aseline Predictors of Fatigue 1 Year After Mild Head Injury (original) (raw)
Related papers
Baseline Predictors of Fatigue 1 Year After Mild Head Injury
Archives of Physical Medicine and Rehabilitation, 2009
de Leon MB, Kirsch NL, Maio RF, Tan-Schriner CU, Millis SR, Frederiksen S, Tanner CL, Breer ML. Baseline predictors of fatigue 1 year after mild head injury. Arch Phys Med Rehabil 2009;90:956-65.
Journal of Neurology
Background Fatigue is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). The aims were to assess frequency of fatigue over the first 6 months after TBI, and examine whether fatigue changes could be predicted by demographic characteristics, injury severity and comorbidities. Methods Patients with acute TBI admitted to 65 trauma centers were enrolled in the study Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI). Subjective fatigue was measured by single item on the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), administered at baseline, three and 6 months postinjury. Patients were categorized by clinical care pathway: admitted to an emergency room (ER), a ward (ADM) or an intensive care unit (ICU). Injury severity, preinjury somatic- and psychiatric conditions, depressive and sleep problems were registered at baseline. For prediction of fatigue changes, descriptive statistics and mixed effect logistic reg...
Fatigue and traumatic brain injury
Annales de réadaptation et de médecine physique : revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique, 2006
Fatigue is frequent and disabling in patients with traumatic brain injury (TBI). Its mechanisms are complex and multifactorial. We performed a literature review of reports of the condition using the following key words: brain injury, depression, neuroendocrine dysfunction, and treatment. Five scales have been used to evaluate fatigue in TBI patients: the Fatigue Severity Scale, the visual analog scale (VAS) for fatigue, the Fatigue Impact Scale, the Barrow Neurological Institute (BNI) Fatigue Scale and the Cause of Fatigue (COF) Questionnaire. The BNI Fatigue Scale and the COF Questionnaire have been designed specifically for brain-injured patients. Fatigue is present in 43-73% of patients and is one of the first symptoms for 7% of them. Fatigue does not seem to be significantly related to injury severity not to time since injury. It can be related to mental effort necessary to overcome attention deficit and slowed processing ("coping hypothesis"). It can also be related t...
Journal of Head Trauma Rehabilitation, 2008
Fatigue is a well-recognized issue for individuals with traumatic brain injury (TBI). This prospective study examined the rate and types of fatigue that are experienced by a cohort of individuals with TBI within the first 2 years, using a multidimensional fatigue scale. The impact of factors such as demographics, injury severity indices, and concomitant psychosocial variables was also examined. Using 2 measures of overall fatigue, 16%-32% at Year 1 and 21%-34% at Year 2 reported significant levels of fatigue. Fatigue did not appear to change between 1 and 2 years post-TBI. Sleep quality was the most prevalent concomitant disturbance followed by depression and pain.
Patterns of Fatigue and Its Correlates Over the First 2 Years After Traumatic Brain Injury
Journal of Head Trauma Rehabilitation, 2008
This study used a prospective longitudinal design to quantify fatigue and associated factors during the first 2 years after traumatic brain injury (TBI). Fifty-one individuals were assessed at 3 time points: within the first 6, 12, and 18-24 months after TBI. Self-reported fatigue improved during the first year, as did pain, sleep quality, cognitive independence, and involvement in productive activity. Further changes up to 2 years after TBI were not observed. The subset of individuals who reported significant increases in fatigue over the first 2 years demonstrated poorer outcomes in cognition, motor symptoms, and general functioning than those with decreased or stable fatigue.
Objective Measurement of Fatigue Following Traumatic Brain Injury
Journal of Head Trauma Rehabilitation, 2008
Objectives: To quantify posttraumatic brain injury (post-TBI) mental fatigue objectively by documenting changes in performance on neuropsychological tests as a result of sustained mental effort and to examine the relationship between objectively measured mental fatigue and self-reported situational and day-today fatigue. Participants: The study included 202 community-dwelling individuals with mild-severe TBI and 73 noninjured controls. Measures: Measures included Cambridge Neuropsychological Test Automated Battery, Global Fatigue Index, and situational fatigue rating. Method: Subjects were administered a 30-minute computerized neuropsychological test battery 3 times. The second and third administrations of the battery were separated by approximately 2 hours of interviews and administration of self-report measures. Results: The neuropsychological test scores were factor analyzed, yielding 3 subscales: speed, accuracy, and executive function. Situational fatigue and day-today fatigue were significantly higher in individual with TBI group than in individuals without TBI and were associated with speed subscale scores. Individuals with TBI evidenced a significant decline in performance on the accuracy subscale score. These declines in performance related to sustained mental effort were not associated with subjective fatigue in the TBI group. While practice effects on the speed and accuracy scores were observed in non-brain-injured individuals, they were not evidenced in individuals with TBI. Conclusions: Findings were largely consistent with previous literature and indicated that while subjective fatigue is associated with poor performance in individuals with TBI, it is not associated with objective decline in performance of mental tasks.
Journal of Clinical Medicine
Fatigue is a common symptom after traumatic brain injuries (TBI) and a crucial target of rehabilitation. The subjective and multifactorial nature of fatigue necessitates a biopsychosocial approach in understanding the mechanisms involved in its development. The aim of this study is to provide a comprehensive exploration of factors relevant to identification and rehabilitation of fatigue following TBI. Ninety-six patients with TBI and confirmed intracranial injuries were assessed on average 200 days post-injury with regard to injury-related factors, several patient-reported outcome measures (PROMS) of fatigue, neuropsychological measures, and PROMS of implicated biopsychosocial mechanisms. Factor analytic approaches yielded three underlying factors, termed Psychosocial Robustness, Somatic Vulnerability and Injury Severity. All three dimensions were significantly associated with fatigue in multiple regression analyses and explained 44.2% of variance in fatigue. Post hoc analyses exami...
