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Traumatic brain injuries (TBI) (completed)

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Objectives

The objective of this project is to examine the cognitive, emotional and functional outcomes, as well as to understand the predictive factors for good health and occupational outcomes. In addition, cost-effectiveness, different rehabilitation strategies and the use of health services will be evaluated.

Background

One of the major challenges of treating serious injuries including traumatic brain injury (TBI) is to have the research based knowledge to maintain and promote health, functions and participation in different life arenas in the long run. Due to the complex nature of the rehabilitation treatments, validated qualitative methods are needed, and cost-effectiveness are rarely evaluated. The use of the international classification of functioning, disability and health (ICF) as a framework for research can elucidate the biopsycho9social, functional and context perspectives. With ICF, the research results across studies and populations can be brought to comparison, and clinicians can determine the appropriate treatment strategies to target specific functional outcomes. Moreover,  the project also focuses on rehabilitation after TBI, the organization of follow-ups post injury, the use of health services and how these health services cover the patient's long-term needs.

Method

The project has a multi-method design and includes meta-analyses, cross-sectional analyses, longitudinal analyses as well as health economic evaluations. The ICF model is used to gain a better understanding of the outcomes after TBI and the complexity and interactions of various factors related to occupational outcomes after TBI.

Public Involvement

  • Norwegian Personal Injury Association (LTN) 

Results

The project showed that early rehabilitation and a continuous treatment program resulted in better function and health-related quality of life both 1 and 5 years after severe TBI. In collaboration with the Department of Health Management and Health Economics, UiO, and Professor Lu at the Virginia Commonwealth University, USA, the project has contributed to the development of methodology and models for health economic evaluation of TBI rehabilitation, and shown that early rehabilitation and continuous treatment program chain is cost effective.

It was also found that persons who have sustained brain injury struggle with sensory problems including a loss of smell as well as reduced functions, health-related quality of life and work participation over many years. Many also reported that their rehabilitation needs had not been met.

Conclusion

TBI often results in multiple functional problems over time, and early initiated rehabilitation and continuous rehabilitation programs have been proven to be effective. However, participants reported many functional problems and unmet rehabilitation needs long after the brain injury had been incurred. Therefore, it is necessary to develop effective rehabilitation measures in different phases for this patient group.

Funding

  • Research council of Norway through CHARM (Research Centre for Habilitation and Rehabilitation Models & services)
  • Sunnaas Rehabilitation Hospital and Oslo University Hospitals 

Cooperation

  • Department of physical medicine and rehabilitation, University Hospitals
  • Sunnaas Hospital HF
  • Department of nursing science, Institute of Health and Society, University of Oslo
  • OsloMet
  • Institute of health management and health economics, University of Oslo
  • Department of general medicine, Institute of Health and Society, University of Oslo
  • The Norwegian Association for persons with injuries
  • Oslo municipality

Postdocs

Two postdoctoral research fellows, Nada Andelic og Solrun Sigurdardottir, are employed to work on this project.

