Background: There are limited data on the interactions between concomitant spinal cord injury (SCI) and traumatic brain injury (TBI) in terms of medical, psychological, functional, and community outcomes. Objective: To investigate the hypothesis that in addition to SCI-associated sensory-motor impairments, people with dual diagnosis would experience additional TBI-associated cognitive impairments that would have a negative impact on community reintegration. Methods: Cross-sectional, case-matched study comparing a consecutive sample of participants with dual diagnosis (n = 30) to an SCI group (n = 30) and TBI group (n = 30). Participants who were on average 3.6 years postrehabilitation discharge were interviewed using a battery of standardized outcome measures. Results: Length of rehabilitation stay was significantly longer in SCI and dual diagnosis participants. Fatigue, pain, sexual dysfunction, depression, and sleep disturbances were frequently reported by all groups. Similar levels of anxiety and depression were reported by participants in all groups, however TBI participants reported higher stress levels. All groups achieved mean FIM scores ≯ 100. The dual diagnosis and SCI groups received more daily care and support than TBI participants. Similar levels of community reintegration were achieved by all groups with a high level of productive engagement in work, study, or volunteer activities. Conclusions: The findings of this study do not support the hypotheses. Postrehabilitation functioning was better than anticipated in adults with dual diagnosis. The contribution of rehabilitation factors, such as longer admission time to develop compensatory techniques and strategies for adaptation in the community, may have contributed to these positive findings.
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August 11 2014
Effects of Concomitant Spinal Cord Injury and Brain Injury on Medical and Functional Outcomes and Community Participation
Melissa Nott;
Melissa Nott
1
School of Community Health, Charles Sturt University, Albury, NSW, Australia
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Ian Baguley;
Ian Baguley
2
Brain Injury Rehabilitation Service, Westmead Hospital, Sydney, NSW, Australia
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Roxana Heriseanu;
Roxana Heriseanu
3
Spinal Injuries Unit, Royal Rehabilitation Centre Sydney, Sydney, NSW, Australia
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Gerard Weber;
Gerard Weber
3
Spinal Injuries Unit, Royal Rehabilitation Centre Sydney, Sydney, NSW, Australia
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James Middleton;
James Middleton
4
NSW Statewide Spinal Cord Injury Service, Sydney, NSW, Australia
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Sue Meares;
Sue Meares
5
Department of Psychology, Macquarie University, Sydney, NSW, Australia
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Jennifer Batchelor;
Jennifer Batchelor
5
Department of Psychology, Macquarie University, Sydney, NSW, Australia
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Andrew Jones;
Andrew Jones
6
Concord Centre for Mental Health, Concord Hospital, Sydney, NSW, Australia
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Claire Boyle;
Claire Boyle
3
Spinal Injuries Unit, Royal Rehabilitation Centre Sydney, Sydney, NSW, Australia
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Stephanie Chilko
Stephanie Chilko
7
Occupational Therapy Department, Balmain Hospital, Sydney, NSW, Australia
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Top Spinal Cord Inj Rehabil (2014) 20 (3): 225–235.
Citation
Melissa Nott, Ian Baguley, Roxana Heriseanu, Gerard Weber, James Middleton, Sue Meares, Jennifer Batchelor, Andrew Jones, Claire Boyle, Stephanie Chilko; Effects of Concomitant Spinal Cord Injury and Brain Injury on Medical and Functional Outcomes and Community Participation. Top Spinal Cord Inj Rehabil 1 July 2014; 20 (3): 225–235. doi: https://doi.org/10.1310/sci2003-225
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