participation of People With Traumatic Brain Injury Before and During the COVID-19 Pandemic: A NIDILRR Traumatic Brain Injury Model Systems Study
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Venkatesan, Umesh M., Adams, Leah M., Rabinowitz, Amanda R., Agtarap, Stephanie, Bombardier, Charles H., Bushnik, Tamara, Chiaravalloti, Nancy D., Juengst, Shannon B., Katta-Charles, Sheryl, Perrin, Paul B., Pinto, Shanti M., Weintraub, Alan H., Whiteneck, Gale G., and Hammond, Flora M.
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- 2023
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4. Replicability of proton MR spectroscopic imaging findings in mild traumatic brain injury: Implications for clinical applications
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Chen, Anna M., Gerhalter, Teresa, Dehkharghani, Seena, Peralta, Rosemary, Gajdošík, Mia, Gajdošík, Martin, Tordjman, Mickael, Zabludovsky, Julia, Sheriff, Sulaiman, Ahn, Sinyeob, Babb, James S., Bushnik, Tamara, Zarate, Alejandro, Silver, Jonathan M., Im, Brian S., Wall, Stephen P., Madelin, Guillaume, and Kirov, Ivan I.
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- 2023
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5. Organisation of services and systems of care in paediatric spinal cord injury rehabilitation in seven countries: a survey with a descriptive cross-sectional design
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Höfers, Wiebke, Jørgensen, Vivien, Sällström, Susanne, Vege, Kristine M., Strøm, Mona, New, Peter W., Bushnik, Tamara, Zakharova, Olga, Krasovsky, Tal, Guttman, Dafna, Ghatasha, Atheer, Genlin, Liu, Yang, Chen, Yu-Xi, Qin, Wahman, Kerstin, Sunnerhagen, Katharina S., Ertzgaard, Per, Sukhov, Renat, Augutis, Marika, Stanghelle, Johan K., and Roaldsen, Kirsti S.
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- 2022
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6. T1 and T2 quantification using magnetic resonance fingerprinting in mild traumatic brain injury
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Gerhalter, Teresa, Cloos, Martijn, Chen, Anna M., Dehkharghani, Seena, Peralta, Rosemary, Babb, James S., Zarate, Alejandro, Bushnik, Tamara, Silver, Jonathan M., Im, Brian S., Wall, Stephen, Baete, Steven, Madelin, Guillaume, and Kirov, Ivan I.
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- 2022
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7. Longitudinal changes in sodium concentration and in clinical outcome in mild traumatic brain injury.
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Gerhalter, Teresa, Chen, Anna M, Dehkharghani, Seena, Peralta, Rosemary, Gajdosik, Mia, Zarate, Alejandro, Bushnik, Tamara, Silver, Jonathan M, Im, Brian S, Wall, Stephen P, Madelin, Guillaume, and Kirov, Ivan I
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- 2024
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8. Developing multidimensional participation profiles after traumatic brain injury: a TBI model systems study.
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Juengst, Shannon B., Agtarap, Stephanie, Venkatesan, Umesh M., Erler, Kimberly S., Evans, Emily, Sander, Angelle M., Klyce, Daniel, O'Neil Pirozzi, Therese M., Rabinowitz, Amanda R., Kazis, Lewis E., Giacino, Joseph T., Kumar, Raj G., Bushnik, Tamara, and Whiteneck, Gale G.
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REHABILITATION for brain injury patients ,SATISFACTION ,SECONDARY analysis ,RESEARCH funding ,INTERVIEWING ,STRUCTURAL equation modeling ,AGE distribution ,RACE ,PUBLIC welfare ,SOCIAL participation ,EDUCATIONAL attainment - Abstract
Purpose. To characterize societal participation profiles after moderate-severe traumatic brain injury (TBI) along objective (Frequency) and subjective (Satisfaction, Importance, Enfranchisement) dimensions. Materials and Methods. We conducted secondary analyses of a TBI Model Systems sub-study (N = 408). Multiaxial assessment of participation included the Participation Assessment with Recombined Tools-Objective and -Subjective questionnaires (Participation Frequency and Importance/Satisfaction, respectively) and the Enfranchisement Scale. Participants provided responses via telephone interview 1–15 years post-injury. Multidimensional participation profiles (classes) were extracted using latent profile analysis. Results. A 4-class solution was identified as providing maximal statistical separation between profiles and being clinically meaningful based on profile demographic features. One profile group (48.5% of the sample) exhibited the "best" participation profile (High Frequency, Satisfaction, Importance, and Enfranchisement) and was also the most advantaged according to socioeconomic indicators. Other profile groups showed appreciable heterogeneity across participation dimensions. Age, race/ethnicity, education level, ability to drive, and urbanicity were features that varied between profiles. Conclusions. Societal participation is a critical, but inherently complex, TBI outcome that may not be adequately captured by a single index. Our data underscore the importance of a multidimensional approach to participation assessment and interpretation using profiles. The use of participation profiles may promote precision health interventions for community integration. Our study found unidimensional measures of societal participation in traumatic brain injury (TBI) populations that focus exclusively on frequency indicators may be overly simplistic and miss key subjective components of participation Taking a multidimensional perspective, we documented four meaningfully distinct participation subgroups (including both objective and subjective dimensions of societal participation) within the TBI rehabilitation population Multidimensional profiles of participation may be used to group individuals with TBI into target groups for intervention (e.g., deeper goal assessment for individuals who do not rate standard participation activities as important, but also do not participate and do not feel enfranchised). [ABSTRACT FROM AUTHOR]
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- 2024
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9. An Umbrella Review of Self-Management Interventions for Health Conditions With Symptom Overlap With Traumatic Brain Injury.
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Sander, Angelic M., Pappadis, Monique R., Bushnik, Tamara, Chiaraualloti, Nancy D., Driver, Simon, Hanks, Robin, Lercher, Kirk, Neumann, Daion, Rabinowitz, Amanda, Seet, Ronald T., Weber, Erica, Ralston, Rick K., Corrigan, John, Kroenke, Kurt, and Hammond, Flora M.
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Objective: To synthesize evidence for the effectiveness of self-management interventions for chronic health conditions that have symptom overlap with traumatic brain injury (TBI) in order to extract recommendations for self-management intervention in persons with TBI. Design: An umbrella review of existing systematic reviews and/or meta-analyses of randomized controlled trials or nonrandomized studies targeting self-management of chronic conditions and specific outcomes relevant to persons with TBI. Method: A comprehensive literature search of 5 databases was conducted using PRISMA guidelines. Two independent reviewers conducted screening and data extraction using the Covidence web-based review platform. Qpality assessment was conducted using criteria adapted from the Assessing the Methodological Qpality of Systematic Reviews-2 (AMSTAR-2). Results: A total of26 reviews met the inclusion criteria, covering a range of chronic conditions and a range of outcomes. Seven reviews were of moderate or high quality and focused on self-management in persons with stroke, chronic pain, and psychiatric disorders with psychotic features. Self-management interventions were found to have positive effects on quality of life, self-efficacy, hope, reduction of disability, pain, relapse and rehospitalization rates, psychiatric symptoms, and occupational and social functioning. Conclusions: Findings are encouraging with regard to the effectiveness of sel fmanagement interventions in patients with symptoms similar to those of TBI. However, reviews did not address adaptation of self-management interventions for those with cognitive deficits or for populations with greater vulnerabilities, such as low education and older adults. Adaptations for TBI and its intersection with these special groups may be needed. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Early Rehabilitation in the Medical and Surgical Intensive Care Units for Patients With and Without Mechanical Ventilation: An Interprofessional Performance Improvement Project
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Corcoran, John R., Herbsman, Jodi M., Bushnik, Tamara, Van Lew, Steve, Stolfi, Angela, Parkin, Kate, McKenzie, Alison, Hall, Geoffrey W., Joseph, Waveney, Whiteson, Jonathan, and Flanagan, Steven R.
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- 2017
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11. Assessing menopause symptoms in women with traumatic brain injury: the development and initial testing of a new scale.
