Responsiveness of the Traumatic Brain Injury – Quality of Life (TBI-QOL) Measurement System

Publication date: Available online 31 January 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Julia M.P. Poritz, Mark Sherer, Pamela A. Kisala, David Tulsky, Luis Leon-Novelo, Esther Ngan
ObjectiveTo assess the responsiveness of the Traumatic Brain Injury – Quality of Life (TBI-QOL) measurement system.DesignParticipants completed the 20 TBI-QOL item banks and the Participation Assessment with Recombined Tools – Objective (PART-O) Productivity Subscale at baseline and 6-month follow-up assessments. Participants were categorized into three groups (increased productivity, unchanged productivity, and decreased productivity) based on PART-O Productivity scores. Paired sample t-tests were used to compare TBI-QOL scores at baseline and 6 months, and standardized response means and Cohen's d were computed to estimate effect sizes.Setting3 TBI Model Systems rehabilitation centers in the U.S.Participants201 community-dwelling adults with traumatic brain injury (TBI)InterventionsNot applicable.Main Outcome Measures20 TBI-QOL item banks.ResultsAs expected, given that there was no intervention, group mean TBI-QOL subdomain scores for the entire sample showed no change or small improvement over the 6-month study period. At the follow-up assessment, 72 participants reported increased productivity, 71 reported decreased productivity, and 58 reported the same level of productivity as they had 6 months prior. When compared with participants who reported unchanged or decreased productivity, participants who reported increased productivity on the PART-O had clinically meaningful (d ≥ 0.30) improvements on seven TBI-QOL measures. The largest improvement was in Independence (mean change, 7.06; d = .84), with differences also observed in the Mobility, Positive Affect and Well-Being, Resilience, Grief/Loss, Ability to Participate, and Satisfaction with Participation subdomains.ConclusionsThe 20 TBI-QOL item banks demonstrate responsiveness to change and measurement stability in a community-dwelling sample. Researchers may use the TBI-QOL to detect changes in HRQOL following a clinical intervention and clinicians may use it in their daily practices to monitor patient recovery.



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