Browsing by Author "Hammond, Flora M."
Now showing 1 - 10 of 93
Results Per Page
Sort Options
Item Acupuncture use for pain after traumatic brain injury: a NIDILRR Traumatic Brain Injury Model Systems cohort study(Taylor & Francis, 2023) Sodders, Mark D.; Martin, Aaron M.; Coker, Jennifer; Hammond, Flora M.; Hoffman, Jeanne M.; Physical Medicine and Rehabilitation, School of MedicineBackground: Pain after traumatic brain injury (TBI) is common and can become chronic. Acupuncture is an increasingly popular non-pharmacologic option in the United States and is commonly used for pain. Objective: We explored demographics, injury characteristics, and pain characteristics of individuals who reported using acupuncture for chronic pain after TBI. Methods: We analyzed a subset of data collected as part of the Pain After Traumatic Brain Injury collaborative study and identified individuals reporting a history of acupuncture as part of management for chronic pain after TBI. We characterized and compared basic demographic data, pain treatment engagements, pain severity, pain interference, functional independence, and pain locations using descriptive and inferential statistics. Results: Our sample included 1,064 individuals. Acupuncture use (n = 208) was lower proportionally among females, Blacks/African Americans, Asians, less educated, and nonmilitary service members. Insurance type varied between acupuncture and non-acupuncture users. Functional and pain outcomes were similar, but acupuncture users reported a higher number of pain sites. Discussion: Acupuncture is one treatment utilized by individuals with TBI and chronic pain. Further investigation would be helpful to understand the barriers and facilitators of acupuncture use to inform clinical trials to examine the potential benefit of acupuncture on pain outcomes after TBI.Item Acute Inpatient Rehabilitation Functional Outcomes and Disposition After Liver Transplant(Elsevier, 2024-03-16) Willoughby, Meghan E.; Ramsey-Morrow, Jacob L.; Littell, Kyle A.; Hammond, Flora M.; Physical Medicine and Rehabilitation, School of MedicineObjective: To describe the outcomes (change in functional independence and discharge disposition) of patients who after liver transplantation received acute inpatient rehabilitation in a freestanding rehabilitation hospital. Design: A retrospective chart review was conducted of patients admitted to an acute inpatient rehabilitation hospital within 6 months of undergoing liver transplantation between January 2014 and December 2018. Change in function from rehabilitation admission to discharge was measured using FIM Change and FIM Efficiency. Setting: A freestanding rehabilitation hospital. Participants: 107 patients who underwent acute inpatient rehabilitation at a freestanding rehabilitation hospital within 6 months after liver transplantation who met inclusion criteria (N=107). Most were men (71.96%), and the mean age of the patient population was 62.15 years. Interventions: Acute inpatient rehabilitation consisting of at least 3 hours of therapy 5 days a week split between physical therapy, occupational therapy, and speech language pathology services. Main outcome measure: FIM Change, FIM Efficiency, Discharge Disposition. Results: Participants were found to have statistically significant positive FIM Change (P<.00001) and FIM Efficiency (P<.00001). The mean FIM Change and Efficiency were 35.7±11.8 and 2.4±1.0, respectively. 83.2% (n = 89) were ultimately discharged to the community. Conclusion: Acute inpatient rehabilitation provides patients who have received a liver transplant with the opportunity to measurably improve their function and independence, with most patients being able to return home.Item Acute Ischemic Stroke After Moderate to Severe Traumatic Brain Injury: Incidence and Impact on Outcome(AHA, 2017-07) Kowalski, Robert G.; Haarbauer-Krupa, Juliet K.; Bell, Jeneita M.; Corrigan, John D.; Hammond, Flora M.; Torbey, Michel T.; Hofmann, Melissa C.; Dams-O'Connor, Kristen; Miller, A. Cate; Whiteneck, Gale G.; Physical Medicine and Rehabilitation, School of MedicineBackground and Purpose—Traumatic brain injury (TBI) leads to nearly 300 000 annual US hospitalizations and increased lifetime risk of acute ischemic stroke (AIS). Occurrence of AIS immediately after TBI has not been well characterized. We evaluated AIS acutely after TBI and its impact on outcome. Methods—A prospective database of moderate to severe TBI survivors, admitted to inpatient rehabilitation at 22 Traumatic Brain Injury Model Systems centers and their referring acute-care hospitals, was analyzed. Outcome measures were AIS incidence, duration of posttraumatic amnesia, Functional Independence Measure, and Disability Rating Scale, at rehabilitation discharge. Results—Between October 1, 2007, and March 31, 2015, 6488 patients with TBI were enrolled in the Traumatic Brain Injury Model Systems National Database. One hundred and fifty-nine (2.5%) patients had a concurrent AIS, and among these, median age was 40 years. AIS was associated with intracranial mass effect and carotid or vertebral artery dissection. High-velocity events more commonly caused TBI with dissection. AIS predicted poorer outcome by all measures, accounting for a 13.3-point reduction in