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Kalpakjian, Claire Z., Hanks, Robin, Quint, Elisabeth H., Millis, Scott, Sander, Angelle M., Lequerica, Anthony H., Bushnik, Tamara, Brunner, Robert, and Rapport, Lisa
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EXPERIMENTAL design ,STATISTICS ,RESEARCH methodology ,DESCRIPTIVE statistics ,RESEARCH funding ,MENOPAUSE ,BRAIN injuries ,DATA analysis ,WOMEN'S health - Abstract
With greater survival rates after catastrophic injury, more women with traumatic brain injury (TBI) are living longer than ever. However, knowledge about this transition in these women is largely unexamined and there are no scales that have been developed to assess the experience of symptoms. To address this gap, we developed and tested a new scale of menopause symptoms in midlife women with TBI. We selected candidate items from two existing measures based on feedback from focus group discussions with seven women with TBI. Twenty candidate items were tested in cognitive interviews with six women with TBI/1 non-TBI. Then, these were field tested with 221 participants (TBI, n = 68; non-TBI, n = 153) recruited from registries. Rasch analysis and convergent validity testing were used to evaluate the new scale. Results of the Rasch analysis indicate that overall, the scale fits well the Rasch model with evidence for unidimensionality. Differential item functioning indicated that the scale performed equally well for women with and without TBI and distinguished pre- and post-menopausal states. Convergent validity was found in the expected directions. These findings support further development of the new scale to understand the experience of menopause symptoms among women with TBI. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Who enrolls and why? Examining center-specific underlying patterns behind enrollment: a New York City-based traumatic brain injury model systems study.
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Ahmed, Asim, Smith, Michelle, Mandal, Soutrik, and Bushnik, Tamara
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BRAIN injury treatment ,DATABASES ,SPANIARDS ,HEALTH facilities ,PATIENT selection ,MEDICAL care ,PATIENTS ,SPANISH language ,DECISION making ,RESEARCH funding ,EMERGENCY medical services ,ELIGIBILITY (Social aspects) ,MANAGEMENT ,SOCIODEMOGRAPHIC factors ,LOGISTIC regression analysis ,ODDS ratio - Abstract
To elucidate the sociodemographic and study factors involved in enrollment in the Traumatic Brain Injury Model System (TBIMS) database, this study examined the effect of a variety of variables on enrollment at a local TBIMS center. A sample of 654 individuals from the local TBIMS center was studied examining enrollment by age, gender, race, ethnicity, homelessness status at date of injury, history of homelessness, health insurance status, presence of social support, primary language, consenting in hospital or after discharge, and the need for an interpreter. Binary logistic regression was conducted to identify variables that predict center-based enrollment into TBIMS. Results demonstrated that older age was associated with decreasing enrollment (OR = 0.99, p = 0.01), needing an interpreter made enrollment less likely (OR = 0.33, p < 0.01), being primarily Spanish speaking predicted enrollment (OR = 3.20, p = 0.02), Hispanic ethnicity predicted enrollment (OR = 7.31, p = 0.03), and approaching individuals in the hospital predicted enrollment (OR = 6.94, p < 0.01). Here, OR denotes the odds ratio estimate from a logistic regression model and P denotes the corresponding p-value. These results can be useful in driving enrollment strategies at this center for other similar TBI research, and to contribute a representative TBI sample to the national database. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Ten-Year Employment Patterns of Working Age Individuals After Moderate to Severe Traumatic Brain Injury: A National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems Study
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Cuthbert, Jeffrey P., Pretz, Christopher R., Bushnik, Tamara, Fraser, Robert T., Hart, Tessa, Kolakowsky-Hayner, Stephanie A., Malec, James F., O'Neil-Pirozzi, Therese M., and Sherer, Mark
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- 2015
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14. Linking the GAD-7 and PHQ-9 to the TBI-QOL Anxiety and Depression Item Banks
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Boulton, Aaron J., Tyner, Callie E., Choi, Seung W., Sander, Angelle M., Heinemann, Allen W., Bushnik, Tamara, Chiaravalloti, Nancy, Sherer, Mark, Kisala, Pamela A., and Tulsky, David S.
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- 2019
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15. Measuring Fatigue in TBI: Development of the TBI-QOL Fatigue Item Bank and Short Form
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Kisala, Pamela A., Bushnik, Tamara, Boulton, Aaron J., Hanks, Robin A., Kolakowsky-Hayner, Stephanie A., and Tulsky, David S.
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- 2019
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16. Spatiotemporal profile of atrophy in the first year following moderate‐severe traumatic brain injury.
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Brennan, Daniel J., Duda, Jeffrey, Ware, Jeffrey B., Whyte, John, Choi, Joon Yul, Gugger, James, Focht, Kristen, Walter, Alexa E., Bushnik, Tamara, Gee, James C., Diaz‐Arrastia, Ramon, and Kim, Junghoon J.
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BRAIN injuries ,ATROPHY ,CEREBRAL atrophy ,CEREBRAL cortical thinning ,OCCIPITAL lobe - Abstract
Traumatic brain injury (TBI) triggers progressive neurodegeneration resulting in brain atrophy that continues months‐to‐years following injury. However, a comprehensive characterization of the spatial and temporal evolution of TBI‐related brain atrophy remains incomplete. Utilizing a sensitive and unbiased morphometry analysis pipeline optimized for detecting longitudinal changes, we analyzed a sample consisting of 37 individuals with moderate‐severe TBI who had primarily high‐velocity and high‐impact injury mechanisms. They were scanned up to three times during the first year after injury (3 months, 6 months, and 12 months post‐injury) and compared with 33 demographically matched controls who were scanned once. Individuals with TBI already showed cortical thinning in frontal and temporal regions and reduced volume in the bilateral thalami at 3 months post‐injury. Longitudinally, only a subset of cortical regions in the parietal and occipital lobes showed continued atrophy from 3 to 12 months post‐injury. Additionally, cortical white matter volume and nearly all deep gray matter structures exhibited progressive atrophy over this period. Finally, we found that disproportionate atrophy of cortex along sulci relative to gyri, an emerging morphometric marker of chronic TBI, was present as early as 3 month post‐injury. In parallel, neurocognitive functioning largely recovered during this period despite this pervasive atrophy. Our findings demonstrate msTBI results in characteristic progressive neurodegeneration patterns that are divergent across regions and scale with the severity of injury. Future clinical research using atrophy during the first year of TBI as a biomarker of neurodegeneration should consider the spatiotemporal profile of atrophy described in this study. [ABSTRACT FROM AUTHOR]
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- 2023
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17. Prior History of Traumatic Brain Injury Among Persons in the Traumatic Brain Injury Model Systems National Database
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Corrigan, John D., Bogner, Jennifer, Mellick, Dave, Bushnik, Tamara, Dams-O'Connor, Kristen, Hammond, Flora M., Hart, Tessa, and Kolakowsky-Hayner, Stephanie
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- 2013
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18. Comparison of Informational and Educational Resource Provision for Individuals Living With Traumatic Brain Injury Based on Language, Nativity, and Neighborhood.
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Wilson, Judith, McGiffin, Jed N., Smith, Michelle, Garduño-Ortega, Olga, Talis, Elina, Zarate, Alejandro, Jenkins, Natalie, Rath, Joseph F., and Bushnik, Tamara
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Objective: To examine a resource provision program for individuals living with moderate-to-severe traumatic brain injury (TBI), using a comparison of the resources provided across social differences of language, nativity, and neighborhood. Setting: The Rusk Rehabilitation TBI Model System (RRTBIMS) collects data longitudinally on individuals from their associated private and public hospitals, located in New York City. Participants: A total of 143 individuals with TBI or their family members. Design: An observational study of relative frequency of resource provision across variables of language, nativity, and neighborhood, using related-samples nonparametric analyses via Cochran's Q test. Main Measures: Variables examined were language, place of birth, residence classification as medically underserved area/population (MUA), and resource categories. Results: Results indicate that US-born persons with TBI and those living in medically underserved communities are provided more resources than those who are born outside the United States or reside in communities identified as adequately medically served. Language was not found to be a factor. Conclusion: Lessons learned from this research support the development of this resource provision program, as well as guide future programs addressing the gaps in health information resources for groups negatively impacted by social determinants of health (SDoH). An approach with immigrant participants should take steps to elicit questions and requests, or offer resources explicitly. We recommend research looking at what interpreter strategies are most effective and research on SDoH in relation to the dynamic interaction of variables in the neighborhood setting. [ABSTRACT FROM AUTHOR]
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- 2023
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19. Development of the Participation Assessment With Recombined Tools–Objective for Use After Traumatic Brain Injury
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Whiteneck, Gale G., Dijkers, Marcel P., Heinemann, Allen W., Bogner, Jennifer A., Bushnik, Tamara, Cicerone, Keith D., Corrigan, John D., Hart, Tessa, Malec, James F., and Millis, Scott R.
