Moving Beyond Rapport: The Importance of Active Facilitation of Therapeutic Alliance in Adult Acquired Brain Injury Rehabilitation.

Purpose: Therapeutic alliance (TA) is critical to rehabilitation outcomes for adults with acquired brain injuries (ABIs). The purpose of this viewpoint article is to review factors that contribute to TA and to suggest ways speech-language pathologists (SLPs) can integrate these factors into their ABI rehabilitation practice.

Method: We evaluated literature describing client and clinician factors shown to affect-or not affect-TA in ABI rehabilitation and mapped findings onto suggested practices that SLPs may use to actively promote TA with their clients.

Adherence to cognitive and physical exercise engagement: a challenge to successful dementia risk reduction and prevention efforts.

With human life expectancy and proportion of older adults increasing, global use of evidence-supported preventative methods to minimize risk of brain-related disabilities such as Alzheimer's disease and other dementias-as well as interventions to slow rate of disease progression-is important. Sustained engagement in cognitive and physical exercise programs may prevent or delay dementia onset as well as maximize health and function of those with dementia. Despite awareness of the importance of cognitive and physical exercise to brain health, exercise program adherence by older adults is extremely challenging.

10-year variability in high and low life satisfaction trajectories post-traumatic brain injury: a TBI model systems study.

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.

Association Between Participation and Satisfaction With Life Over Time in Older Adults With Traumatic Brain Injury: A TBI Model Systems Study.

Objective: To examine the association between participation and satisfaction with life at 1, 2, 5, and 10 years after traumatic brain injury (TBI) in older adults.

Setting: Community.

Participants: Participants ( N = 2362) who sustained complicated mild to severe TBI, requiring inpatient rehabilitation, at age 60 years or older and had follow-up data on participation and satisfaction with life for at least 1 follow-up time point across 1, 2, 5, and 10 years.

Developing multidimensional participation profiles after traumatic brain injury: a TBI model systems study.

To characterize societal participation profiles after moderate-severe traumatic brain injury (TBI) along objective (Frequency) and subjective (Satisfaction, Importance, Enfranchisement) dimensions. We conducted secondary analyses of a TBI Model Systems sub-study ( = 408). Multiaxial assessment of participation included the Participation Assessment with Recombined Tools-Objective and -Subjective questionnaires (Participation Frequency and Importance/Satisfaction, respectively) and the Enfranchisement Scale.

Identification of Factors in Moderate-Severe TBI Related to a Functional Decline in Cognition Decades After Injury.

Objective: To investigate whether a functional decline in cognitive activities decades after moderate-to-severe traumatic brain injury (m-sTBI) might relate to injury features and/or lifetime health factors, some of which may emerge as consequences of the injury.

Design: Secondary analysis of the TBI Model Systems National Database, a prospective, multi-center, longitudinal study of patients with m-sTBI.

Setting: TBI Model Systems Centers.

Early Factors Predictive of Extreme High and Low Life Satisfaction 10 Years Post-Moderate to Severe Traumatic Brain Injury.

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.

Alternative Structure Models of the Traumatic Brain Injury Rehabilitation Needs Survey: A Veterans Affairs TBI Model Systems Study.

Objective: To explore the factor structure of the Rehabilitation Needs Survey (RNS).

Design: Secondary analysis of observational cohort study who were 5-years post-traumatic brain injury (TBI).

Setting: Five Inpatient Rehabilitation Facilities.

Predictors of High School and College Graduation After Sustaining a Moderate-to-Severe Traumatic Brain Injury.

Objective: To identify early predictors of US high school and college graduation after moderate-to-severe traumatic brain injury (TBI).

Setting: Inpatient rehabilitation and community.

Participants: TBI Model Systems participants, aged 16 to 24 years, enrolled as high school or college students at time of injury.

The Importance of Motivation to Older Adult Physical and Cognitive Exercise Program Development, Initiation, and Adherence.

Brain health is essential to successful aging, and exercise is essential to brain health. Evidence supports the benefits of regular physical and cognitive exercise in preventing or delaying progressin of mild cognitive impairment and dementia. Despite known benefits, motivation to initiate and adhere to an exercise program can be challenging to older adults.

Family Needs After Traumatic Brain Injury: A VA TBI Model Systems Study.

Objective: To describe the self-reported needs of family caregivers of service members and veterans (SMVs) who sustained a traumatic brain injury (TBI) and to identify predictors of the unmet family caregiver needs.

Setting: Five Department of Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRCs).

Participants: Family caregivers of SMVs enrolled in the VA PRC TBI Model Systems (TBIMS) national database who were within their first 5 years post-TBI ( n = 427).

Caregiver Characteristics of Adults with Acute Traumatic Brain Injury in the United States and Latin America.

Objectives: To compare characteristics of caregivers of adults with acute traumatic brain injury (TBI) in the U.S. and Latin America (Mexico and Colombia).

Factors Associated With High and Low Life Satisfaction 10 Years After Traumatic Brain Injury.