Functional Independence Measure total score (95% confidence interval, −16.8 to −9.7; P<0.001), a 1.9-point increase in Disability Rating Scale (95% confidence interval, 1.3–2.5; P<0.001), and an 18.3-day increase in posttraumatic amnesia duration (95% confidence interval, 13.1–23.4; P<0.001). Conclusions—Ischemic stroke is observed acutely in 2.5% of moderate to severe TBI survivors and predicts worse functional and cognitive outcome. Half of TBI patients with AIS were aged ≤40 years, and AIS patients more often had cervical dissection. Vigilance for AIS is warranted acutely after TBI, particularly after high-velocity events.Item Advanced Therapy in Traumatic Brain Injury Inpatient Rehabilitation: Effects on Outcomes During the First Year after Discharge(Elsevier, 2019) Timpson, Misti; Hade, Erinn M.; Beaulieu, Cynthia; Horn, Susan D.; Hammond, Flora M.; Peng, Juan; Montgomery, Erin; Giuffrida, Clare; Gilchrist, Kamie; Lash, Aubrey; Dijkers, Marcel; Corrigan, John D.; Bogner, Jennifer; Physical Medicine and Rehabilitation, School of MedicineObjective To use causal inference methods to determine if receipt of a greater proportion inpatient rehabilitation treatment focused on higher level functions, e.g. executive functions, ambulating over uneven surfaces (Advanced Therapy, AdvTx) results in better rehabilitation outcomes. Design A cohort study using propensity score methods applied to the TBI-Practice-Based Evidence (TBI-PBE) database, a database consisting of multi-site, prospective, longitudinal observational data. Setting Acute inpatient rehabilitation (IRF). Participants Patients enrolled in the TBI-PBE study (n=1843), aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, receiving their first IRF admission to one of 9 sites in the US, and consented to follow-up 3 and 9 months post discharge from inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures: Participation Assessment with Recombined Tools-Objective-17, FIMTM Motor and Cognitive scores, Satisfaction with Life Scale, and Patient Health Questionnaire-9. Results Controlling for measured potential confounders, increasing the percentage of AdvTx during inpatient TBI rehabilitation was found to be associated with better community participation, functional independence, life satisfaction, and decreased likelihood of depression during the year following discharge from inpatient rehabilitation. Participants who began rehabilitation with greater disability experienced larger gains on some outcomes than those who began rehabilitation with more intact abilities. Conclusions Increasing the proportion of treatment targeting higher level functions appears to have no detrimental and a small, beneficial effect on outcome. Caution should be exercised when inferring causality given that a large number of potential confounders could not be completely controlled with propensity score methods. Further, the extent to which unmeasured confounders influenced the findings is not known and could be of particular concern due to the potential for the patient’s recovery trajectory to influence therapists’ decisions to provide a greater amount AdvTx.Item Aging with Traumatic Brain Injury: Deleterious Effects of Injury Chronicity Are Most Pronounced in Later Life(Mary Ann Liebert, 2021) Rabinowitz, Amanda R.; Kumar, Raj G.; Sima, Adam; Venkatesan, Umesh M.; Juengst, Shannon B.; O’Neil-Pirozzi, Therese M.; Watanabe, Thomas K.; Goldin, Yelena; Hammond, Flora M.; Dreer, Laura E.; Physical Medicine and Rehabilitation, School of MedicineUnderstanding the effects of age on longitudinal traumatic brain injury (TBI) outcomes requires attention to both chronic and evolving TBI effects and age-related changes in health and function. The present study examines the independent and interactive effects of aging and chronicity on functional outcomes after TBI. We leveraged a well-defined cohort of individuals who sustained a moderate/severe TBI and received acute inpatient rehabilitation at specialized centers with high follow up rate as part of their involvement in the TBI Model Systems longitudinal study. We selected individuals at one of two levels of TBI chronicity (either 2 or 10 years post-injury) and used an exact matching procedure to obtain balanced chronicity groups based on age and other characteristics (N = 1993). We found that both older age and greater injury chronicity were related to greater disability, reduced functional independence, and less community participation. There was a significant age by chronicity interaction, indicating that the adverse effects of greater time post-injury were most pronounced among survivors who were age 75 or older. The inflection point at roughly 75 years of age was corroborated by post hoc analyses, dividing the sample by age at 75 years and examining the interaction between age group and chronicity. These findings point to a need for provision of rehabilitation services in the chronic injury period, particularly for those who are over 75 years old. Future work should investigate the underlying mechanisms of this interaction towards the goal of developing interventions and models of care to promote healthy aging with TBI.Item Amantadine Did Not Positively Impact Cognition in Chronic Traumatic Brain Injury: A