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- 2011
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20. Perceived care partner burden at 1-year post-injury and associations with emotional awareness, functioning, and empathy after TBI: A TBI model systems study.
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Klyce, Daniel W., Merced, Kritzianel, Erickson, Alexander, Neumann, Dawn M., Hammond, Flora M., Sander, Angelle M., Bogner, Jennifer A., Bushnik, Tamara, Chung, Joyce S., and Finn, Jacob A.
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RESEARCH ,EMPATHY ,SCIENTIFIC observation ,CROSS-sectional method ,BURDEN of care ,RISK assessment ,SPOUSES ,RESEARCH funding ,DESCRIPTIVE statistics ,PSYCHOLOGY of caregivers ,EMOTION regulation ,BRAIN injuries ,SEXUAL partners ,REHABILITATION for brain injury patients ,SECONDARY analysis ,PARENTS - Abstract
BACKGROUND: People with traumatic brain injury (TBI) can lack awareness of their own emotions and often have problems with emotion dysregulation, affective disorders, and empathy deficits. These impairments are known to impact psychosocial behaviors and may contribute to the burden experienced by care partners of individuals with TBI. OBJECTIVE: To examine the associations of emotional awareness, emotional functioning, and empathy among participants with TBI with care partner burden. METHOD: This multisite, cross-sectional, observational study used data from 90 dyads (participants with TBI and their care partner) 1-year post-injury. Participants with TBI completed the Difficulty with Emotional Regulation Scale (DERS; Awareness, Clarity, Goals, Impulse, Nonacceptance, and Strategies subscales); PTSD Checklist-Civilian Version; NIH Toolbox Anger-Affect, Hostility and Aggression Subdomains; PHQ-9; GAD-7; and the Interpersonal Reactivity Index (empathic concern and perspective taking subscales). Care partners completed the Zarit Burden Inventory (ZBI) and provided demographic information. RESULTS: Care partners were predominately female (77%), and most were either a spouse/partner (55.2%) or parent (34.4%). In an unadjusted model that included assessments of emotional awareness, emotional functioning, and empathy of the participant with TBI, the DERS-Awareness and NIH-Hostility subscales accounted for a significant amount of variance associated with care partner burden. These findings persisted after adjusting for care partner age, relationship, education, and the functional status of the participant with TBI (β= 0.493 and β= 0.328, respectively). CONCLUSION: These findings suggest that high levels of hostility and low emotional self-awareness can significantly affect the burden felt by TBI care partners. [ABSTRACT FROM AUTHOR]
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- 2023
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21. Specialized stroke rehabilitation services in seven countries: Preliminary results from nine rehabilitation centers
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Langhammer, Birgitta, Becker, Frank, Sunnerhagen, Katharina S., Zhang, Tong, Du, Xiaoxia, Bushnik, Tamara, Panchenko, Maria, Keren, Ofer, Banura, Samir, Elessi, Khamis, Luzon, Fuad, Lundgren-Nilsson, Åsa, Li, Xie, Sällström, Susanne, and Stanghelle, Johan Kvalvik
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- 2015
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22. Menopause Characteristics and Subjective Symptoms in Women With and Without Spinal Cord Injury
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Kalpakjian, Claire Z., Quint, Elisabeth H., Bushnik, Tamara, Rodriguez, Gianna M., and Terrill, Melissa Sendroy
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- 2010
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23. Cognitive Dependence in Physically Independent Patients at Discharge From Acute Traumatic Brain Injury Rehabilitation.
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Rath, Joseph F., McGiffin, Jed N., Glubo, Heather, McDermott, Hannah W., Beattie, Aaron, Arutiunov, Caitlyn, Schaefer, Lynn A., Im, Brian, and Bushnik, Tamara
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To determine the incidence of cognitive dependence in adults who are physically independent at discharge from acute traumatic brain injury (TBI) rehabilitation. Analysis of historical clinical and demographic data obtained from inpatient stay. Inpatient rehabilitation unit in a large, metropolitan university hospital. Adult inpatients with moderate to severe TBI (N=226) who were physically independent at discharge from acute rehabilitation. Not applicable. FIM Motor and Cognitive subscales, discharge destination, and care plan. Approximately 69% (n=155) of the physically independent inpatients were cognitively dependent at discharge from acute rehabilitation, with the highest proportions of dependence found in the domains of problem solving and memory. Most (82.6%; n=128) of these physically independent, yet cognitively dependent, patients were discharged home. Of those discharged home, 82% (n=105) were discharged to the care of family members, and 11% (n=15) were discharged home alone. Patients from racial and ethnic minority backgrounds were significantly more likely than White patients to be discharged while cognitively dependent. The majority of physically independent patients with TBI were cognitively dependent at the time of discharge from acute inpatient rehabilitation. Further research is needed to understand the effect of cognitive dependence on caregiver stress and strain and the disproportionate burden on racial and ethnic minority patients and families. Given the potential functional and safety limitations imposed by cognitive deficits, health care policy and practice should facilitate delivery of cognitive rehabilitation services in acute TBI rehabilitation. [ABSTRACT FROM AUTHOR]
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- 2022
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24. Assessment of the individual and compounding effects of marginalization factors on injury severity, discharge location, recovery, and employment outcomes at 1 year after traumatic brain injury.
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Garduño-Ortega, Olga, Huihui Li, Smith, Michelle, Lanqiu Yao, Wilson, Judith, Zarate, Alejandro, and Bushnik, Tamara
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BRAIN injuries ,SOCIAL impact ,WOUNDS & injuries ,INPATIENT care ,SUPPORTED employment ,PSYCHIATRIC hospital care ,LANGUAGE ability ,COMPLICATED grief ,EMPLOYMENT - Abstract
Objective: The aim of this study is to examine the effect of eight distinct marginalized group memberships and explore their compounding effect on injury severity, recovery, discharge location, and employment outcomes 1-year after traumatic brain injury (TBI). Methods: Individuals with medically confirmed, complicated mild-severe TBI (N = 300) requiring inpatient rehabilitation care between the ages of 18 and 65 were recruited at two urban (public and private) health systems between 2013 and 2019. Data were collected from self-report and medical record abstraction. Marginalized groupmembership (MGM) includes racial and ethnic minority status, less than a high school diploma/GED, limited English proficiency, substance abuse, homelessness, psychiatric hospitalizations, psychiatric disorders, and incarceration history. Membership in four or more of these groups signifies high MGM. In addition, these factors were explored individually. Unadjusted and adjusted linear and logistic regressions and Kruskal-Wallis tests were used to assess the associations of interest in RStudio. Results: After adjusting for age, sex, and cause of injury, compared to TBI patients with low MGM, those with high MGM experience significantly longer post-traumatic amnesia (95% CI = 2.70, 16.50; p = 0.007) and are significantly more likely to have a severe TBI (per the Glasgow-Coma Scale) (95% CI = 1.70, 6.10; p < 0.001) than a complicated mild-moderate injury. Individuals with high MGM also are significantly less likely to be engaged in competitive paid employment 1 year after injury (95% CI = 2.40, 23.40; p = 0.001). Patients with high MGM are less likely to be discharged to the community compared to patients with low MGM, but this association was not significant (95% CI = 0.36, 1.16; p = 0.141). However, when assessing MGMs in isolation, certain associations were not significant in unadjusted or adjusted models. Conclusion: This exploratory study's findings reveal that when four or more marginalization factors intersect, there is a compounding negative association with TBI severity, recovery, and employment outcomes. No significant association was found between high MGM and discharge location. When studied separately, individual MGMs had varying effects. Studying marginalization factors affecting individuals with TBI has critical clinical and social implications. These findings underline the importance of addressing multidimensional factors concurrent with TBI recovery, as the long-term effects of TBI can place additional burdens on individuals and their economic stability. [ABSTRACT FROM AUTHOR]
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- 2022
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25. The effects of plasticity-based cognitive rehabilitation on resting-state functional connectivity in chronic traumatic brain injury: A pilot study.
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Lindsey, Hannah M., Lazar, Mariana, Mercuri, Giulia, Rath, Joseph F., Bushnik, Tamara, Flanagan, Steven, and Voelbel, Gerald T.
