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Understanding Pain After Traumatic Brain Injury: Impact on Community Participation

Hoffman, Jeanne M. PhD; Pagulayan, Kathleen F. PhD; Zawaideh, Nadya BA; Dikmen, Sureyya PhD; Temkin, Nancy PhD; Bell, Kathleen R. MD

American Journal of Physical Medicine & Rehabilitation: December 2007 - Volume 86 - Issue 12 - p 962-969
doi: 10.1097/PHM.0b013e31815b5ee5
Research Article: Brain Injury

Hoffman JM, Pagulayan KF, Zawaideh N, Dikmen S, Temkin N, Bell KR: Understanding pain after traumatic brain injury: impact on community participation. Am J Phys Med Rehabil 2007;86:962–969.

Objective: To examine the prevalence of pain 1 yr after moderate to severe traumatic brain injury (TBI) and identify predictors from the time of injury. Additionally, factors related to pain at 1 yr after injury were examined along with the impact of pain on community participation.

Design: Prospective cohort study of 146 individuals enrolled during acute inpatient rehabilitation for TBI and community follow-up at 1 yr after injury.

Results: Higher reports of depressive symptoms during inpatient rehabilitation and at 1 yr after injury were significantly related to reports of pain at 1 yr when controlling for demographic and injury characteristics. Being female and nonwhite were also factors related to increased reports of pain. Pain and community participation were significantly related until depression was entered into the model. Depression is a significant factor in the relationship between pain and community participation.

Conclusion: Whereas pain was frequently reported 1 yr after injury, injury-related factors were surprisingly unrelated. Further evaluation of the role that depression plays in the relationship between pain and community participation will be important to determine appropriate management of pain and depression and to optimize participation in individuals with TBI.

From the Departments of Rehabilitation Medicine (JMH, KFP, NZ, SD, NT, KRB) and Department of Neurological Surgery (SD, NT), University of Washington, Seattle, Washington.

All correspondence and requests for reprints should be addressed to Jeanne Hoffman, PhD, University of Washington School of Medicine, Department of Rehabilitation Medicine, 1959 NE Pacific Street, Box 356490, Seattle, WA 98195.

Supported by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education (Grant No. H133A020508).

Part of the material presented in this manuscript was presented at the American Congress of Rehabilitation Medicine Conference, Chicago, October, 2005.

© 2007 Lippincott Williams & Wilkins, Inc.