Multi-Site, Randomized, Controlled Trial(Mary Ann Liebert, 2018-10-01) Hammond, Flora M.; Sherer, Mark; Malec, James F.; Zafonte, Ross D.; Dikmen, Sureyya; Bogner, Jennifer; Bell, Kathleen R.; Barber, Jason; Temkin, Nancy; Physical Medicine and Rehabilitation, School of MedicineDespite limited evidence to support the use of amantadine to enhance cognitive function after traumatic brain injury (TBI), the clinical use for this purpose is highly prevalent and is often based on inferred belief systems. The aim of this study was to assess effect of amantadine on cognition among individuals with a history of TBI and behavioral disturbance using a parallel-group, randomized, double-blind, placebo-controlled trial of amantadine 100 mg twice-daily versus placebo for 60 days. Included in the study were 119 individuals with two or more neuropsychological measures greater than 1 standard deviation below normative means from a larger study of 168 individuals with chronic TBI (>6 months post-injury) and irritability. Cognitive function was measured at treatment days 0, 28, and 60 with a battery of neuropsychological tests. Composite indices were generated: General Cognitive Index (included all measures), a Learning Memory Index (learning/memory measures), and Attention/Processing Speed Index (attention and executive function measures). Repeated-measures analysis of variance revealed statistically significant between-group differences favoring the placebo group at day 28 for General Cognitive Index (p = 0.002) and Learning Memory Index (p = 0.001), but not Attention/Processing Speed Index (p = 0.25), whereas no statistically significant between-group differences were found at day 60. There were no statistically significant between-group differences on adverse events. Cognitive function in individuals with chronic TBI is not improved by amantadine 100 mg twice-daily. In the first 28 days of use, amantadine may impede cognitive processing. However, the effect size was small and mean scores for both groups were generally within expectations for persons with history of complicated mild-to-severe TBI, suggesting that changes observed across assessments may not have functional significance. The use of amantadine to enhance cognitive function is not supported by these findings.Item Amantadine effect on perceptions of irritability after traumatic brain injury: results of the amantadine irritability multisite study(Mary Ann Liebert, Inc., 2015-08-15) Hammond, Flora M.; Sherer, Mark; Malec, James F.; Zafonte, Ross D.; Whitney, Marybeth; Bell, Kathleen; Dikmen, Sureyya; Bogner, Jennifer; Mysiw, Jerry; Pershad, Rashmi; Physical Medicine and Rehabilitation, School of MedicineThis study examines the effect of amantadine on irritability in persons in the post-acute period after traumatic brain injury (TBI). There were 168 persons ≥6 months post-TBI with irritability who were enrolled in a parallel-group, randomized, double-blind, placebo-controlled trial receiving either amantadine 100 mg twice daily or equivalent placebo for 60 days. Subjects were assessed at baseline and days 28 (primary end-point) and 60 of treatment using observer-rated and participant-rated Neuropsychiatric Inventory (NPI-I) Most Problematic item (primary outcome), NPI Most Aberrant item, and NPI-I Distress Scores, as well as physician-rated Clinical Global Impressions (CGI) scale. Observer ratings between the two groups were not statistically significantly different at day 28 or 60; however, observers rated the majority in both groups as having improved at both intervals. Participant ratings for day 60 demonstrated improvements in both groups with greater improvement in the amantadine group on NPI-I Most Problematic (p<0.04) and NPI-I Distress (p<0.04). These results were not significant with correction for multiple comparisons. CGI demonstrated greater improvement for amantadine than the placebo group (p<0.04). Adverse event occurrence did not differ between the two groups. While observers in both groups reported large improvements, significant group differences were not found for the primary outcome (observer ratings) at either day 28 or 60. This large placebo or nonspecific effect may have masked detection of a treatment effect. The result of this study of amantadine 100 mg every morning and noon to reduce irritability was not positive from the observer perspective, although there are indications of improvement at day 60 from the perspective of persons with TBI and clinicians that may warrant further investigation.Item Are Burns a Chronic Condition? Examining Patient Reported Outcomes up to 20 Years after Burn Injury – A Burn Model System National Database Investigation(Wolters Kluwer, 2022) Abouzeid, Cailin A.; Wolfe, Audrey E.; Ni, Pengsheng; Carrougher, Gretchen J.; Gibran, Nicole S.; Hammond, Flora M.; Holavanahalli, Radha; McMullen, Kara A.; Roaten, Kimberly; Suman, Oscar; Stewart, Barclay T.; Wolf, Steven; Zafonte, Ross; Kazis, Lewis E.; Ryan, Colleen M.; Schneider, Jeffrey C.; Physical Medicine and Rehabilitation, School of MedicineBackground: People living with burn injury often face long-term physical and psychological sequelae associated with their injuries. Few studies have examined the impacts of burn injuries on long-term health and function, life