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PILOT projects ,PATIENT aftercare ,EFFECT sizes (Statistics) ,FUNCTIONAL connectivity ,COGNITION ,NEUROPLASTICITY ,COGNITIVE rehabilitation ,REPEATED measures design ,ANALYSIS of covariance ,REHABILITATION for brain injury patients - Abstract
BACKGROUND: Traumatic brain injury (TBI) often results in chronic impairments to cognitive function, and these may be related to disrupted functional connectivity (FC) of the brain at rest. OBJECTIVE: To investigate changes in default mode network (DMN) FC in adults with chronic TBI following 40 hours of auditory processing speed training. METHODS: Eleven adults with chronic TBI underwent 40-hours of auditory processing speed training over 13-weeks and seven adults with chronic TBI were assigned to a non-intervention control group. For all participants, resting-state FC and cognitive and self-reported function were measured at baseline and at a follow-up visit 13-weeks later. RESULTS: No significant group differences in cognitive function or resting-state FC were observed at baseline. Following training, the intervention group demonstrated objective and subjective improvements on cognitive measures with moderate-to-large effect sizes. Repeated measures ANCOVAs revealed significant (p < 0.001) group×time interactions, suggesting training-related changes in DMN FC, and semipartial correlations demonstrated that these were associated with changes in cognitive functioning. CONCLUSIONS: Changes in the FC between the DMN and other resting-state networks involved in the maintenance and manipulation of internal information, attention, and sensorimotor functioning may be facilitated through consistent participation in plasticity-based auditory processing speed training in adults with chronic TBI. [ABSTRACT FROM AUTHOR]
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- 2022
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26. Life Satisfaction Assessment 1 Year after Traumatic Brain Injury: Exploring the Impact of Language and Employment Status.
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Tang, Ron, Garduño-Ortega, Olga, and Bushnik, Tamara
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To assess satisfaction with life in the context of primary language spoken at home and paid employment status in individuals with TBI. Retrospective, secondary data analysis gathered from the Rusk Rehabilitation TBI Model System (RRTBIMS) at discharge and one-year from injury. Two urban hospitals in New York City. A total of 204 individuals with TBI enrolled in the RRTBIMS between May 2013 and October 2021. Participants were primarily from a racial minority group (59.9%), male (82.4%), single (51.5%), and born in the US (58.3%). Individuals had an average age of 48 years (SD=18.6). N/A. Satisfaction with Life Scale (SWLS) collected one year from injury. Participants who reported speaking a language other than English at home had higher SWLS scores (M=23.3, SD=7.4) than English speakers (M=20.5, SD=7.7). Individuals with paid employment one-year post-injury had higher satisfaction with life (M=24.1, SD=7.4) compared to those unemployed or in unpaid work (M=20.3, SD=7.6). Significant differences between SWLS scores and language spoken at home (p=0.007) and paid employment status (p <.001) were revealed in t-test analyses. Life satisfaction is dependent on many lifestyle factors. After a TBI, individuals often report low life satisfaction. These findings add to the existing literature by revealing that speaking a non-English language at home and being in paid employment correlates with higher life satisfaction one-year from injury. These findings provide practitioners valuable insights to guide intervention and rehabilitation efforts to increase life satisfaction and quality of life outcomes among individuals with TBI. All authors have no conflict of interests to report. [ABSTRACT FROM AUTHOR]
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- 2024
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27. Social and Romantic Relationships and Sexual Health: A qualitative exploration of individuals with traumatic brain injury (TBI).
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Edmonds, Reilly, Garduño-Ortega, Olga, Smith, Michelle, Wilson, Judy, and Bushnik, Tamara
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To assess social relationships, dating, and sexual health in individuals who have experienced a TBI. Individuals face a variety of effects after TBI, which can alter their ability to interact with others in the same way as prior to their injury. This study assesses how TBI affects social relationships, dating, and sexual health for individuals with TBI. Qualitative study using semi-structured interviews. Community-based individuals with TBI in the New York Tri-State area. This study utilized 22 interviews from individuals with TBI conducted during a previous analysis assessing TBI as a chronic disease. Interviewees' average age was 45 representing a range in injury severities (nine severe, eight moderate, five complicated mild). This study aimed to document how individuals with TBI navigate changes and barriers faced with interpersonal relationships (e.g., family, friends, significant others), dating, and sexual health post-injury. N/A. Qualitative individual experiences noting changes in social relationships, dating, and sexual health post-TBI. Twenty-two participants identified alterations in social relationships overall, with a subset noting challenges specific to dating and sexual health. Preliminary thematic analysis revealed the following themes: 1) Friendships from pre-injury were lost or declined due to the communication and socializing needed to maintain them; 2) Neurofatigue makes it difficult to date and connect; 3) Difficulties related to close others' lack of understanding about TBI challenges; and 4) Sexual health declines both physically and emotionally between romantic partners. TBI is often referred to as "an invisible illness". The expanded support networks of individuals with TBI may not comprehend the associated deficits, which can lead to a decline in quality of friendships or romantic partnerships and pose challenges when dating. The post-TBI emotional, mental, and physical changes can also alter sexual relationships. This data indicates a need for increased awareness of the effects of TBI among the general population and for providers to discuss the injury's potential implications on social relationships, dating, and sexual health. N/A. [ABSTRACT FROM AUTHOR]
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- 2024
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28. Responsiveness of the Traumatic Brain Injury Quality of Life Cognition Banks in Recent Brain Injury.
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Tyner, Callie E., Kisala, Pamela A., Boulton, Aaron J., Sherer, Mark, Chiaravalloti, Nancy D., Sander, Angelle M., Bushnik, Tamara, and Tulsky, David S.
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BRAIN injuries ,NEUROPSYCHOLOGICAL rehabilitation ,BRAIN banks ,QUALITY of life measurement ,EXECUTIVE function ,QUALITY of life - Abstract
Patient report of functioning is one component of the neurocognitive exam following traumatic brain injury, and standardized patient-reported outcomes measures are useful to track outcomes during rehabilitation. The Traumatic Brain Injury Quality of Life measurement system (TBI-QOL) is a TBI-specific extension of the PROMIS and Neuro-QoL measurement systems that includes 20 item banks across physical, emotional, social, and cognitive domains. Previous research has evaluated the responsiveness of the TBI-QOL measures in community-dwelling individuals and found clinically important change over a 6-month assessment interval in a sample of individuals who were on average 5 years post-injury. In the present study, we report on the responsiveness of the TBI-QOL Cognition–General Concerns and Executive Function item bank scores and the Cognitive Health Composite scores in a recently injured sample over a 1-year study period. Data from 128 participants with complicated mild, moderate, or severe TBI within the previous 6 months were evaluated. The majority of the sample was male, white, and non-Hispanic. The participants were 18–92 years of age and were first evaluated from 0 to 5 months post-injury. Eighty participants completed the 1-year follow-up assessment. Results show acceptable standard response mean values (0.47–0.51) for all measures and minimal detectable change values ranging from 8.2 to 8.8 T-score points for Cognition–General Concerns and Executive Functioning measures. Anchor rating analysis revealed that changes in scores on the Executive Function item bank and the Cognitive Health Composite were meaningfully associated with participant-reported changes in the areas of attention, multitasking, and memory. Evaluation of change score differences by a variety of clinical indicators demonstrated a small but significant difference in the three TBI-QOL change scores by TBI injury severity grouping. These results support the responsiveness of the TBI-QOL cognition measures in newly injured individuals and provides information on the minimal important differences for the TBI-QOL cognition measures, which can be used for score interpretation by clinicians and researchers seeking patient-reported outcome measures of self-reported cognitive QOL after TBI. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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29. T1 and T2 quantification using magnetic resonance fingerprinting in mild traumatic brain injury.
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Gerhalter, Teresa, Cloos, Martijn, Chen, Anna M., Dehkharghani, Seena, Peralta, Rosemary, Babb, James S., Zarate, Alejandro, Bushnik, Tamara, Silver, Jonathan M., Im, Brian S., Wall, Stephen, Baete, Steven, Madelin, Guillaume, and Kirov, Ivan I.
