Comparative effectiveness of traumatic brain injury rehabilitation: differential outcomes across TBI model systems centers.

OBJECTIVE: To measure patient functional outcomes across rehabilitation centers. SETTING: Traumatic Brain Injury Model System (TBIMS) centers. PARTICIPANTS: Patients with traumatic brain injury (TBI) admitted to 21 TBIMS rehabilitation centers (N = 6975, during 1999-2008). DESIGN: Retrospective analysis of prospectively collected data. MAIN MEASURES: Center-specific functional outcomes of TBI patients using Functional Independence Measure, Disability Rating Scale, and Glasgow Outcome Scale-Extended. RESULTS: There were large differences in patient characteristics across centers (demographics, TBI severity, and functional deficits at admission to rehabilitation). However, even after taking those factors into account, there were significant differences in functional outcomes of patients treated at different TBIMS centers. CONCLUSION: There are significant differences in functional outcomes of TBI patients across rehabilitation centers.

The neurocognitive outcome of nocardia: a brief, longitudinal case study.

Nocardia infection is a rare bacterial disorder that tends to affect the lungs and, in immunocompromised individuals, may progress to the brain. The brief, consecutive neuropsychological and neurobehavioral data of a 49-year-old male who developed multiple nocardia-related brain abscesses in the left frontal, occipital, and right cerebellar areas are reviewed. Neuropsychological findings indicated that he maintained mild-to-moderate impairments, primarily in executive functions, upon follow-up evaluation 43 days subsequent to baseline evaluation. This case demonstrates the utility of brief, serial neuropsychological screening in tracking the progression of an infectious process for the purposes of treatment planning and disposition.

Using grip strength force curves to detect simulation: a preliminary investigation.

Analysis of grip strength force curves has successfully detected suboptimal effort in industrial rehabilitation research. This study examined force curve analysis as an effort measure when grip strength was administered according to standardized neuropsychological procedures in a sample without reported neurologic and upper extremity injury. Eighty-two undergraduates were randomized to control (n = 26), naïve simulator (n = 28), and coached simulator (n = 28) conditions. Outcome measures included grip strength in kilograms, variables calculated from grip strength force curves, and the Word Memory Test (WMT). While average force in kilograms was not significantly different between groups, significant differences were found on the average to peak force ratio as calculated from grip strength force curves. The classification accuracy of average to peak force ratio was lower than the WMT, but comparable to other effort measures. Force curve analysis may warrant further study in a clinical sample.