Publications by authors named "Mitch Sevigny"
Traumatic brain injury (TBI) and subsequent post-traumatic epilepsy (PTE) often impair daily activities and mental health (MH), which contribute to long-term TBI-related disability. PTE also affects driving capacity, which impacts functional independence, community participation, and satisfaction with life (SWL). However, studies evaluating the collective impact of PTE on multidimensional outcomes are lacking.
View Article and Find Full Text PDFObjective: To determine whether there are differences in healthcare utilization for chronic pain based on location (rural vs urban/suburban) or healthcare system (civilians vs Military Service Members and Veterans [SMVs]) after moderate-severe TBI.
Setting: Eighteen Traumatic Brain Injury Model Systems (TBIMS) Centers.
Participants: A total of 1,741 TBIMS participants 1 to 30 years post-injury reporting chronic pain at their most recent follow-up interview.
Traumatic brain injury (TBI) clinical practice guidelines for pain management and rehabilitation support the use of nonpharmacologic complementary and integrative health (CIH) modalities, such as acupuncture for remediating pain. Barriers to delivering CIH modalities, such as acupuncture warrant examination. The objective of this study is to explore provider perspectives on challenges to accessing acupuncture treatment for chronic pain in persons with TBI and describe differences across health care settings.
View Article and Find Full Text PDFPurpose/objective: This study aimed to determine the feasibility of using commercially available heart rate variability (HRV) biofeedback training to improve physiological and self-reported stress and anxiety among adults with tetraplegia. HRV biofeedback teaches individuals to effectively modify their HRV levels in synchronization with their respiration rate and amplitude.
Research Method/design: Thirty participants with tetraplegia were enrolled and allocated into one of two study arms: biofeedback or control.
Article Synopsis
- Study aimed to assess alexithymia prevalence in individuals with moderate-to-severe TBI one year post-injury, explore related demographic and injury factors, and analyze its links to emotional functioning and life satisfaction.
- Among 196 participants, 14.3% had high levels of alexithymia, with tendencies observed for lower education levels in this group.
- High alexithymia scores were linked to significant emotional dysregulation and post-traumatic stress, and moderately related to other negative emotional states and lower life satisfaction.
Objectives: The development of venous thromboembolism (VTE) is a common complication following spinal cord injury (SCI) and brain injury (BI), leading to significant morbidity and mortality. The purpose of this study was to explore the incidence of VTE in patients with the dual diagnosis (DD) of SCI and concomitant BI using ultrasonography.
Design: Retrospective study.
Context/objective: There is a growing global interest in quantifying spinal cord lesions and spared neural tissue using magnetic resonance imaging (MRI) in individuals with spinal cord injury (SCI). The primary objective of this study was to assess the relationships between spinal cord lesion characteristics assessed on MRI and bowel, bladder, and overall independence following SCI.
Design: Retrospective, exploratory study.
Article Synopsis
- - A retrospective multi-site cohort study aimed to create a machine learning model to predict ambulatory status in spinal cord injury (SCI) patients one year after their injury, using data from the SCI Model System database collected between January 2000 and May 2019.
- - The study analyzed data from 4,523 patients, comparing traditional prediction methods with machine learning algorithms, finding that the Elastic Net Penalized Logistic Regression (ENPLR) model had the best predictive accuracy.
- - The ENPLR model showed improved performance metrics over traditional methods, indicating that machine learning could more accurately identify patients' likelihood to walk post-injury, suggesting future research could enhance these predictions by incorporating additional variables.
Purpose: To determine how life satisfaction changes across the first 10 years following traumatic brain injury (TBI).
Methods: Participants included 1,941 individuals from the TBI Model Systems database with life satisfaction data at 1-, 5-, and 10-years post-TBI. Based on Satisfaction With Life Scale scores, individuals were characterized as having one of the five 10-year life satisfaction trajectories: 'Stable High,' 'Stable Low,' 'Increased to High,' 'Decreased to Low,' and 'Unstable.
Objective: To examine the unique contribution of alexithymia at 1 year after traumatic brain injury (TBI) to the prospective prediction of emotional and social health outcomes at 2 years after injury.
Design: Multicenter, longitudinal cohort study.
Setting: Data were collected during year 1 and year 2 postinjury follow-up interviews across 4 TBI Model System centers.
Objectives: To compare 1-year mobility outcomes of individuals with traumatic motor incomplete spinal cord injury (miSCI) who participated in standardized locomotor training (LT) within the first year of injury to those who did not.
Methods: This retrospective case-control analysis conducted with six US rehabilitation hospitals used SCI Model Systems (SCIMS) data comparing 1-year postinjury outcomes between individuals with miSCI who participated in standardized LT to those who received usual care (UC). Participants were matched on age, gender, injury year, mode of mobility, and rehabilitation center.