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MAGNETIC resonance imaging ,BRAIN injuries ,WHITE matter (Nerve tissue) ,GRAY matter (Nerve tissue) ,NEUROPSYCHOLOGICAL tests - Abstract
Objectives: To assess whether MR fingerprinting (MRF)–based relaxation properties exhibit cross-sectional and prospective correlations with patient outcome and compare the results with those from DTI. Methods: Clinical imaging, MRF, and DTI were acquired in patients (24 ± 10 days after injury (timepoint 1) and 90 ± 17 days after injury (timepoint 2)) and once in controls. Patient outcome was assessed with global functioning, symptom profile, and neuropsychological testing. ADC and fractional anisotropy (FA) from DTI and T
1 and T2 from MRF were compared in 12 gray and white matter regions with Mann–Whitney tests. Bivariate associations between MR measures and outcome were assessed using the Spearman correlation and logistic regression. Results: Data from 22 patients (38 ± 12 years; 17 women) and 18 controls (32 ± 8 years; 12 women) were analyzed. Fourteen patients (37 ± 12 years; 11 women) returned for timepoint 2, while two patients provided only timepoint 2 clinical outcome data. At timepoint 1, there were no differences between patients and controls in T1 , T2 , and ADC, while FA was lower in mTBI frontal white matter. T1 at timepoint 1 and the change in T1 exhibited more (n = 18) moderate to strong correlations (|r|= 0.6–0.85) with clinical outcome at timepoint 2 than T2 (n = 3), FA (n = 7), and ADC (n = 2). High T1 at timepoint 1, and serially increasing T1 , accounted for five of the six MR measures with the highest utility for identification of non-recovered patients at timepoint 2 (AUC > 0.80). Conclusion: T1 derived from MRF was found to have higher utility than T2 , FA, and ADC for predicting 3-month outcome after mTBI. Key Points: • In a region-of-interest approach, FA, ADC, and T1 and T2 all showed limited utility in differentiating patients from controls at an average of 24 and 90 days post-mild traumatic brain injury. • T1 at 24 days, and the serial change in T1 , revealed more and stronger predictive correlations with clinical outcome at 90 days than did T2 , ADC, or FA. • T1 showed better prospective identification of non-recovered patients at 90 days than ADC, T2 , and FA. [ABSTRACT FROM AUTHOR]- Published
- 2022
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30. Traumatic Spinal Cord Injuries in Horseback Riding: A 35-Year Review
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Lin, Cindy Y., Wright, Jerry, Bushnik, Tamara, and Shem, Kazuko
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- 2011
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31. Impact of Mean Arterial Blood Pressure During the First Seven Days Post Spinal Cord Injury
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Cohn, Jennifer A., Wright, Jerry, McKenna, Stephen L., and Bushnik, Tamara
- Published
- 2010
32. Personal Attendant Turnover: Association with Level of Injury, Burden of Care, and Psychosocial Outcome
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Bushnik, Tamara, Wright, Jerry, and Burdsall, Debra
- Published
- 2007
33. Environmental factors and their role in participation and life satisfaction after spinal cord injury
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Whiteneck, Gale, Meade, Michelle A., Dijkers, Marcel, Tate, Denise G., Bushnik, Tamara, and Forchheimer, Martin B.
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- 2004
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34. The effects of neuroplasticity-based auditory information processing remediation in adults with chronic traumatic brain injury.
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Voelbel, Gerald T., Lindsey, Hannah M., Mercuri, Giulia, Bushnik, Tamara, and Rath, Joseph
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CHRONIC diseases ,NEUROPLASTICITY ,COGNITION ,WORD deafness ,TREATMENT effectiveness ,RANDOMIZED controlled trials ,QUESTIONNAIRES ,BRAIN injuries ,STATISTICAL sampling - Abstract
BACKGROUND: Adults with chronic traumatic brain injury (TBI) may experience long-term deficits in multiple cognitive domains. Higher-order functions, such as verbal memory, are impacted by deficits in the ability to acquire verbal information. OBJECTIVE: This study investigated the effects of a neuroplasticity-based computerized cognitive remediation program for auditory information processing in adults with a chronic TBI. METHODS: Forty-eight adults with TBI were randomly assigned to an intervention or control group. Both groups underwent a neuropsychological assessment at baseline and post-training. The Intervention group received 40 one-hour cognitive training sessions with the Brain Fitness Program. RESULTS: The intervention group improved in performance on measures of the Woodcock-Johnson-III Understanding Directions subtest and Trail Making Test Part-A. They also reported improvement on the cognitive domain of the Cognitive Self-Report Questionnaire. CONCLUSIONS: The present study demonstrated that a neuroplasticity-based computerized cognitive remediation program may improve objective and subjective cognitive function in adults with TBI several years post-injury. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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35. Refining understanding of life satisfaction in elderly persons with traumatic brain injury using age-defined cohorts: a TBI model systems study.
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Niemeier, Janet P., Hammond, Flora M., O'Neil-Pirozzi, Therese M., Venkatesan, Umesh M., Bushnik, Tamara, Zhang, Yue, and Kennedy, Richard E.
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QUALITY of life ,MENTAL health ,PATIENT participation ,SOCIAL support ,AGE distribution ,SATISFACTION ,RETROSPECTIVE studies ,EPIDEMIOLOGY ,PATIENTS' attitudes ,BRAIN injuries ,WOUNDS & injuries ,REHABILITATION ,LONGITUDINAL method ,PSYCHOLOGICAL resilience - Abstract
Objective: Examine effects of age cohort on post-injury life satisfaction in elderly persons with TBI Design: Retrospective cohort Setting: TBI Model Systems centers. Participants: 5,109 elderly participants with TBI in the TBI Model Systems National Database Interventions: Not applicable Main Outcome Measures: Demographics, injury characteristics and cause, outcomes, age at time of analysis, time to follow commands, maximum follow-up period, and scores on the Satisfaction With Life Scale (SWLS) and Participation Assessment with Recombined Tools-Objective (PART-O) scores at 1, 2, 5, or 10 years post-injury. Results: Life satisfaction post-TBI across groups increased with age. The young-old sub-group demonstrated the poorest life satisfaction outcomes, while the oldest sub-group experienced greatest life satisfaction. In contrast, participation decreased with age. Conclusions: Findings show diversity in satisfaction with life following moderate to severe TBI for three elderly age-cohorts. Differences may be due to variations in generation-based lived experience, in perceived meaningfulness of participation, could echo prior evidence of greater resilience in the oldest group, or could reflect bias within the study sample. Further research into between- and within- differences for elderly TBI age cohorts is needed to more precisely meet their needs for physical and functional rehabilitation as well as psychological supports. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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36. Primary Language and Participation Outcomes in Hispanics With Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study.
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Sander, Angelle M., Ketchum, Jessica M., Lequerica, Anthony H., Pappadis, Monique R., Bushnik, Tamara, Hammond, Flora M., and Sevigny, Mitch
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Objective: To examine the relationship between primary language and participation outcomes in English- and Spanish-speaking persons with complicated mild to severe traumatic brain injury (TBI) at 1 year post-injury. Setting: Community following discharge from inpatient rehabilitation. Participants: A total of 998 Hispanic participants with outcomes available at year 1 follow-up; 492 (49%) indicated English as their primary language and 506 (51%) indicated Spanish as their primary language. Design: Prospective, multicenter, cross-sectional, observational cohort study. Main Measures: Community participation at 1 year post-injury was assessed by 3 domains of the Participation Assessment with Recombined Tools-Objective (PART-O): Out and About, Productivity, and Social Relations. Results: Unadjusted group comparisons showed better participation outcomes for English versus Spanish speakers for all PART-O domains and for the Balanced Total score. After controlling for relevant covariates, Englishspeaking participants had significantly better PART-O Balanced Total scores and better scores on the Social Relations domain, although effect sizes were small. Conclusions: Hispanic persons with TBI whose primary language is Spanish may require greater assistance integrating socially back into their communities after TBI. However, potential cultural differences in value placed on various social activities must be considered. Potential cultural bias inherent in existing measures of participation should be investigated in future studies. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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37. Narrative review of clinical practice guidelines for treating people with moderate or severe traumatic brain injury.
