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Fatigue in traumatic brain injury patients
Light to moderate traumatic brain injuries / Annals of Physical and Rehabilitation Medicine 59S (2016) e131–e137
executive functions were evaluated by the DEX scale. The global social-functional evolution was measured by the GOS scale. Results The mean age was 32.19 ± 12.37 years with a sex-ratio of 3,5. The mean follow-up period was 3,9 ± 2.24 years. Fifteen patients (55.6%) had severe TBI. Memory disorders were observed in 9 patients (36%) when evaluated by the MMS scale and in 5 patients (18.5%) by the GOAT scale. Depressive symptoms were found in 17 patients (70.4%); Moreover, anxiety was noted in 15 patients (55.6%). Behavioral troubles, such as aggressiveness and agitation were noted respectively in 17 (63%) and 6 patients (22.2%). Severe agitation level was found in one patient (3.7%). Abnormal executive functions were noted in 17 patients (76.7%) with an average. Dex score of 23.68 ± 22.8. The most affected dimensions were intentionality and negative affect. Dex score of 23.68 ± 22.8. The most affected dimensions were intentionality and negative affect. We have found correlations between cognitive impairment and the education level (P < 0.01), between aggression and male sex (P < 0.01) and between abnormal executive functions and the initial GSC score (P = 0.04, r = –0.43). The lack of overall improvement (GOS scale) was correlated to the degree of abnormal executive function (P = 0.02). Discussion–conclusion The executive function disorders, depressed mood and the memory disorders seemed to be the most frequent among neuropsychological disorders in TBI. We noted that it is so important to evaluate neuropsychological disorders in TBI because they were underestimated. We have started this experience despite the lack of means in our department. The evaluation of the executive function in addition to the classic neurospsychological assessment is essential to propose efficient means of rehabilitation. Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.302 PO018
Fatigue in traumatic brain injury patients
Sameh Ghroubi ∗ , Islem Feki , Samar Alila , Mohamed Habib Elleuch CHU Habib Bourguiba, service service de médecine physique, rééducation et réadaptation fonctionnelle, unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, route de l’Aéroport 0,5 km, BP 1169, 3029 Sfax, Morocco ∗ Corresponding author. E-mail address: [email protected] (S. Ghroubi) Objective The goal of the study was to assess fatigue in traumatic brain injury patients (TBI), identify potential predictors of its occurrence and its impact on quality of life. Material/patients and methods We conducted a cross-sectional descriptive study about 25 patients suffering from TBI conducted in the physical medicine and rehabilitation department. The fatigue assessment was performed by two scales: Fatigue Severity Scale (FSS) and EVA Fatigue (EVAF). Depression was evaluated by the HAD scale. Quality of life was assessed by (SF36) scale. Results The average age of our patients was 32.19 ± 12.37 with a sex-ratio of 3.5. Thirteen patients (52%) were victims of severe TBI. Fatigue was present in 64% of patients (FSS > 36). The mean score calculated by the FSS scale was 42.64 ± 16.43. The mean EVA Fatigue was 5.23 ± 2.32. Depressive symptoms was found in 68% of TBI, 94% of them have expressed fatigue (P = 0.01). The average score for quality of life assessed by SF36 was 43.63 ± 15.8. We found a significant correlation between the FSS score and the SF36 score (P < 0.01, r = –0.76). Fatigue was more common in males (P = 0.01, r = 0.53). In addition, fatigue was negatively correlated with the level of education (P = 0.03, r = –0.44). However, fatigue was not related to the period length after TBI, the initial GSG score or to the age.
