Relative contribution of acute cognitive and motor functioning on community integration 1 year after moderate-severe TBI

Objectives: The objective of this study was to understand the relative contribution of acute motor versus cognitive functioning on community integration 1 year after moderate-severe traumatic brain injury (TBI). Methods: Secondary data analysis of 779 participants in the TBI Model Systems National Database who experienced a moderate-severe TBI requiring inpatient rehabilitation. Participants were categorized into four groups: low motor/low cognition, low motor/high cognition, high motor/low cognition, or high motor/high cognition. Community integration outcomes measured 1 year post-TBI included the Participation Assessment with Recombined Tools-Objective (PART-O), driving status, Supervision Rating Scale, residence, re-injury, and employment status. Results: Participants with both high motor/high cognition had higher scores on the PART-O total score (p < 0.001), living independently (p = 0.023), living in a private residence (p = 0.002), and being employed (p = 0.026) at 1 year. Participants with high motor/high cognition and high motor/low cognition had higher odds of driving (p = 0.001 and p = 0.034, respectively) when compared to low motor/low cognition. All groups relative to the low motor/low cognition group had higher odds of being re-injured. Discussion and Conclusions: High motor and high cognitive function at rehabilitation are associated with favorable community integration outcomes 1 year post-injury, though greater participation afforded by high function may confer elevated risk of re-injury.