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Gerber, Lynn H., Deshpande, Rati, Moosvi, Ali, Zafonte, Ross, Bushnik, Tamara, Garfinkel, Steven, and Cai, Cindy
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ONLINE information services ,MEDICAL databases ,CINAHL database ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,MEDICAL protocols ,SEVERITY of illness index ,RESEARCH funding ,MEDLINE ,REHABILITATION for brain injury patients - Abstract
BACKGROUND: Practice guidelines (CPGs) provide informed treatment recommendations from systematic reviews and assessment of the benefits and harms that are intended to optimize patient care. Review of CPGs addressing rehabilitation for people with moderate/severe traumatic brain injury (TBI), has not been fully investigated. OBJECTIVE: Identify published, vetted, clinical practice guidelines that address rehabilitation for people with moderate/severe TBI. METHODS: Six data bases were accessed using key word search terms: "Traumatic Brain Injury" and "Clinical Practice Guidelines" and "Rehabilitation". Further inclusions included "adult" and "moderate or severe". Exclusions included: "mild" and "concussive injury". Three reviewers read abstracts and manuscripts for final inclusion. The AGREE II template was applied for additional appraisal. RESULTS: There were 767 articles retrieved using the search terms, 520 were eliminated because of content irrelevance; and 157 did not specify rehabilitation treatment or did not follow a process for CPGs. A total of 17 CPGs met all criteria and only 4 of these met all AGREE II criteria. CONCLUSION: There are few CPGs addressing rehabilitation for people with moderate/severe TBI. More interventional trials are needed to determine treatment effectiveness. Timely and methodologically sound vetting of studies are needed to ensure CPG reliability and facilitate access to quality, effective treatment for people with moderate/severe TBI. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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38. Changes in Cortical Grey Matter Volumes After Plasticity-based Auditory Information Processing Remediation Training in Adults with a Chronic Traumatic Brain Injury: A Pilot Study.
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Lei, Yating, Lindsey, Hannah, Rath, Joseph, Bushnik, Tamara, Flanagan, Steven, and Voelbel, Gerald
- Abstract
Examine changes in cortical gray matter following computerized cognitive training for auditory information processing in chronic adults with traumatic brain injury (TBI). 14-week, quasi-experimental design. Laboratory. Nineteen adults (intervention: 11; control: 8) with mild to severe TBI (mean age = 42.6 years [SD = 11.0], male = 58%, time since injury = 124.6 months [SD = 146.1]). The intervention group underwent 40 one-hour sessions over 14 weeks with the Brain Fitness Program, focusing on auditory information processing exercises. Training progressively increased in difficulty, ensuring an 85% correct response rate. Participants used noise-canceling headphones. The control group did not receive an intervention but was contacted once a week. MRI data was captured twice (baseline & one-week post-training) at NYU's Center for Biomedical Imaging on a 3T Siemens Tim Trio or Prisma Fit whole-body scanner using a 12-channel head coil. Cortical surface reconstruction and data extraction were facilitated by FreeSurfer. While none of the results remained statistically significant after controlling for multiple comparisons with False Discovery Rate correction, the intervention group exhibited more pronounced post-intervention gray matter volume (GMV) changes compared to the control group in both the left and right brain lobes (left: f2 = 0.213; right: f2 = 0.510). Notably, the right frontal (f2 = 0.736) and right occipital (f2 = 0.617) regions exhibited large effects. Medium effects were found in the left occipital (f2 = 0.342), left frontal (f2 = 0.201), and right parietal regions (f2 = 0.156). Preliminary findings indicate that computerized auditory information processing training induces neuroplastic changes in GMV in chronic TBI populations. None. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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39. Women with Limb Loss: The Unique Needs of an Underserved Population.
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Disla, Roxanne, Pruziner, Alison, Sidiropoulos, Alexis, Bushnik, Tamara, Hyre, Michael, Nelson, Leif, Klingbeil, Heidi, and Maikos, Jason
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To determine the unique impact of limb loss on women, including physical, and psychosocial needs. The survey consisted of an online needs assessment consisting of a bank of existing limb loss- and non-limb loss-specific surveys, which were arranged around domains of general health, quality of life, prosthetic use/needs, psychosocial health and behaviors, and body image. These surveys were supplemented with written items to ensure adequate coverage of relevant domains. Preliminary statistical analysis was conducted using independent sample t-tests with sex as the grouping variable and physical/psychosocial parameters as the dependent variables. Participants home or in the clinic of a VA, Walter Reed or NYU hospitals as the survey was online. Surveys were completed electronically and anonymously without individually identifiable information. The participants were female and male individuals with limb loss that were at least one year post amputation date and over the age of 18. 128 women and 103 men from across the nation completed the survey. N/A. We utilized a battery of outcome measures including the Orthotics and Prosthetics Users Survey (OPUS), Prosthesis Evaluation Questionnaire (PEQ), the Trinity Amputation and Prosthesis Experience Scales- Revised (TAPES-R) and Amputee Body Image Scale (ABIS). Results indicated that identified gender had a significant association (i.e., worse outcomes for women) with the following parameters: Appearance, importance for maintaining limb health, aesthetic satisfaction, and functional satisfaction, general and social adjustment to the prosthesis, activity restriction, and body image. Preliminary analyses indicates that women with limb loss have unique physical and psychosocial needs, thus challenging providers for women with limb loss to evolve healthcare delivery and research practices, as well as work jointly with industry in order to meet the unique needs of this population. The authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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40. Reproductive Health in Women with Physical Disability: A Conceptual Framework for the Development of New Patient-Reported Outcome Measures.
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Kalpakjian, Claire Z., Kreschmer, Jodi M., Slavin, Mary D., Kisala, Pamela A., Quint, Elisabeth H., Chiaravalloti, Nancy D., Jenkins, Natalie, Bushnik, Tamara, Amtmann, Dagmar, Tulsky, David S., Madrid, Roxanne, Parten, Rebecca, Evitts, Michael, and Grawi, Carolyn L.
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COMMUNICATION ,CONCEPTUAL structures ,FOCUS groups ,HEALTH services accessibility ,INTERVIEWING ,RESEARCH methodology ,HEALTH outcome assessment ,PSYCHOLOGY of People with disabilities ,WOMEN'S health ,REPRODUCTIVE health ,QUALITATIVE research ,THEMATIC analysis ,HEALTH literacy ,MEDICAL coding - Abstract
Background: Barriers in the built environment, enduring stereotypes and biases, and limited disability competency of health care providers compromise access to and quality of reproductive health care for women with physical disabilities. One way to improve our understanding of critical factors that drive reproductive health inequity and its impact on access to care is to use patient-reported outcome measures (PROMs) that capture relevant and meaningful information about experience. In this study, we developed a conceptual framework as the foundation for relevant and clinicallymeaningful patient-reported outcomemeasures targeting the interface of disability and reproductive health. Materials and Methods: We conducted semistructured focus groups and interviews to assess women's experiences around their reproductive health and contextual factors related to disability. We used deductive and inductive qualitative coding approaches to develop the conceptual framework. Results: Eighty-one women between the ages of 16 and 50 with a self-reported physical disability, defined by an impairment of mobility, participated in 13 focus groups (N= 64) and 17 individual interviews. Five major themes characterized the conceptual framework that emerged--knowledge about reproductive health, communication about reproductive health, relationships, the reproductive health care environment, and self-advocacy/identity--all of which had some relationship with five major reproductive health issues--pregnancy and labor/delivery, periods and menstrual management, contraception, sexuality and sexual functioning, and pelvic examinations. Conclusions: This conceptual framework will serve as a foundation for PROM and guide intervention development to reduce reproductive health inequity and improve reproductive health outcomes of women with physical disabilities. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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41. Factors associated with the remission of insomnia after traumatic brain injury: a traumatic brain injury model systems study.
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Lequerica, Anthony H., Weber, Erica, Dijkers, Marcel P., Dams-O'Connor, Kristen, Kolakowsky-Hayner, Stephanie A., Bell, Kathleen R., Bushnik, Tamara, Goldin, Yelena, and Hammond, Flora M.