e135
Discussion–conclusion Fatigue is a persistent symptom after traumatic brain injury. It is often undervalued. Depressive symptoms may be responsible for its appearance. Fatigue had a significant impact on quality of life. The proposal for specific rehabilitation protocols taking into account the aspect of fatigue may be efficient for these patients. Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.303 PO019
Quality of life after traumatic brain injury
Sameh Ghroubi ∗ , Samar Alila , Islem Feki , Mohamed Habib Elleuch CHU Habib Bourguiba, service service de médecine physique, rééducation et réadaptation fonctionnelle, unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, route de l’Aéroport 0,5 km, BP 1169, 3029 Sfax, Morocco ∗ Corresponding author. E-mail address: [email protected] (S. Ghroubi) Objective The aim of this study was to assess the quality of life (QoL) of traumatic brain injury (TBI) patients and to explore its predictive factors. Material/patients and methods This is a descriptive and analytical cross-sectional study, including 27 TBI patients followed in the physical medicine and rehabilitation department (PMR). The collected data were: age, educational level, marital status, initial Glosgow score and intensive care unit length of stay. The assessment of the QoL was based on two scales, the first one was specific: Quality of Life after Brain Injury (QOLIBRI), while the second was generic: the SF-36. We had assessed memory disorders by the mini-mental state (MMS) and functional capacity by The Functional Independence Measure (FIM). The handicap was assessed by Go Outcome Scale (GOS). Possible correlations between QoL and the different variables were explored. Results The mean age of patients was 32.19 years. For QOLIBRI scale, the overall average score was 48.03%, the most affected dimensions were the feelings and social relations. Regarding the SF-36 scale, impaired QoL was found in 74% of these patients, the overall average score was 43.02. A significant correlation was found between QOLIBRI and mental composite score of the SF36 (P = 0.012). Memory disorder was significantly correlated with QoL (P = 0.037). There were no statistically significant correlations between QoL and the other variables. Discussion–conclusion Memory disorder was the main predictive factor of impaired quality of life of traumatic brain injury patients; however, there was no correlation between handicap and QoL. This alteration of QOL has clinical implications and highlights the necessity of more efforts to optimize the rehabilitation interventions. Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.304 PO020
Physical and rehabilitation medicine management of heterotopic ossification in brain injury Khawla Achour , Eya Mersni , Bassem Krifa , Emna Bahlouli , Sonia Lebib ∗ , Catherine Dziri Institut d’orthopédie Kassab, médecine physique, La Mannouba, Tunisia ∗ Corresponding author. E-mail address: [email protected] (S. Lebib)
executive functions were evaluated by the DEX scale. The global social-functional evolution was measured by the GOS scale. Results The mean age was 32.19 ± 12.37 years with a sex-ratio of 3,5. The mean follow-up period was 3,9 ± 2.24 years. Fifteen patients (55.6%) had severe TBI. Memory disorders were observed in 9 patients (36%) when evaluated by the MMS scale and in 5 patients (18.5%) by the GOAT scale. Depressive symptoms were found in 17 patients (70.4%); Moreover, anxiety was noted in 15 patients (55.6%). Behavioral troubles, such as aggressiveness and agitation were noted respectively in 17 (63%) and 6 patients (22.2%). Severe agitation level was found in one patient (3.7%). Abnormal executive functions were noted in 17 patients (76.7%) with an average. Dex score of 23.68 ± 22.8. The most affected dimensions were intentionality and negative affect. Dex score of 23.68 ± 22.8. The most affected dimensions were intentionality and negative affect. We have found correlations between cognitive impairment and the education level (P < 0.01), between aggression and male sex (P < 0.01) and between abnormal executive functions and the initial GSC score (P = 0.04, r = –0.43). The lack of overall improvement (GOS scale) was correlated to the degree of abnormal executive function (P = 0.02). Discussion–conclusion The executive function disorders, depressed mood and the memory disorders seemed to be the most frequent among neuropsychological disorders in TBI. We noted that it is so important to evaluate neuropsychological disorders in TBI because they were underestimated. We have started this experience despite the lack of means in our department. The evaluation of the executive function in addition to the classic neurospsychological assessment is essential to propose efficient means of rehabilitation. Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.302 PO018