Results

  1. Does an early onset and continuous chain of rehabilitation improve the long term functional outcome of patients with severe traumatic brain injury? Journal of neurotrauma 29:66–74 (January 1, 2012), Nada Andelic, Erik Bautz-Holter, Pal Ronning, Kjell Olafsen, Solrun Sigurdardottir, Anne-Kristine Schanke, Unni Sveen, Sveinung Tornas, Maria Sandhaug and Cecilie Roe.
  2. Health-related quality of life 5 years after moderate-to severe traumatic brain injury, Journal of Neurotrauma, A73-A73, 30/2013, 0897-7151, Andelic N, Roe, C.
  3. The epidemiology of traumatic brain injury, Lancet Neurol. 2013 Jan;12(1):28-9. doi: 10.1016/S1474-4422(12)70294-6, Andelic N.
  4. Traumatic Brain Injury: Methodological Approaches to Estimate Health- and Economic Outcomes, J Neurotrauma. 2013 Jul 23,  Lu J, Roe C, Aas E, Lapane KL, Niemeier J, Arango-Lasprilla JC, Andelic N.
  5. Traumatic brain injury in Scandinavian countries: recent research and new frontiers, Journal of Rehabil Med 2013 Sep; 45: 705–842, Guest Editors, Nada Andelic, Juan Carlos Arango-Lasprilla, Cecilie Røe.
  6. Impact of personal and environmental factors on employment outcome two years after moderate-to-severe traumatic brain injury, J Rehabil Med. 2013 Sep 3;45(8):801-7. doi: 10.2340/16501977-1168, Forslund MV, Roe C, Arango-Lasprilla JC, Sigurdardottir S, Andelic N.
  7. The complexity of traumatic brain injury, Editorial, J Rehabil Med 2013; 45: 708–709, Andelic N, Arango-Lasprilla, Roe C.
  8. Multi-level modelling of employment probability trajectories and employment stability at 1, 2 and 5 years after traumatic brain injury, Brain Inj. 2014 Mar 21, Forslund MV, Arango-Lasprilla JC, Roe C, Perrin PB, Sigurdardottir S, Andelic N.
  9. Neuropsychological Functioning in a National Cohort of Severe Traumatic Brain Injury: Demographic and Acute Injury-Related Predictors, J Head Trauma Rehabil, 2014 Apr 1, Sigurdardottir S, Andelic N, Wehling E, Roe C, Anke A, Skandsen T, Holthe O, Jerstad T, Aslaksen PM, Schanke AK.
  10. Depressive symptoms and psychological distress during the first five years after traumatic brain injury: Relationship with psychosocial stressors, fatigue and pain, J Rehabil Med. 2013 Sep;45(8):808-14,Sigurdardottir S, Andelic N, Roe C, Schanke AK.
  11. Cost-effectiveness analysis (CEA) of an early-initiated, continuous chain of rehabilitation after severe traumatic brain injury, J Neurotrauma. 2014 Apr 10, Andelic N, Ye J, Tornas S, Roe C, Lu J, Bautz-Holter E, Moger T, Sigurdardottir S, Schanke AK, Aas E.
  12. Self-perceived health care needs and delivery of health care services 5 years after moderate-to-severe traumatic brain injury, PM R. 2014 May 15, Andelic N, Soberg H, Berntsen S3, Sigurdardottir S, Roe C.
  13. Multilevel modeling of partnered relationship trajectories and relationship stability at 1, 2, and 5 years after traumatic brain injury in Norway, NeuroRehabilitation. 2014 May 12, Forslund MV, Arango-Lasprilla JC, Roe C, Perrin PB, Andelic N.
  14. Self-reported competency - validation of the Norwegian version of the patient competency rating scale for traumatic brain injury, Disabil Rehabil. 2014 Apr 29, Sveen U, Andelic N, Bautz-Holter E, Røe C.
  15. Identifying longitudinal trajectories of emotional distress symptoms 5 years after traumatic brain injury, Brain Inj. 2014 Jul 16, 28(12):1542-50, Sigurdardottir S, Andelic N, Roe C, Schanke AK.
  16. Trajectories of physical health in the first 5 years after traumatic brain injury, J Neurol. 2014 Dec 5, Andelic N, Perrin PB, Forslund MV, Soberg HL, Sigurdardottir S, Sveen U, Jerstad T, Roe C.
  17. Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI): a prospective longitudinal observational study, Neurosurgery. 2015 Jan;76(1):67-80. doi: 10.1227, Maas AI, Menon DK, Steyerberg EW, Citerio G, Lecky F, Manley GT, Hill S, Legrand V, Sorgner A. 
  18. Physical and mental health 10 years after multiple trauma: A prospective cohort study, J Trauma Acute Care Surg. 2015 Mar;78(3):628-33. doi: 10.1097, Soberg HL, Bautz-Holter E, Finset A, Roise O, Andelic N.
  19. Modeling of Community Integration Trajectories in the First Five Years after Traumatic Brain Injury, J Neurotrauma 2015 Jun 11, Andelic N, Arango-Lasprilla JC, Perrin PB, Sigurdardottir S, Lu J, Landa LO, Forslund MV, Roe C.
