Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses · 2026
Factors Associated With Motor and Cognitive Function Recovery After Traumatic Brain Injury: A Retrospective Cohort Study.
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Yang Shu-Mei, Lai Ting-Ju, Lu You-Lin, Chen Hsing-Yu, Tsai Hsiao-Ting, Cheng Sheng-Hao, Lin Meng-Ting
Аннотация
PURPOSE: To identify predictors of motor and cognitive function recovery in patients with traumatic brain injury (TBI) for optimizing rehabilitation strategies.
DESIGN: A retrospective cohort study.
METHODS: Medical records of hospitalized patients with TBI at a tertiary medical center between June 2019 and June 2023 were reviewed. Patients with a history of brain surgery or tumors before the TBI were excluded. Demographic data, neurological assessments, rehabilitation indicators, and imaging findings were collected. Functional outcomes, including the modified Rankin Scale (mRS), Glasgow Outcome Scale (GOS), Glasgow Outcome Scale-Extended (GOSE), and Barthel index (BI), and cognitive outcomes assessed using the Rancho Los Amigos Scale (RLAS), were evaluated at multiple time points. Multivariable regression analyses identified independent predictors of recovery.
RESULTS OR FINDINGS: Among 160 patients, worse motor and cognitive function outcomes were associated with older age, lower initial RLAS scores, impaired sitting balance, temporal lobe hematomas, hydrocephalus, prolonged hospitalization, delayed physical therapy, immobility-related complications, anemia, and poor premorbid function. Among these, modifiable factors, including delayed initiation of physical therapy [adjusted odds ratio (aOR): 1.049, P=.014] and immobility-related complications (aOR: 2.363, P=.013), were independently associated with worse 4-week mRS outcomes.
CLINICAL RELEVANCE TO THE PRACTICE OF REHABILITATION NURSING: Understanding key predictors of recovery allows rehabilitation nurses to identify high-risk patients early, prioritize interventions, and tailor rehabilitation plans to improve outcomes.
CONCLUSIONS: Initial cognitive function and sitting balance serve as important prognostic indicators at presentation, whereas prevention of clinical complications represents a modifiable target for intervention to promote recovery in patients with TBI. Targeted strategies based on these predictors can enhance rehabilitation effectiveness.
DESIGN: A retrospective cohort study.
METHODS: Medical records of hospitalized patients with TBI at a tertiary medical center between June 2019 and June 2023 were reviewed. Patients with a history of brain surgery or tumors before the TBI were excluded. Demographic data, neurological assessments, rehabilitation indicators, and imaging findings were collected. Functional outcomes, including the modified Rankin Scale (mRS), Glasgow Outcome Scale (GOS), Glasgow Outcome Scale-Extended (GOSE), and Barthel index (BI), and cognitive outcomes assessed using the Rancho Los Amigos Scale (RLAS), were evaluated at multiple time points. Multivariable regression analyses identified independent predictors of recovery.
RESULTS OR FINDINGS: Among 160 patients, worse motor and cognitive function outcomes were associated with older age, lower initial RLAS scores, impaired sitting balance, temporal lobe hematomas, hydrocephalus, prolonged hospitalization, delayed physical therapy, immobility-related complications, anemia, and poor premorbid function. Among these, modifiable factors, including delayed initiation of physical therapy [adjusted odds ratio (aOR): 1.049, P=.014] and immobility-related complications (aOR: 2.363, P=.013), were independently associated with worse 4-week mRS outcomes.
CLINICAL RELEVANCE TO THE PRACTICE OF REHABILITATION NURSING: Understanding key predictors of recovery allows rehabilitation nurses to identify high-risk patients early, prioritize interventions, and tailor rehabilitation plans to improve outcomes.
CONCLUSIONS: Initial cognitive function and sitting balance serve as important prognostic indicators at presentation, whereas prevention of clinical complications represents a modifiable target for intervention to promote recovery in patients with TBI. Targeted strategies based on these predictors can enhance rehabilitation effectiveness.