Objective: To identify correlates of life satisfaction at 10 years after moderate to severe traumatic brain injury (TBI) using an extreme phenotyping approach.

Design: Effect sizes were calculated in this observational cohort study to estimate relationships of 10-year postinjury extremely high, extremely low, and moderate life satisfaction with (1) pre-injury demographics, injury-related factors, and functional characteristics at inpatient rehabilitation admission and discharge; and (2) postinjury demographics and clinical and functional measures at 10 years postinjury.

Setting: Multicenter longitudinal database study.

Health and cognition among adults with and without Traumatic Brain Injury: A matched case-control study.

Objectives: To evaluate associations between traumatic brain injury (TBI) and presence of health conditions, and to compare associations of health and cognition between TBI cases and controls.

Methods: This matched case-control study used data from the TBI Model Systems National Database (TBI cases) and Midlife in the United States II and Refresher studies (controls).  248 TBI cases were age-, sex-, race-, and education-matched without replacement to three controls.

Tutorial: The Speech-Language Pathologist's Role in Return to Work for Adults With Traumatic Brain Injury.

Purpose: Return to work (RTW) is a major life participation metric used for persons with a traumatic brain injury (TBI). Speech-language pathologists (SLPs) have clinical expertise in the cognitive-communication aspects of TBI. This clinical focus article aims to support the clinical practice of SLPs by summarizing key interprofessional vocational rehabilitation (VR) models and illustrating the role of the SLP throughout the RTW process with a case study.

Refining understanding of life satisfaction in elderly persons with traumatic brain injury using age-defined cohorts: a TBI model systems study.

Objective: Examine effects of age cohort on post-injury life satisfaction in elderly persons with TBIDesign: Retrospective cohortSetting: TBI Model Systems centers.

Participants: 5,109 elderly participants with TBI in the TBI Model Systems National DatabaseInterventions: Not applicableMain Outcome Measures: Demographics, injury characteristics and cause, outcomes, age at time of analysis, time to follow commands, maximum follow-up period, and scores on the Satisfaction With Life Scale (SWLS) and Participation Assessment with Recombined Tools-Objective (PART-O) scores at 1, 2, 5, or 10 years post-injury.

Results: Life satisfaction post-TBI across groups increased with age.

Acquired Brain Injury Survivor Long-Term Cognitive Exercise Engagement Post-Speech Therapy Discharge.

Purpose The purpose of this article is to promote the viewpoint that speech-language pathologists (SLPs) are well positioned to actively encourage individuals with cognitive-communication disorders following acquired brain injury (ABI) to engage in ongoing, long-term, cognitive exercise post-therapy discharge. Method This viewpoint article draws on evidence from the well-researched area of physical exercise, reports findings of early-stage research in the much less studied area of cognitive exercise, and highlights relevant aspects of motivational theory informing exercise participation. Informed by these, an evidence-supported model of cognitive exercise engagement is offered to inform ABI-targeted cognitive wellness empowerment efforts, and a case study illustrates clinical application of the model.

Aging with Traumatic Brain Injury: Deleterious Effects of Injury Chronicity Are Most Pronounced in Later Life.

Understanding 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.

Cognitive Exercise Self-Efficacy of Community-Dwelling Older Adults: Measurement and Associations with Other Self-Reported Cognitive Exercise Factors.

Exercise self-efficacy, the confidence a person has in their ability to develop and meet exercise goals, is key to exercise motivation. The primary objective of this pilot study was to explore associations among cognitive exercise self-efficacy, cognitive exercise frequency, challenge, and enjoyment in older adults. A prospective, cross-sectional, observational study design was used with 133 community-dwelling individuals aged 55 years and older.

Cognitive-Communication Predictors of Employment Outcomes 1 and 5 Years Posttraumatic Brain Injury.

Objective: To examine changes in functional memory, problem solving, comprehension, expression, and social communication over the first 2 years posttraumatic brain injury (TBI) and the ability of each to predict return to work (RTW) outcomes at 1 year and 5 years postinjury.

Design: Secondary analysis of data from a multicenter longitudinal cohort study.

Setting: Acute inpatient rehabilitation facilities and community follow-up.

Functional Change from Five to Fifteen Years after Traumatic Brain Injury.

Few studies have assessed the long-term functional outcomes of traumatic brain injury (TBI) in large, well-characterized samples. Using the Traumatic Brain Injury Model Systems cohort, this study assessed the maintenance of independence between years 5 and 15 post-injury and risk factors for decline. The study sample included 1381 persons with TBI who received inpatient rehabilitation, survived to 15 years post-injury, and were available for data collection at 5 or 10 years and 15 years post-injury.

Reinjury After Moderate to Severe TBI: Rates and Risk Factors in the NIDILRR Traumatic Brain Injury Model Systems.

Objectives: To compare characteristics of those who do and do not sustain subsequent traumatic brain injuries (TBIs) following index TBI and to identify reinjury risk factors.

Design: Secondary data analysis of an ongoing longitudinal cohort study.

Setting: TBI Model Systems Centers.