  20. Community integration 2 years after moderate and severe traumatic brain injury, Brain Inj. 2015 May 12:1-6, Sandhaug M, Andelic N, Langhammer B, Mygland A.
  21. Family needs after brain injury: A cross cultural study, Neurorehabilitation, 36 (2), 203-214, Norup A, Perrin PB, Cuberos Urbano G, Anke A, Andelic N, Doyle ST, Quijano MC, Caracuel A, Sosa DMD, Jove IGE, Arango-Lasprilla JC.
  22. Functional level during the two years after moderate and severe traumatic brain injury, Brain inj. 2015 Sep 11:1-8., Sandhaug M, Andelic N, Langhammer B, Mygland A.
  23. Olfactory identification and its relationship to executive functioning and functional outcome one year after severe traumatic brain injury. Neuropsychology. 2015 Jun 15. Epub ahead of print, Sigurdardottir, S., Wehling, E, Andelic, N, Skandsen, T, Anke, A, Roe, C. Oistensen Holthe, O, Schanke, A-K.
  24. Long-Term Functional and Psychosocial Consequences and Health Care Provision after Traumatic Brain Injury, Behav Neurol. 2016;2016:2678081. doi: 10.1155/2016/2678081. Epub 2016 Mar 10, Andelic N, Sigurdardottir S, Arango-Lasprilla JC, Godbolt AK
  25. Rehabilitation pathways, functional independence and satisfaction with rehabilitation services one year after severe traumatic brain injury. Eur J Phys Rehabil Med. 2016 Apr 6. [Epub ahead of print], Sveen, U, Roe, C, Sigurdardottir, S, Skandsen, T, Andelic, N, Manskow, U, Berntsen, SA, Soberg, HL, Anke, A.
  26. Modelling of community integration trajectories in the first 5 years after traumatic brain injury. J Neurotrauma. J Neurotrauma. 2016 Jan 1;33(1):95-100. doi: 10.1089/neu.2014.3844. Andelic N, Arango-Lasprilla, JC, Perrin, PB, Sigurdardottir, S, Lu, J, Landa, LO, Forslund, MV, Roe, C.
  27. Functional recovery and life satisfaction in the first year after severe traumatic brain injury: A prospective multicenter study of a Norwegian national cohort. J Head Trauma Rehabil. Jul-Aug;30(4):E38-49, Anke A, Andelic N, Skandsen T, Knoph R, Ader T, Manskow U, Sigurdardottir S, Roe C. (2015).
  28. Healthcare needs of patients with Huntington's disease in the South-East Region of Norway. Journal of Neurology, Neurosurgery, and Psychiatry 2014 ;Volum 85. Suppl. 1 s. A85-A85, Van Walsem RM; Howe E; Frich JC; Andelic N.
  29. Utilisation of cognitive aids and quality of life in HD patients. Journal of Neurology, Neurosurgery, and Psychiatry 2014; Volum 85. Suppl. 1 s. A90-A90, Howe, Emilie; Van Walsem, Regina Marleen; Frich, Jan C; Andelic, Nada.
  30. Utvikling av strategier for å håndtere kognitive vansker: en kvalitativ studie om erfaringer fem år etter traumatisk hjerneskade. Ergoterapeuten 2-2016 S.40-49. Lindstad MØ, Andelic N, Sveen U.
  31. Volumetric and morphometric MRI findings in patients with mild traumatic brain injury. Brain Injury, May 2016. Hellstrøm T, Westlye L, Server A, Løvstad M, Brunborg K, Lund MJ, Nordhøy W, Andreassen O, Andelic N.
  32. Long-Term Functional and Psychosocial Consequences and Health Care Provision after Traumatic Brain Injury, Special issue, Behavioural Neurology. Guest Editors: Andelic N, Sigurdardottir S, Arango-Lasprilla JC, Godbolt AK.
  33. Following international trends while subject to past traditions: neuropsychological test use in the Nordic countries. Clin Neuropsychol. 2016 Jan-Dec;30(sup1):1479-1500. Epub 2016 Sep 27. Egeland J, Løvstad M, Norup A, Nybo T, Persson BA, Rivera DF, Schanke AK, Sigurdardottir S, Arango-Lasprilla JC.
  34. Longitudinal changes in brain morphology from 4 weeks to 12 months after mild traumatic brain injury: Associations with cognitive functions and clinical variables. Brain Inj. 2017 Apr 17:1-12. doi: 10.1080/02699052.2017.1283537. [Epub ahead of print]. Hellstrom T, Westlye LT, Sigurdardottir S, Brunborg C, Soberg HL, Holthe Ø, Server A, Lund MJ, Andreassen OA, Andelic N.
  35. Predicting Outcome 12 Months after Mild Traumatic Brain Injury in Patients Admitted to a Neurosurgery Service. Front Neurol. 2017 Apr 10;8:125. doi: 10.3389/fneur.2017.00125. eCollection 2017. PMID: 28443058 Free Article. Hellstrøm T, Kaufmann T, Andelic N, Soberg HL, Sigurdardottir S, Helseth E, Andreassen OA, Westlye LT.
  36. Cognitive event related potentials during the sub-acute phase of severe traumatic brain injury and their relationship to outcome. J Neurotrauma. 2017 Jun 8. doi: 10.1089/neu.2017.5062. [Epub ahead of print] PMID: 28594285. Hauger SL, Olafsen K, Schnakers C, Andelic N, Nilsen KB, Helseth E, Funderud I, Andersson S, Schanke AK, Løvstad M.
