Logo for the Journal of Rehab R and D

Volume 46 Number 6, 2009
   Pages 819 — 826

Abstract — Auditory and visual impairments in patients with blast-related traumatic brain injury: Effect of dual sensory impairment on Functional Independence Measure

Henry L. Lew, MD, PhD;1-4 Donn W. Garvert, BA;5 Terri K. Pogoda, PhD;4,6 Pei-Te Hsu, MD;1-2,4 Jennifer M. Devine, MD;1 Daniel K. White, PT, ScD;7 Paula J. Myers, PhD;8 Gregory L. Goodrich, PhD5*

1Physical Medicine and Rehabilitation Service, Department of Veterans Affairs (VA) Boston Healthcare System, Boston, MA; 2Harvard Medical School, Boston, MA; 3Defense and Veterans Brain Injury Center, VA Boston Healthcare System, Boston, MA; 4Traumatic Brain Injury Center of Excellence, VA Boston Healthcare System, Boston, MA; 5VA Palo Alto Health Care System, Palo Alto, CA; 6Center for Organization, Leadership and Management Research, VA Boston Healthcare System, Boston, MA; 7Boston University Medical Center, Boston, MA; 8Audiology Section, James A. Haley Veterans' Hospital, Tampa, FL

Abstract —  The frequencies of hearing impairment (HI), vision impairment (VI), or dual (hearing and vision) sensory impairment (DSI) in patients with blast-related traumatic brain injury (TBI) and their effects on functional recovery are not well documented. In this preliminary study of 175 patients admitted to a Polytrauma Rehabilitation Center, we completed hearing and vision examinations and obtained Functional Independence Measure (FIM) scores at admission and discharge for 62 patients with blast-related TBI. We diagnosed HI only, VI only, and DSI in 19%, 34%, and 32% of patients, respectively. Only 15% of the patients had no sensory impairment in either auditory or visual modality. An analysis of variance showed a group difference for the total and motor FIM scores at discharge (p < 0.04). Regression model analyses demonstrated that DSI significantly contributed to reduced gain in total (t = -2.25) and motor (t = -2.50) FIM scores (p < 0.05). Understanding the long-term consequences of sensory impairments in the functional recovery of patients with blast-related TBI requires further research.

Key words: blast-related, brain injuries, dual sensory impairment, Functional Independence Measure, hearing, outcomes assessment, polytrauma, rehabilitation, sensory disorders, vision.

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