satisfaction, and community integration beyond 5 years postinjury. The purpose of this study was to examine these outcomes up to 20 years after burn injury. Methods: Data from the Burn Model System National Longitudinal Database (1993-2020) were analyzed. Patient-reported outcome measures were collected at discharge (preinjury status recall) and 5 years, 10 years, 15 years, and 20 years after injury. Outcomes examined were the SF-12/VR-12 Physical Component Summary and Mental Component Summary, Satisfaction with Life Scale, and Community Integration Questionnaire. Trajectories were developed using linear mixed models with repeated measures of outcome scores over time, controlling for demographic and clinical variables. Results: The study population included 421 adult burn survivors with a mean age of 42.4 years. Lower Physical Component Summary scores (worse health) were associated with longer length of hospital stay, older age at injury and greater time since injury. Similarly, lower Mental Component Summary scores were associated with longer length of hospital stay, female sex, and greater time since injury. Satisfaction with Life Scale scores decrease negatively over time. Lower Community Integration Questionnaire scores were associated with burn size and Hispanic/Latino ethnicity. Conclusion: Burn survivors' physical and mental health and satisfaction with life worsened over time up to 20 years after injury. Results strongly suggest that future studies should focus on long-term follow-up where clinical interventions may be necessary.Item Assessing Negative Attributions After Brain Injury With the Ambiguous Intentions Hostility Questionnaire(Wolters Kluwer, 2020-09) Neumann, Dawn; Sander, Angelle M.; Perkins, Susan M.; Bhamidipalli, Surya Sruthi; Witwer, Noelle; Combs, Dennis; Hammond, Flora M.; Physical Medicine and Rehabilitation, School of MedicineOBJECTIVES: (1) To explore the construct validity of the Ambiguous Intentions Hostility Questionnaire (AIHQ) in participants with traumatic brain injury (TBI) (ie, confirm negative attributions are associated with anger and aggression); and (2) use the AIHQ to examine negative attribution differences between participants with and without TBI. SETTING: Two rehabilitation hospitals. PARTICIPANTS: Eighty-five adults with TBI and 86 healthy controls (HCs). DESIGN: Cross-sectional survey. MAIN MEASURES: The AIHQ, a measure of negative attributions (intent, hostility, and blame), anger, and aggressive responses to hypothetical scenarios. RESULTS: Attributions were significantly correlated with anticipated anger and aggressive responses to AIHQ scenarios. Compared with HCs, participants with TBI reported stronger negative attributions (P ≤ .001), anger (P = .021), and aggressive responses (P = .002) to the scenarios. CONCLUSION: Negative attributions were associated with anger and aggression responses, demonstrating construct validity of the AIHQ in the TBI population. Participants with TBI judged others' behaviors more severely than HCs, similar to prior research using a different attribution measure. The AIHQ has promise as a practical instrument for assessing negative attributions after TBI.Item Association Between Anxiety Symptoms, Depression Symptoms, and Life Satisfaction Among Individuals 1 Year After Spinal Cord Injury: Findings From the SCIRehab Project(Elsevier, 2022-08-03) Parker, Maria A.; Ichikawa, Jodi K.; Bombardier, Charles H.; Hammond, Flora M.; Epidemiology, School of Public HealthObjective: To examine the association between anxiety symptoms, depression symptoms, and life satisfaction 1 year after SCI. Design: Cross-sectional analysis of data from the SCIRehab Project. A linear regression model estimated the association between anxiety symptoms and life satisfaction and tested the moderating effect of depression symptoms on the association between anxiety symptoms and depression symptoms with an interaction term. Setting: Six rehabilitation facilities across the United States. Participants: A total to 940 persons older than 12 years who received inpatient spinal cord injury (SCI) rehabilitation between 2007 and 2009 were followed up 1 year post injury (n=940). Interventions: None. Main outcome measures: Life satisfaction 1 year after SCI measured via the Satisfaction With Life Scale. Results: Unadjusted analyses showed anxiety symptoms were associated with decreased life satisfaction for individuals with SCI. In adjusted analyses, anxiety symptoms were not associated with life satisfaction. In adding an interaction term, anxiety symptoms were associated with 2 points lower life satisfaction holding the other variables constant (P=.02). There was a moderating effect of depression symptoms on the association between anxiety symptoms and life satisfaction. Persons with anxiety symptoms had lower life satisfaction scores at lower levels of depression symptoms but higher life satisfaction scores at higher levels of depression symptoms than persons with no anxiety. Conclusions: In clinical settings, both anxiety and depression symptoms should be monitored, measured, and treated together to optimally improve life satisfaction for persons with SCI. Prioritizing interventions known to have transdiagnostic effects may achieve the best results.