  37. Minimum data set to measure rehabilitation needs and health outcome after major trauma: application of an international framework. Eur J Phys Rehabil Med. 2016 Jun;52(3):331-46. Epub 2016 Jan 8. Hoffman KP, Playford DE, Grill E, Soberg HL, Brohi K.
  38. User involvement and experiential knowledge in interprofessional rehabilitation: a grounded theory study. BMC Health Serv Res. 2016 Oct 4;16(1):547. Slomic M, Christiansen B, Soberg HL, Sveen U.
  39. Provider perceptions of the assessment and rehabilitation of sexual functioning after Traumatic Brain Injury. Brain Inj. 2017 Jul 12:1-7. doi: 10.1080/02699052.2017.1332784. [Epub ahead of print]. Arango-Lasprilla JC, Olabarrieta-Landa L, Ertl MM, Stevens LF, Morlett-Paredes A, Andelic N, Zasler N.
  40. Survey on International Health Professional Training and Attitudes on Sexuality After Traumatic Brain Injury. Sex Disabil. 2017. DOI 10.1007/s11195-017-9503-y. Arango-Lasprilla JC, Olabarrieta-Landa L, Ertl MM, Stevens LF, Morlett-Paredes A, Andelic N, Zasler N. 
  41. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study. Cnossen MC, Huijben JA, van der Jagt M, Volovici V, van Essen T, Polinder S, Nelson D, Ercole A, Stocchetti N, Citerio G, Peul WC, Maas AIR, Menon D, Steyerberg EW, Lingsma HF; CENTER-TBI investigators. Crit Care. 2017 Sep 6;21(1):233. doi: 10.1186/s13054-017-1816-9.
  42. Combined cognitive and vocational interventions after mild to moderate traumatic brain injury: study protocol for a randomized controlled trial. Howe EI, Langlo KS, Terjesen HCA, Røe C, Schanke AK, Søberg HL, Sveen U, Aas E, Enehaug H, Alves DE, Klethagen P, Sagstad K, Moen CM, Torsteinsbrend K, Linnestad AM, Nordenmark TH, Rismyhr BS, Wangen G, Lu J, Ponsford J, Twamley EW, Ugelstad H, Spjelkavik Ø, Løvstad M, Andelic N. Trials. 2017 Oct 17;18(1):483. doi: 10.1186/s13063-017-2218-7.
  43. White matter microstructure is associated with functional, cognitive and emotional symptoms 12 months after mild traumatic brain injury. Hellstrøm T, Westlye LT, Kaufmann T, Trung Doan N, Søberg HL, Sigurdardottir S, Nordhøy W, Helseth E, Andreassen OA, Andelic N. Sci Rep. 2017 Oct 23;7(1):13795. doi: 10.1038/s41598-017-13628-1.
  44. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Maas AIR, Menon DK, Adelson PD, Andelic N, Bell MJ, Belli A, Bragge P, Brazinova A, Büki A, Chesnut RM, Citerio G, Coburn M, Cooper DJ, Crowder AT, Czeiter E, Czosnyka M, Diaz-Arrastia R, Dreier JP, Duhaime AC, Ercole A, van Essen TA, Feigin VL, Gao G, Giacino J, Gonzalez-Lara LE, Gruen RL, Gupta D, Hartings JA, Hill S, Jiang JY, Ketharanathan N, Kompanje EJO, Lanyon L, Laureys S, Lecky F, Levin H, Lingsma HF, Maegele M, Majdan M, Manley G, Marsteller J, Mascia L, McFadyen C, Mondello S, Newcombe V, Palotie A, Parizel PM, Peul W, Piercy J, Polinder S, Puybasset L, Rasmussen TE, Rossaint R, Smielewski P, Söderberg J, Stanworth SJ, Stein MB, von Steinbüchel N, Stewart W, Steyerberg EW, Stocchetti N, Synnot A, Te Ao B, Tenovuo O, Theadom A, Tibboel D, Videtta W, Wang KKW, Williams WH, Wilson L, Yaffe K; InTBIR Participants and Investigators. Lancet Neurol. 2017 Nov 6. pii: S1474-4422(17)30371-X. doi: 10.1016/S1474-4422(17)30371-X. PMID: 29122524
  45. Return to work after severe traumatic brain injury: a national study with a one-year follow-up of neurocognitive and behavioural outcomes. Sigurdardottir S, Andelic N, Wehling E, Anke A, Skandsen T, Holthe OO, Manskow US, Roe C. Neuropsychol Rehabil. 2018 Apr 18:1-17. doi: 10.1080/09602011.2018.1462719. [Epub ahead of print] PMID: 29667477

  46. Variation in general supportive and preventive intensive care management of traumatic brain injury: a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Huijben JA, Volovici V, Cnossen MC, Haitsma IK, Stocchetti N, Maas AIR, Menon DK, Ercole A, Citerio G, Nelson D, Polinder S, Steyerberg EW, Lingsma HF, van der Jagt M; CENTER-TBI investigators and participants. Crit Care. 2018 Apr 13;22(1):90. doi: 10.1186/s13054-018-2000-6. PMID: 29650049 Free PMC Article

Tags: Rehabilitation, Traumatic Brain Injury
Published Jan. 19, 2012 3:51 PM - Last modified June 23, 2022 1:30 PM

Contact

Project Leader:

Helene Lundgaard Søberg, Oslo University Hospitals

Deputy leader:

Per Koren Solvang, OsloMet

Participants

Detailed list of participants