Acute predictors of return to employment after traumatic brain injury: A longitudinal follow-up

Keyser-Marcus, Lori; Bricout, John C.; Wehman, Paul; Campbell, Leanne R.; Cifu, David X.; Englander, Jeffrey; High, Walter M.; Zafonte, Ross

doi:10.1053/apmr.2002.31605

Cited by 175 publications

(115 citation statements)

References 38 publications

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“…Young age, preinjury productivity, college education, prior professional or managerial occupation, discharge from IR to home, duration of rehabilitation, good social and/or professional support network, absence of psychiatric symptoms, and improvement from admission to discharge IR FIM scores are all factors associated with a greater potential for postinjury gainful employment [16,[30][31][32][33]. Sex seems to have no significant influence on outcomes after TBI [34].…”

Section: Discussionmentioning

confidence: 95%

“…Conversely, persistence of incontinence may be associated with poor outcomes in TBI [15][16]. If return of bowel and/or bladder continence and cognition is shown in subsequent prospective studies to be useful in long-term STBI outcome prediction, possible applications might include early determination of rehabilitation services targeted to specific functional deficits, vocational rehabilitation planning, intervention development, resource allocation, cost projection, and family counseling.…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies have looked at the utility of the FIM for long-term outcome prediction [14][15][16]. However, these studies have relied primarily on total FIM scores, which include both the motor and cognitive components of this scale, on admission and/or on discharge from IR [14][15][16].…”

Section: Traumatic Brain Injury (Tbi)mentioning

confidence: 99%

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Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury

Kushner¹,

Johnson-Greene²

2014

J Rehabil Res Dev

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Abstract-The study objective was to examine postacute changes in bowel and bladder continence and cognition after severe traumatic brain injury (TBI) in persons with long-term functional recovery to full independence. This case series included nine patients initially admitted to inpatient rehabilitation (IR) with severe TBI who had returned to prior responsibilities and functional independence by 8 to 15 mo. Patients had initial Glasgow Coma Scale scores of 3 to 6, posttraumatic amnesia durations of 18 to 70 d, time-to-follow-commands of 16 to 56 d, initial abnormal brain computed tomography scans, and initial pupil abnormalities. IR Functional Independence Measure (FIM) cognitive and sphincter score improvements were compared with national TBI FIM data from Uniform Data Systems for Medical Rehabilitation (UDSMR) for 2010 (n = 16,368). All patients had IR improvements in cognitive and sphincter FIM scores approximately twice the national UDSMR data for 2010. All patients had combined IR discharge sphincter FIM scores that were 12 or greater, indicating independence to modified independence with bowel and bladder function with no incontinence. Five participants (55%) were admitted to IR with sphincter FIM scores of 11 to 12, indicating recovery of continence during acute care. These findings suggest potential usefulness of IR cognitive FIM score changes and of the recovery of bowel and bladder continence for predicting favorable functional outcomes following severe TBI.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury

Kushner¹,

Johnson-Greene²

2014

J Rehabil Res Dev

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“…[2][3][4][5][6] The situation for youth and young adults with disabilities, aged 16-26 years, can be particularly disheartening as their vision of themselves as full and active participants in society is typically not fully formed at onset of their disability. One of the strongest predictors of return to work following a disability is a history of employment pre-disability; [7][8][9][10] a fact that may not be true for the majority of individuals with disabilities in this age group. Indeed, many of the individuals in the targeted age demographic may not have even finished high school or may be in transition between high school and post-secondary education.…”

Section: Introductionmentioning

confidence: 99%

Return to work and school: a model mentoring program for youth and young adults with spinal cord injury

et al. 2010

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Study design: This is a prospective study. Objectives: Young individuals with spinal cord injury (SCI) need support to actively participate in the community after their injuries. The 'Back on Track' mentoring program was developed to match mentees with SCI with mentors to assist with post-injury adjustment. The objectives of this study were to improve the percentage of youth and young adults with SCI, who access post-secondary education or employment opportunities and to improve quality of life. Setting: This study had a community-based setting. Methods: Each mentee with SCI was matched with a community-based mentor, with or without a disability. The mentoring relationship was planned for 2 years. Participants were evaluated with standardized questionnaires at intake, at the time of post-secondary education or employment entry and 4 months post entry. Results: In total, 39 individuals with SCI, age 16-26 years, were enrolled. Average age of mentees was 19.8 years (s.d. ¼ 3.0). In total, 29 participants were matched with mentors, and 10 participants (34%) completed the program, with seven (24%) returning to school, two (6.9%) returning to work and one individual (3.4%) attending school part time. Conclusion: Although multiple barriers to success occurred, this program demonstrated that it could assist the youth and young adults with SCI to obtain post-secondary education and employment. This type of support system should be encouraged in order to improve the quality and satisfaction of life for young adults with disabilities.

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“…Research has shown that individuals with TBI often experience difficulty securing and/or returning to competitive employment postinjury and maintaining employment for extended periods of time. [1][2][3][4][5][6] Estimates of the employment rate for persons with TBI range from around 20% to 50% depending on the severity of the injury, the prior work experience of the individual, and demographic characteristics (eg, age, education, socioeconomic status). 2,3,[7][8][9] Prior investigations [10][11][12] have noted several negative psychosocial consequences of unemployment for individuals with TBI, including depression, decreased social functioning, and various physical ailments.…”

mentioning

confidence: 99%

Supported employment for persons with traumatic brain injury: A preliminary investigation of long-term follow-up costs and program efficiency

Wehman

Kregel

Keyser-Marcus

et al. 2003

Archives of Physical Medicine and Rehabilitation

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ABSTRACT. Wehman P, Kregel J, Keyser-Marcus L, Sherron-Targett P, Campbell L, West M, Cifu DX. Supported employment for persons with traumatic brain injury: a preliminary investigation of long-term follow-up costs and program efficiency. Arch Phys Med Rehabil 2003;84:192-6. Objective: To investigate the long-term follow-up costs of supported employment as well as the wage and employment characteristics for individuals with moderate to severe traumatic brain injury (TBI) who participated in supported employment services over a 14-year time period.Design: Longitudinal design with prospectively collected data.Setting: A university-based supported employment program that uses the individual placement model of supported employment.Participants: Fifty-nine individuals with moderate to severe TBI who were consecutively referred for supported employment services. The sample was restricted to individuals who were placed into a least 1 supported employment position during the study period.Interventions: Not applicable. Main Outcome Measures: Data were collected on clients placed into at least 1 competitive supported employment position from 1985 to 1999. Analyses were performed to examine the costs of supported employment, employment characteristics (eg, wages, length of employment), and benefit-cost ratios of supported employment for individuals with TBI.Results: The average length of employment for the current sample was 42.58 months. Average gross earnings were $26,129.74 for individuals during their entire duration of employment. Billing charges accrued for employment services averaged $10,349.37. Individuals with TBI earned an average of $17,515 more than the costs associated with their supported employment.Conclusions: Our investigation provides additional support for the conclusion that supported employment is cost effective for individuals with disabilities, including individuals with TBI, and that the costs of supported employment decrease over time.

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Acute predictors of return to employment after traumatic brain injury: A longitudinal follow-up

Cited by 175 publications

References 38 publications

Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury

Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury

Return to work and school: a model mentoring program for youth and young adults with spinal cord injury

Supported employment for persons with traumatic brain injury: A preliminary investigation of long-term follow-up costs and program efficiency

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