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MENTAL depression risk factors ,FATIGUE risk factors ,INSOMNIA risk factors ,BRAIN injuries ,LONGITUDINAL method ,MATHEMATICAL models ,MEDICAL cooperation ,QUESTIONNAIRES ,RESEARCH ,RISK assessment ,SELF-evaluation ,SLEEP ,SOCIAL participation ,THEORY ,SECONDARY analysis ,DISEASE remission ,DISEASE complications - Abstract
Objective: To examine the factors associated with the remission of insomnia by examining a sample of individuals who had insomnia within the first two years after traumatic brain injury (TBI) and assessing their status at a secondary time point. Design and Methods: Secondary data analysis from a multicenter longitudinal cohort study. A sample of 40 individuals meeting inclusion criteria completed a number of self-report scales measuring sleep/wake characteristics (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Insomnia Severity Index, Sleep Hygiene Index), fatigue and depression (Multidimensional Assessment of Fatigue, Patient Health Questionnaire-9), and community participation (Participation Assessment with Recombined Tools-Objective). One cohort was followed at 1 and 2 years post-injury (n = 19) while a second cohort was followed at 2 and 5 years post-injury (n = 21). Results: Remission of insomnia was noted in 60% of the sample. Those with persistent insomnia had significantly higher levels of fatigue and depression at their final follow-up and poorer sleep hygiene across both follow-up time-points. A trend toward reduced community participation among those with persistent insomnia was also found. Conclusion: Individuals with persistent post-TBI insomnia had poorer psychosocial outcomes. The chronicity of post-TBI insomnia may be associated with sleep-related behaviors that serve as perpetuating factors. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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42. Measuring Pain in TBI: Development of the TBI-QOL Pain Interference Item Bank and Short Form.
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Carlozzi, Noelle E., Kisala, Pamela A., Boulton, Aaron J., Roth, Elliot, Kratz, Anna L., Sherer, Mark, Sander, Angelle M., Heinemann, Allen W., Chiaravalloti, Nancy D., Bushnik, Tamara, and Tulsky, David S.
- Abstract
To develop a pain interference item bank, computer adaptive test (CAT), and short form for use by individuals with traumatic brain injury (TBI). Cross-sectional survey study. Five TBI Model Systems rehabilitation hospitals. Individuals with TBI (N=590). Not applicable. Traumatic Brain Injury–Quality of Life (TBI-QOL) Pain Interference item bank. Confirmatory factor analysis provided evidence of a single underlying trait (χ
2 [740]=3254.030; P <.001; Comparative Fix Index=0.988; Tucker-Lewis Index=0.980; Root Mean Square Error of Approximation=0.076) and a graded response model (GRM) supported item fit of 40 Pain Interference items. Items did not exhibit differential item functioning or local item dependence. GRM calibration data were used to inform the selection of a 10-item static short form and to program a TBI-QOL Pain Interference CAT. Comparative analyses indicated excellent comparability and reliability across test administration formats. The 40-item TBI-QOL Pain Interference item bank demonstrated strong psychometric properties. End users can administer this measure as either a 10-item short form or CAT. [ABSTRACT FROM AUTHOR]- Published
- 2020
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43. Development and Calibration of the TBI-QOL Ability to Participate in Social Roles and Activities and TBI-QOL Satisfaction With Social Roles and Activities Item Banks and Short Forms.
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Heinemann, Allen W., Kisala, Pamela A., Boulton, Aaron J., Sherer, Mark, Sander, Angelle M., Chiaravalloti, Nancy, Bushnik, Tamara, Hanks, Robin, Roth, Elliot, and Tulsky, David S.
- Abstract
To develop traumatic brain injury (TBI)-optimized versions of the Quality of Life in Neurological Disorders (Neuro-QoL) Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities item banks, evaluate the psychometric properties of the item banks developed for adults with TBI, develop short form and computer adaptive test (CAT) versions, and report information to facilitate research and clinical applications. We used a mixed methods design to develop and evaluate Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities items. Focus groups defined the constructs, cognitive interviews guided item revisions, and confirmatory factor analysis and item response theory methods helped calibrate item banks and evaluate differential item functioning related to demographic and injury characteristics. Five TBI Model Systems centers in the United States. Community-dwelling adults with TBI (N=556). None. Traumatic Brain Injury–Quality of Life (TBI-QOL) Ability to Participate in Social Roles and Activities and TBI-QOL Satisfaction with Social Roles and Activities item banks. Forty-five Ability to Participate in Social Roles and Activities and 41 Satisfaction with Social Roles and Activities items demonstrated good psychometric properties. Although some of the items are new, most were drawn from analogous banks in the Neuro-QoL measurement system. Consequently, the 2 TBI-QOL item banks were linked to the Neuro-QoL metric, and scores are comparable with the general population. All CAT and short forms correlated highly (>0.90) with the full item banks and demonstrate comparable construct coverage and measurement error. The TBI-QOL Ability to Participate in Social Roles and Activities and TBI-QOL Satisfaction with Social Roles and Activities item banks are TBI-optimized versions of the Neuro-QoL Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities item banks and demonstrate excellent measurement properties in individuals with TBI. These measures, particularly in CAT or short form format, are suitable for efficient and precise measurement of social outcomes in clinical and research applications. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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44. SEXUAL HEALTH POLICIES IN STROKE REHABILITATION: A MULTINATIONAL STUDY.
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VIKAN, Jannike K., NILSSON, Marie I., BUSHNIK, Tamara, DENG, Wanying, ELESSI, Khamis, FROST-BAREKET, Yael, KOVRIGINA, Elena, SHAHWAN, Jeries, SNEKKEVIK, Hildegun, ÅKESSON, Elisabet, STANGHELLE, Johan K., and FUGL-MEYER, Kerstin S.
- Published
- 2019
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45. Cluster Analysis of Vulnerable Groups in Acute Traumatic Brain Injury Rehabilitation.
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Kucukboyaci, N. Erkut, Long, Coralynn, Smith, Michelle, Rath, Joseph F., and Bushnik, Tamara
- Abstract
Abstract Objective To analyze the complex relation between various social indicators that contribute to socioeconomic status and health care barriers. Design Cluster analysis of historical patient data obtained from inpatient visits. Setting Inpatient rehabilitation unit in a large urban university hospital. Participants Adult patients (N=148) receiving acute inpatient care, predominantly for closed head injury. Interventions Not applicable. Main Outcome Measures We examined the membership of patients with traumatic brain injury in various "vulnerable group" clusters (eg, homeless, unemployed, racial/ethnic minority) and characterized the rehabilitation outcomes of patients (eg, duration of stay, changes in FIM scores between admission to inpatient stay and discharge). Results The cluster analysis revealed 4 major clusters (ie, clusters A–D) separated by vulnerable group memberships, with distinct durations of stay and FIM gains during their stay. Cluster B, the largest cluster and also consisting of mostly racial/ethnic minorities, had the shortest duration of hospital stay and one of the lowest FIM improvements among the 4 clusters despite higher FIM scores at admission. In cluster C, also consisting of mostly ethnic minorities with multiple socioeconomic status vulnerabilities, patients were characterized by low cognitive FIM scores at admission and the longest duration of stay, and they showed good improvement in FIM scores. Conclusions Application of clustering techniques to inpatient data identified distinct clusters of patients who may experience differences in their rehabilitation outcome due to their membership in various "at-risk" groups. The results identified patients (ie, cluster B, with minority patients; and cluster D, with elderly patients) who attain below-average gains in brain injury rehabilitation. The results also suggested that systemic (eg, duration of stay) or clinical service improvements (eg, staff's language skills, ability to offer substance abuse therapy, provide appropriate referrals, liaise with intensive social work services, or plan subacute rehabilitation phase) could be beneficial for acute settings. Stronger recruitment, training, and retention initiatives for bilingual and multiethnic professionals may also be considered to optimize gains from acute inpatient rehabilitation after traumatic brain injury. Highlight • Simultaneous co-occurrence (ie, clustering) of some demographic and clinical variables may affect the acute rehabilitation outcomes of patients with traumatic brain injury, rendering ethic/racial minority and elderly groups particularly vulnerable to shorter stays despite small gains in functional variables. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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46. Sleep after TBI: How the TBI Model Systems have advanced the field.
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Bell, Kathleen R., Bushnik, Tamara, Dams-O'Connor, Kristen, Goldin, Yelena, Hoffman, Jeanne M., Lequerica, Anthony H., Nakase-Richardson, Risa, Zumsteg, Jennifer M., and Ripley, David L.
