Km. Hall et al., Assessing traumatic brain injury outcome measures for long-term follow-up of community-based individuals, ARCH PHYS M, 82(3), 2001, pp. 367-374
Objectives: To determine which outcome measures are best and least suited f
or assessing long-term functional outcome of individuals with traumatic bra
in injury (TBI) in the community.
Design: Survey of participants in the community an average of 5 years after
TBI. A battery of outcome measures was given.
Setting: Community in northern California after inpatient rehabilitation.
Participants: Forty-eight adult individuals with prior moderate to severe T
BI. All subjects had received inpatient rehabilitation 2 to 9 years previou
sly and could be reached for telephone interview.
Main Outcome Measures: The Community Integration Questionnaire, Neurobehavi
oral Functioning Inventory (NFI), Patient Competency Rating Scale (PCRS), L
evel of Cognitive Functioning Scale (LCFS), FLM(TM) instrument, Functional
Assessment Measure (FIM+FAM), Supervision Rating Scale (SRS), Disability Ra
ting Scale (DRS), Revised Craig Handicap Assessment and Reporting Technique
(R-CHART), and Glasgow Outcome Scale (GOS). The number of maximal scores o
n each of the surveys was studied to determine which instruments continued
to reveal deficits years after TBI.
Results: Most individuals obtained maximum scores, ie, functional independe
nce, on these scales: LCFS, FIM motor subscale and total score, R-CHART phy
sical independence subscale, FIM+FAM, GOS, and the SRS. Measures with the f
ewest maximum scores (<36%, measuring deficits still extant in the group) w
ere the R-CHART cognition subscale and the NFI memory/attention and communi
cation subscales, and employment subscales. Items, subscales, and total sco
res that showed good variability and correlated most highly and frequently
with other scales also demonstrating good variability were the PCRS, the DR
S and FIM+FAM employment items, the R-CHART cognition subscale, and the NFI
motor, memory/attention, communication, and depression subscales (the R-CH
ART cognition subscale and NFI memory/attention subscale were highly correl
ated with the PCRS;.84,.83).
Conclusions: Measures that appeared to contribute little to assessing funct
ional status of a TBI sample years postinjury were the FIM, FIM+FAM, SRS, G
OS, and LCFS. Measures that showed a range of deficits across participants
were DRS employability, the NFI, PCRS, and the R-CHART cognition subscale.