Disclosures: Armando S. Miciano, Jr., MD: No financial relationships or conflicts of interest

Background and/or Objectives: Study aims: 1) quantify the life satisfaction (LiS) of individuals after mild Traumatic Brain Injury (mTBI); 2) investigate inter-relationship between LiS and body function changes (‘BF” pain, fatigue, anxiety, depression, sleep disturbance) and post-concussions symptoms (PCS); and, 3) establish association of LiS and activity limitations (AL).

Design: Retrospective cross-sectional study

Setting: PMR clinic

Participants: 37 subjects with mTBI (age range 37-84; mean age [SD] 46 [16])

Interventions: N/A

Main Outcome Measures: The Life-Satisfaction Questionnaire-9 (LiSat-9) quantified LiS. BF measures included: Rivermead Post-Concussion-Questionnaire (RPQ); PROMIS-29v2.0-sub-scales for anxiety/depression/fatigue/sleep disturbance; Patient-Health-Questionnaire-9 (PHQ-9); and, General-Anxiety-Disorder-7 (GAD-7). The following measures quantified AL: 1) Capacity qualifiers – 6-Minute-Walk-Test-speed: for gait-speed (6MWT-speed); 6MWT-Distance, Dynamic Gait Index (DGI): for power/endurance; Berg Balance Scale (BBS): for balance; Dynamometer Test: for strength; and, 2) performance qualifiers – PROMIS-29v2.0-Physical-Function (PROMIS-PF); Pain-Disability-Questionnaire (PDQ); and, Rivermead Head-Injury-Follow-up-Questionnaire (RHIF).

Results: Mean (SD) scores were: LiSat-9: 3.0(1.0); PROMIS-29v2.0 sub-scales anxiety 61(12), fatigue 59(10), sleep disturbance 62(9); 
6MWT-speed (mph) 2.13(0.6); DGI (total 24) 19(5); BBS (total 56) 47(10); and, dynamometer (kg.) 27(13). Pearson’s Correlation Coefficient calculated associations among most variables. LiS significantly negatively correlated with: 1) BF changes – anxiety (r=-0.55;p=0.00), fatigue (r=-0.46; p=0.005), sleep disturbance (r=-0.39;p=0.0.17); 2) RPQ (r=-0.63;p=0.005); 3) PHQ-9 (r=-0.42;p=0.016); and, 4) GAD-7 (r=-0.47;p=0.020). LiS significantly negatively correlated with PDQ (r=-0.73;p=0.0) and RHF (r=-0.64;p=0.004) and significantly positively correlated with PROMIS-PF (r=0.63;p=0.0) and DGI (r=0.65;p=0.0). Non-parametric correlations (Spearman’s) showed significantly positively correlations of LiS with BBS (r=0.67;p=0.00) and 6MWT-distance (r=0.61;p=0.00).

Conclusions: MTBI patients tend to have a dissatisfied life with significantly associated changes in: 1) body function (moderate anxiety symptoms, mild fatigue, moderate sleep disturbance); 2) capacity (clinically slow; mild power/endurance deficit); and, 3) performance (moderate decrease in physical function; moderate pain related impairment). The study supports the target of said BF markers, exercise deficits, and pain-related impairments for interventions in individuals with mTBI to address their dissatisfied life situation. Future research should be on inter-relationships of BF and AL in other chronic neurologic syndromes.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/life-satisfaction-after-mild-traumatic-brain-injury/