- Subjects
- *
BRAIN injuries , *CIRCADIAN rhythms , *INSOMNIA , *INTERPROFESSIONAL relations , *PATIENT compliance , *SLEEP apnea syndromes , *SLEEP disorders , *SECONDARY analysis , *TREATMENT effectiveness , *SEVERITY of illness index - Abstract
BACKGROUND: Identification and management of comorbidities in TBI has become an increasing focus for optimizing TBI outcomes. Recent meta-analyses highlight sleep disturbance and sleep disorders following TBI (Mathias & Alvaro, 2012). Improving the recognition and treatment of sleep disorders in TBI should be a central focus of rehabilitation. The Traumatic Brain Injury Model System (TBIMS) has created an infrastructure allowing multi-center investigations into sleep dysfunction in those who have had a moderate to severe TBI and received inpatient rehabilitation. OBJECTIVE: This paper will describe the 1) infrastructure used to advance sleep dysfunction/disorders research following TBI, 2) preliminary findings from these studies, and 3) repository of data which can be accessed for secondary analyses by investigators outside of the TBIMS infrastructure. METHODS: Two internal mechanisms allow investigators at TBIMS sites to collaborate on projects of shared interest: Research Modules and Special Interest Groups (SIG). RESULTS: To date, five studies have resulted from the TBIMS collaborative process focusing on insomnia, circadian disruption, and sleep apnea. CONCLUSIONS: Future directions for the SIG include continued development of available knowledge and understanding of the multidimensional factors that contribute to TBI-related sleep disturbance, optimal assessment tools, effectiveness of available treatments, and treatment compliance in this population. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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47. Examining the Effects of a Powered Exoskeleton on Quality of Life and Secondary Impairments in People Living With Spinal Cord Injury.
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Juszczak, Michael, Gallo, Estelle, and Bushnik, Tamara
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Background: Secondary impairments associated with spinal cord injury (SCI) limit one's independent functionality and negatively impact quality of life (QoL). Objective: The purpose of this study was to explore changes in secondary health conditions that may result from using a powered exoskeleton as well as their potential impact on QoL. Methods: Forty-five participants presenting with SCI ranging from T3-L2 were included in this study. Outcome measures included self-reported assessments of pain, spasticity, bladder/bowel function, Satisfaction with Life Scale (SWLS), and Modified Ashworth Scale (MAS). Results: Participants reported significantly less spasticity at the conclusion of the study, 0.9 ± 1.7, compared to baseline, 1.6 ± 0.9 [t (44) = 2.83, p < .001]. MAS testing revealed that 26.7% of participants presented with decreased spasticity at the conclusion of the trial. Participants reported less pain at the end of the trial, 0.9 ± 1.6, compared to the start, 1.1 ± 1.7 [t (44) = 1.42, p > .05]. No negative changes in bowel and bladder were reported; positive changes were reported by 20% and 9% of participants with respect to bowel and bladder management. There was no statistically significant change in SWLS sum score from baseline, 20.4 ± 8.0, to conclusion of the study, 21.3 ± 7.6 [t (44) = -1.1, p > .05]. Conclusion: Findings suggest using a powered exoskeleton may decrease spasticity in people living with SCI. Although improvements in secondary impairments did not result in a significant improvement in QoL, it is believed that using a powered exoskeleton in one's community will lead to increased community integration facilitating an improvement in QoL. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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48. Race/Ethnicity and Retention in Traumatic Brain Injury Outcomes Research: A Traumatic Brain Injury Model Systems National Database Study.
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Sander, Angelle M., Lequerica, Anthony H., Ketchum, Jessica M., Hammond, Flora M., Williams Gary, Kelli, Pappadis, Monique R., Felix, Elizabeth R., Johnson-Greene, Douglas, and Bushnik, Tamara
- Abstract
Objective: To investigate the contribution of race/ethnicity to retention in traumatic brain injury (TBI) research at 1 to 2 years postinjury. Setting: Community. Participants: With dates of injury between October 1, 2002, and March 31, 2013, 5548 whites, 1347 blacks, and 790 Hispanics enrolled in the Traumatic Brain Injury Model Systems National Database. Design: Retrospective database analysis. Main Measure: Retention, defined as completion of at least 1 question on the follow-up interview by the person with TBI or a proxy. Results: Retention rates 1 to 2 years post-TBI were significantly lower for Hispanic (85.2%) than for white (91.8%) or black participants (90.5%) and depended significantly on history of problem drug or alcohol use. Other variables associated with low retention included older age, lower education, violent cause of injury, and discharge to an institution versus private residence. Conclusions: The findings emphasize the importance of investigating retention rates separately for blacks and Hispanics rather than combining them or grouping either with other races or ethnicities. The results also suggest the need for implementing procedures to increase retention of Hispanics in longitudinal TBI research. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
49. Initial Outcomes from a Multicenter Study Utilizing the Indego Powered Exoskeleton in Spinal Cord Injury.
- Author
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Tefertiller, Candy, Hays, Kaitlin, Jones, Janell, Jayaraman, Arun, Hartigan, Clare, Bushnik, Tamara, and Forrest, Gail F.
- Abstract
Objective: To assess safety and mobility outcomes utilizing the Indego powered exoskeleton in indoor and outdoor walking conditions with individuals previously diagnosed with a spinal cord injury (SCI). Methods: We conducted a multicenter prospective observational cohort study in outpatient clinics associated with 5 rehabilitation hospitals. A convenience sample of nonambulatory individuals with SCI (N = 32) completed an 8-week training protocol consisting of walking training 3 times per week utilizing the Indego powered exoskeleton in indoor and outdoor conditions. Participants were also trained in donning/ doffing the exoskeleton during each session. Safely measures such as adverse events (AEs) were monitored and reported. Time and independence with donning/doffing the exoskeleton as well as walking outcomes to include the 10-meter walk test (1OMWT), 6-minute walk test (6MWT), Timed Up & Go test (TUG), and 600-meter walk test were evaluated from midpoint to final evaluations. Results: All 32 participants completed the training protocol with limited device-related AEs, which resulted in no interruption in training. The majority of participants in this trial were able to don and doff the Indego independently. Final walking speed ranged from 0.19 to 0.55 m/s. Final average indoor and outdoor walking speeds among all participants were 0.37 m/s (SD = 0.08, 0.09, respectively), after 8 weeks of training. Significant (p < .05) improvements were noted between midpoint and final gait speeds in both indoor and outdoor conditions. Average walking endurance also improved among participants after training. Conclusion: The Indego was shown to be safe for providing upright mobility to 32 individuals with SCIs who were nonambulatory. Improvements in speed and independence were noted with walking in indoor and outdoor conditions as well as with donning/doffing the exoskeleton. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
50. Characteristics of Firearm Brain Injury Survivors in the Traumatic Brain Injury Model Systems (TBIMS) National Database: A Comparison of Assault and Self-Inflicted Injury Survivors.
- Author
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Bertisch, Hilary, Krellman, Jason W., Bergquist, Thomas F., Dreer, Laura E., Ellois, Valerie, and Bushnik, Tamara
- Abstract
Objective To characterize and compare subgroups of survivors with assault-related versus self-inflicted traumatic brain injuries (TBIs) via firearms at the time of inpatient rehabilitation and at 1-, 2-, and 5-year follow-up. Design Secondary analysis of data from the Traumatic Brain Injury Model Systems National Database (TBIMS NDB), a multicenter, longitudinal cohort study. Setting Retrospective analyses of a subset of individuals enrolled in the TBIMS NDB. Participants Individuals 16 years and older (N=399; 310 via assault, 89 via self-inflicted injury) with a primary diagnosis of TBI caused by firearm injury enrolled in the TBIMS NDB. Interventions Not applicable. Main Outcome Measures Disability Rating Scale, Glasgow Outcome Scale–Extended, sociodemographic variables (sex, age, race, marital status), injury-related/acute care information (posttraumatic amnesia, loss of consciousness, time from injury to acute hospital discharge), and mental health variables (substance use history, psychiatric hospitalizations, suicide history, incarcerations). Results Individuals who survived TBI secondary to a firearm injury differed by injury mechanism (assault vs self-inflicted) on critical demographic, injury-related/acute care, and mental health variables at inpatient rehabilitation and across long-term recovery. Groups differed in terms of geographic area, age, ethnicity, education, marital status, admission Glasgow Coma Scale score, and alcohol abuse, suicide attempts, and psychiatric hospitalizations at various time points. Conclusions These findings have implications for prevention (eg, mental health programming and access to firearms in targeted areas) and for rehabilitation planning (eg, by incorporating training with coping strategies and implementation of addictions-related services) for firearm-related TBI, based on subtype of injury. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
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