Evidence map›Paper›PMID 26212400›Full record

Observational studyArchives of physical medicine and rehabilitation2015

Patient Effort in Traumatic Brain Injury Inpatient Rehabilitation: Course and Associations With Age, Brain Injury Severity, and Time Postinjury.

Ronald T Seel, John D Corrigan, Marcel P Dijkers, Ryan S Barrett, Jennifer Bogner, Randall J Smout, William Garmoe, Susan D Horn

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Archives of physical medicine and rehabilitation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07364773 (Enhancing Rehabilitation Participation in Patients With Spinal Cord Injury or Disorder Using Motivational Interviewing), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07364773 narecruitingnot on this mapstarted 2025, after this paper: background citation

Enhancing Rehabilitation Participation in Patients With Spinal Cord Injury or Disorder Using Motivational Interviewing

TypeinterventionalSponsorShirley Ryan AbilityLabRan2025 to 2027Enrolled180ConditionsSpinal Cord Injuries (SCI), Spinal Cord DiseaseArmsMotivational Interviewing
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
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  5. Article
  6. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ronald T SeelCrawford Research Institute, Shepherd Center, Atlanta, GA. Electronic address: ron_seel@shepherd.org.
John D CorriganDepartment of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH.
Marcel P DijkersDepartment of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Ryan S BarrettInstitute for Clinical Outcomes Research, International Severity Information Systems, Salt Lake City, UT.
Jennifer BognerDepartment of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH.
Randall J SmoutInstitute for Clinical Outcomes Research, International Severity Information Systems, Salt Lake City, UT.
William GarmoeMedstar National Rehabilitation Hospital, Washington, DC.
Susan D HornInstitute for Clinical Outcomes Research, International Severity Information Systems, Salt Lake City, UT.

Funding

Improving Outcomes in Acute Rehabilitation for TBIR01HD050439 · NICHD · INTERNATIONAL SEVERITY INFO SYSTEMS,INC. · PI HORN, SUSAN D · 2007 to 2011
$3.3M
NICHD NIH HHS 1R01HD050439-01NICHD NIH HHS R01 HD050439
6 · The paper itself

Abstract

objectiveTo describe patients' level of effort in occupational, physical, and speech therapy sessions during traumatic brain injury (TBI) inpatient rehabilitation and to evaluate how age, injury severity, cognitive impairment, and time are associated with effort.

designProspective, multicenter, longitudinal cohort study.

settingAcute TBI rehabilitation programs.

participantsPatients (N=1946) receiving 138,555 therapy sessions.

interventionsNot applicable.

main outcome measuresEffort in rehabilitation sessions rated on the Rehabilitation Intensity of Therapy Scale, FIM, Comprehensive Severity Index brain injury severity score, posttraumatic amnesia (PTA), and Agitated Behavior Scale (ABS).

resultsThe Rehabilitation Intensity of Therapy Scale effort ratings in individual therapy sessions closely conformed to a normative distribution for all 3 disciplines. Mean Rehabilitation Intensity of Therapy Scale ratings for patients' therapy sessions were higher in the discharge week than in the admission week (P<.001). For patients who completed 2, 3, or 4 weeks of rehabilitation, differences in effort ratings (P<.001) were observed between 5 subgroups stratified by admission FIM cognitive scores and over time. In linear mixed-effects modeling, age and Comprehensive Severity Index brain injury severity score at admission, days from injury to rehabilitation admission, days from admission, and daily ratings of PTA and ABS score were predictors of level of effort (P<.0001).

conclusionsPatients' level of effort can be observed and reliably rated in the TBI inpatient rehabilitation setting using the Rehabilitation Intensity of Therapy Scale. Patients who sustain TBI show varying levels of effort in rehabilitation therapy sessions, with effort tending to increase over the stay. PTA and agitated behavior are primary risk factors that substantially reduce patient effort in therapies.

Indexed as

Physical ExertionActivities of Daily LivingAdultAge FactorsBrain InjuriesCognition DisordersCohort StudiesComorbidityFemaleHumansInjury Severity ScoreInpatientsLength of StayMaleMiddle AgedOccupational TherapyAmnesia, anterogradeCraniocerebral traumaPsychomotor agitationRehabilitation

Identifiers

PMID26212400
PMCPMC5504881

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.