Endocrine Abnormalities and Fatigue After Traumatic Brain Injury
Journal of Head Trauma Rehabilitation, 2006
Objective: Determine head injury self-reported sequelae/problems, services referral, if services accessed, and service needs. Design: Followup study. Setting: Hospital emergency departments. Participants: Patients (N = 1098) treated/ discharged from 3 emergency departments. Interventions: Provision of head injury information/ referral to services. Methods: Criteria included brain injury ICD-9-CM codes, facial fractures, lacerations, and 1 or more clinical signs/symptoms. Demographics, contact information, cause of injury, radiology/imaging, and discharge codes were provided by staff to project director. Follow-up conducted to determine physical/cognitive/behavioral problems; difficulties performing daily activities; services referral; if services accessed; and who to contact for help with problems. Results: AIS scores indicated that 9% had minor, 91% moderate, and 1% severe injury. Also, 18% had loss of consciousness (LOC), 72% suffered concussion, and 17% suffered nonspecific brain injury. First follow-up postinjury ranged from 2 to 18 weeks. A total of 157 persons (14%) were excluded from follow-up; 368 (33%) were unable to contact with minimum 8 attempts; and follow-up was completed on 573 (52%). Of these, 247 (43%) reported 1 or more problems including headaches (73%), tiredness (41%), neck pain (39%), dizziness (37%), weakness (24%), memory (23%), and vision changes (22%). Factors statistically significant among persons with problems included age, LOC, concussion with LOC, and AIS = 2 (moderate injury). Gender and weeks postinjury followup were not significant. Conclusions: This study found that 23% of patients reported problems at first follow-up and 20% at second follow-up; the majority of patients did not know where to seek services. Emergency department staff should be trained to provide patients at discharge with basic information about short-and long-term effects of traumatic brain injury and services/resources contacts.
Chronic Stress and Fatigue-Related Quality of Life After Mild to Moderate Traumatic Brain Injury
Journal of Head Trauma Rehabilitation, 2011
Objective-To determine relationships between chronic stress, fatigue-related quality of life (QOL-F) and related covariates after mild-to-moderate traumatic brain injury (TBI). Design-Observational and cross-sectional Participants-A total of 84 community-dwelling individuals with mild-to-moderate TBI recruited from multiple outpatient rehabilitation clinics assessed on average 15 months after injury. Method-Data were collected with self-report surveys and chart abstraction. Measures-Neurofunctional Behavioral Inventory, Perceived Stress Scale-14, Impact of Events Scale, McGill Pain Short-form Scale, and modified version of the Fatigue Impact Scale. Results-Fatigue-related quality of life was associated with somatic symptoms, perceived situational stress, but not with event-related stress (PTSD symptoms) related to index TBI, preinjury demographic, or post-injury characteristics. Somatic symptoms and chronic situational stress accounted for 42% of the variance in QOL (F). Conclusions-QOL (F) in community-dwelling individuals with mild-to-moderate TBI is associated with chronic situational stress and somatic symptoms. Symptom management strategies may need to include general stress management to reduce fatigue burden and improve quality of life. Keywords traumatic brain injury; fatigue; quality of life; stress; psychological While fatigue is present in 14-22% of the general population, estimates among individuals with traumatic brain injury (TBI) range much higher: from 21% to as high as 70%. 1,2. While fatigue occurs after TBI regardless of the severity of brain injury, 1-5 an effort to understand the variability of its frequency is found in comparison studies focused on those with mild TBI (MTBI). For example, Ponsford and associates 6 noted significantly higher fatigue levels at 1 week post mild TBI (MTBI) compared to a trauma control group, but these differences
Systematic Review of Interventions for Fatigue After Traumatic Brain Injury
Journal of Head Trauma Rehabilitation, 2014
To conduct a systematic review of the evidence on interventions for posttraumatic brain injury fatigue (PTBIF). Methods: Systematic searches of multiple databases for peer-reviewed studies published in English on interventions targeting PTBIF as a primary or secondary outcome through January 22, 2014. Reference sections were also reviewed to identify additional articles. Articles were rated using the 2011 American Academy of Neurology Classification of Evidence Scheme for therapeutic studies. Results: The searches yielded 1526 articles. Nineteen articles met all inclusion criteria: 4 class I, 1 class II/III, 10 class III, and 4 class IV. Only 5 articles examined fatigue as a primary outcome. Interventions were pharmacological and psychological or involved physical activity, bright blue light, electroencephalographic biofeedback, or electrical stimulation. Only 2 interventions (modafinil and cognitive behavioral therapy with fatigue management) were evaluated in more than 1 study. Conclusions: Despite areas of promise, there is insufficient evidence to recommend or contraindicate any treatments of PTBIF. Modafinil is not likely to be effective for PTBIF. Piracetam may reduce it, as may bright blue light. Cognitive behavioral therapy deserves additional study. High-quality research incorporating appropriate definition and measurement of fatigue is required to explore the potential benefits of promising interventions, evaluate fatigue treatments shown to be effective in other populations, and develop new interventions for PTBIF.