Date Presented 04/04/2025
Participation in life activities initially declines after traumatic brain injury (TBI) but may improve over time, enhancing quality of life. This highlights the need for OT intervention to reengage clients in meaningful activities and explore new activities of interest.
Primary Author and Speaker: Amanda Gahlot
PURPOSE: Participation in life activities is a crucial outcome of recovery after moderate to severe traumatic brain injury (TBI) and is associated with improved quality of life (QOL), overall sense of well-being, and increased purpose in life (Sherman et al., 2024). Participation after TBI can include adjusted participation patterns and re-engagement in meaningful activities (Nalder et al., 2019). However, little is known about how participation patterns change over time since the initial injury. This study aims to map changes in re-engagement and participation patterns over time since TBI.
DESIGN: Cross-sectional study of 47 adults with moderate to severe TBI living in the community.
METHOD: The TBI-QOL scale was used to measure quality of life (Tulsky et al., 2016) and the Electronic Activity Card Sort (ACS3) measures current, previous, and new activity engagement in four domains of participation: IADLs, leisure, fitness, and social activities (Boone et al., 2022).
RESULTS: Participation across all four domains decreased from before injury, with the most significant decrease in fitness and social activities. 85.5% of participants reported engagement in new activities since TBI demonstrating adjusted participation patterns. There was a significant relationship between QOL and current activity engagement and re-engagement. Finally, participants were divided into three groups based on time from injury (early recovery <5 years; mid recovery 5-10 years, and late recovery >10 years post-injury) with the late recovery group demonstrating significantly higher levels of re-engagement than the early recovery group.
CONCLUSION: This study provides insights into patterns of participation after TBI and reinforces that higher levels of participation are related to better rated QOL. OT interventions should emphasize strategies to re-engage clients in meaningful activities and explore new activities of interest, facilitating improved participation and QOL after TBI.
References
Sherman, D. S., Burnett, H. J., Jr., & Lindstrom, D. (2024). Engagement in Meaningful Activity Mediates the Relationship Between Stressful Life Events and Functional Resilience. OTJR (Thorofare N J), 15394492241237746. https://doi.org/10.1177/15394492241237746
Nalder, E., Hartman, L., Hunt, A., & King, G. (2019). Traumatic brain injury resiliency model: A conceptual model to guide rehabilitation research and practice. Disabil Rehabil, 41(22), 2708–2717. https://doi.org/10.1080/09638288.2018.1474495
Boone, A. E., Wolf, T. J., & Baum, C. M. (2022). Development and initial testing of the electronic Activity Card Sort (ACS3) among community-dwelling adults. The American Journal of Occupational Therapy, 76(3). https://doi.org/10.5014/ajot.2022.047522
Tulsky, D. S., Kisala, P. A., Victorson, D., Carlozzi, N., Bushnik, T., Sherer, M., Choi, S. W., Heinemann, A. W., Chiaravalloti, N., Sander, A. M., Englander, J., Hanks, R., Kolakowsky-Hayner, S., Roth, E., Gershon, R., Rosenthal, M., & Cella, D. (2016). TBI-QOL: Development and calibration of item banks to measure patient reported outcomes following traumatic brain injury. J Head Trauma Rehabil, 31(1), 40–51. https://doi.org/10.1097/htr.0000000000000131