Fatigue in traumatic brain injury patients
Sameh Ghroubi ∗ , Islem Feki , Samar Alila , Mohamed Habib Elleuch CHU Habib Bourguiba, service service de médecine physique, rééducation et réadaptation fonctionnelle, unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, route de l’Aéroport 0,5 km, BP 1169, 3029 Sfax, Morocco ∗ Corresponding author. E-mail address: [email protected] (S. Ghroubi) Objective The goal of the study was to assess fatigue in traumatic brain injury patients (TBI), identify potential predictors of its occurrence and its impact on quality of life. Material/patients and methods We conducted a cross-sectional descriptive study about 25 patients suffering from TBI conducted in the physical medicine and rehabilitation department. The fatigue assessment was performed by two scales: Fatigue Severity Scale (FSS) and EVA Fatigue (EVAF). Depression was evaluated by the HAD scale. Quality of life was assessed by (SF36) scale. Results The average age of our patients was 32.19 ± 12.37 with a sex-ratio of 3.5. Thirteen patients (52%) were victims of severe TBI. Fatigue was present in 64% of patients (FSS > 36). The mean score calculated by the FSS scale was 42.64 ± 16.43. The mean EVA Fatigue was 5.23 ± 2.32. Depressive symptoms was found in 68% of TBI, 94% of them have expressed fatigue (P = 0.01). The average score for quality of life assessed by SF36 was 43.63 ± 15.8. We found a significant correlation between the FSS score and the SF36 score (P < 0.01, r = –0.76). Fatigue was more common in males (P = 0.01, r = 0.53). In addition, fatigue was negatively correlated with the level of education (P = 0.03, r = –0.44). However, fatigue was not related to the period length after TBI, the initial GSG score or to the age.
e135
Discussion–conclusion Fatigue is a persistent symptom after traumatic brain injury. It is often undervalued. Depressive symptoms may be responsible for its appearance. Fatigue had a significant impact on quality of life. The proposal for specific rehabilitation protocols taking into account the aspect of fatigue may be efficient for these patients. Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.303 PO019
Quality of life after traumatic brain injury
Sameh Ghroubi ∗ , Samar Alila , Islem Feki , Mohamed Habib Elleuch CHU Habib Bourguiba, service service de médecine physique, rééducation et réadaptation fonctionnelle, unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, route de l’Aéroport 0,5 km, BP 1169, 3029 Sfax, Morocco ∗ Corresponding author. E-mail address: [email protected] (S. Ghroubi) Objective The aim of this study was to assess the quality of life (QoL) of traumatic brain injury (TBI) patients and to explore its predictive factors. Material/patients and methods This is a descriptive and analytical cross-sectional study, including 27 TBI patients followed in the physical medicine and rehabilitation department (PMR). The collected data were: age, educational level, marital status, initial Glosgow score and intensive care unit length of stay. The assessment of the QoL was based on two scales, the first one was specific: Quality of Life after Brain Injury (QOLIBRI), while the second was generic: the SF-36. We had assessed memory disorders by the mini-mental state (MMS) and functional capacity by The Functional Independence Measure (FIM). The handicap was assessed by Go Outcome Scale (GOS). Possible correlations between QoL and the different variables were explored. Results The mean age of patients was 32.19 years. For QOLIBRI scale, the overall average score was 48.03%, the most affected dimensions were the feelings and social relations. Regarding the SF-36 scale, impaired QoL was found in 74% of these patients, the overall average score was 43.02. A significant correlation was found between QOLIBRI and mental composite score of the SF36 (P = 0.012). Memory disorder was significantly correlated with QoL (P = 0.037). There were no statistically significant correlations between QoL and the other variables. Discussion–conclusion Memory disorder was the main predictive factor of impaired quality of life of traumatic brain injury patients; however, there was no correlation between handicap and QoL. This alteration of QOL has clinical implications and highlights the necessity of more efforts to optimize the rehabilitation interventions. Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.304 PO020
Physical and rehabilitation medicine management of heterotopic ossification in brain injury Khawla Achour , Eya Mersni , Bassem Krifa , Emna Bahlouli , Sonia Lebib ∗ , Catherine Dziri Institut d’orthopédie Kassab, médecine physique, La Mannouba, Tunisia ∗ Corresponding author. E-mail address: [email protected] (S. Lebib)