Objective: To describe the characteristics and outcomes of older (65+) Medicare beneficiaries with traumatic brain injury (TBI) treated in inpatient rehabilitation facilities between 2013 and 2018.
Design: Descriptive study using IRF Patient Assessment Instrument (IRF-PAI) data reporting trends of the sociodemographic and clinical characteristics and outcomes of inpatient rehabilitation facilities Medicare patients with TBI.
Setting: Inpatient rehabilitation facilities in the United States.
Article Synopsis
- * Participants included 3,804 individuals aged 1 to 30 years post-injury, who completed a Pain Survey about 8 years after their injury.
- * Results showed that individuals with current chronic pain faced significantly worse psychosocial outcomes, such as higher levels of PTSD, anxiety, and depression, and lower life satisfaction and community participation, compared to those with no pain or resolved past pain.
Article Synopsis
- The study assesses chronic pain prevalence in individuals with traumatic brain injury (TBI), finding that about 60% experience chronic pain at some point.
- It compares three groups: those with current chronic pain, past chronic pain, and no chronic pain, noting that current pain is associated with worse functional outcomes.
- The results highlight the need for more effective pain management and the inclusion of pain metrics in future research related to TBI.
Background: Oral health and regular dental care are critical to overall health. Research has found associations between oral health and infections, respiratory disease, and poor quality of life in the general population. While risks for all are increased in people with spinal cord injury (SCI), there is limited information on dental care after SCI.
View Article and Find Full Text PDFCharacterizing Extreme Phenotypes for Perceived Improvement From Treatment in Persons With Chronic Pain Following Traumatic Brain Injury: A NIDILRR and VA TBI Model Systems Collaborative Project.
J Head Trauma Rehabil
January 2024
Objective: To define and characterize extreme phenotypes based on perceived improvement in pain for persons with chronic pain following traumatic brain injury (TBI).
Setting: Eighteen Traumatic Brain Injury Model System (TBIMS) Centers.
Participants: A total of 1762 TBIMS participants 1 to 30 years post-injury reporting chronic pain at their most recent follow-up interview.
Characterizing Extreme Phenotypes for Pain Interference in Persons With Chronic Pain Following Traumatic Brain Injury: A NIDILRR and VA TBI Model Systems Collaborative Project.
J Head Trauma Rehabil
January 2024
Objective: To define and characterize extreme phenotypes based on pain interference for persons with chronic pain following traumatic brain injury (TBI).
Setting: Eighteen Traumatic Brain Injury Model System (TBIMS) Centers.
Participants: A total of 1762 TBIMS participants 1 to 30 years post-injury reporting chronic pain at their most recent follow-up interview.
Background: Traumatic brain injury (TBI) is a complex health problem in military veterans and service members (V/SM) that often involves comorbid vestibular impairment. Sleep apnea is another comorbidity that may exacerbate, and/or be exacerbated by, vestibular dysfunction.
Objective: To examine the relationship between sleep apnea and vestibular symptoms in V/SM diagnosed with TBI of any severity.
Objective: To derive and validate a simple, accurate CPR to predict future independent walking ability after SCI at the bedside that does not rely on motor scores and is predictive for those initially classified in the middle of the SCI severity spectrum.
Design: Retrospective cohort study. Binary variables were derived, indicating degrees of sensation to evaluate predictive value of pinprick and light touch variables across dermatomes.
To assess the incidence and possible risk factors for venous thromboembolism (VTE) in patients admitted to a SCI rehabilitation center. Retrospective review. Acute neurorehabilitation hospital specializing in SCI.
View Article and Find Full Text PDFObjective: To evaluate independence and exertion when using a lightweight wheelchair in comparison with ultra-lightweight wheelchairs (rigid and folding) for individuals with brain injury using a hemipropulsion technique.
Design: Randomized cross-over.
Setting: Rehabilitation hospital.
Objective: To identify demographic, injury-related, and 1-year postinjury clinical and functional predictors of high and low life satisfaction at 10 years after moderate to severe traumatic brain injury (TBI) using an extreme phenotyping approach.
Setting: Multicenter longitudinal database study.
Participants: A total of 3040 people from the National Institute on Disability, Independent Living, and Rehabilitation Research TBI Model Systems database with life satisfaction data at 10 years post-TBI.
Objective: To determine the incidence of VTE in the population with brain injuries (BIs) using ultrasonography, and to assess the risk of pulmonary embolism (PE) development and/or bleeding complications related to anticoagulation.
Design: Retrospective study.
Setting: Acute rehabilitation hospital.