Determining the Incidence of Vestibular Dysfunction in Traumatic Brain Injury Patients
Condition: Brain Injuries, Traumatic
MeSH terms: Brain Injuries; Brain Injuries, Traumatic; Wounds and Injuries
Study type: Observational

Summary: 
      The purpose of this study is to determine the incidence of vestibular dysfunction in
      traumatic brain injury patients admitted to acute inpatient rehabilitation. This study also
      seeks to validate the AbilityLab Vestibular Screening Tool (AVeST) and the AVeST+, tools
      designed to quickly screen individuals for vestibular dysfunction following traumatic brain
      injury.
    

Detailed description: 
      There are approximately 2.5 million hospital visits in the US each year for traumatic brain
      injury. Vestibular dysfunction is a common sequela of traumatic brain injury (TBI) affecting
      up to 50% of TBI patients at 5 years after injury. It is one of the most distressing problems
      for caregivers following TBI. Further complicating this issue is the fact that many
      individuals with TBI underestimate the severity of their balance deficits, which may further
      increase the risk of falls and subsequent injury. Sitting balance on admission to inpatient
      rehabilitation following TBI has been found to be one of the strongest predictors of
      functional status at discharge from inpatient rehabilitation. Due to the multifaceted
      presentation of vestibular dysfunction, evaluation is challenging, and there is currently no
      standardized approach to screening. While the incidence of vestibular dysfunction has been
      studied in mild TBI (mTBI) and sports related concussions, there is a gap in the literature
      regarding the incidence of vestibular dysfunction in moderate to severe TBI patients in acute
      inpatient rehabilitation.

      The benefits of having an established vestibular dysfunction screening and rehabilitation
      program are multifold. Vestibular rehabilitation following TBI has demonstrated improvements
      in cognitive function, ability to return to activities of daily living, ability to return to
      work, and the need for assistance. While one prior single blind randomized controlled trial
      aimed to evaluate the effectiveness of a structured vestibular rehabilitation program in TBI
      individuals, there is a need for a large-scale study to evaluate the effectiveness of
      screening for vestibular dysfunction in order to create a systematic approach. Many TBI
      patients are not diagnosed with vestibular dysfunction until much later in their hospital
      course which impedes participation in therapy and likely has a detrimental effect on their
      rate of recovery. Identifying these patients earlier in their rehabilitation course will
      allow interventions that will improve and accelerate patient outcomes. An additional benefit
      of this study is to determine the incidence of vestibular dysfunction in moderate to severe
      TBI patients to outline the necessary resources to care for patients with this problem. Data
      collected will be utilized to validate the AVeST and the AVeST+. Additionally, this study
      will fill a gap in the literature in delineating the incidence of vestibular impairment in
      individuals with moderate to severe brain injury, a population heretofore not previously
      studied.
    

Intervention name(s): Vestibular Evaluation
Intervention type(s): Other
Intervention description(s): Each patient will have a full vestibular evaluation by a physical therapist
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Traumatic brain injury patients admitted to an inpatient rehabilitation facility
      
Keywords: Traumatic Brain Injury; Acute TBI; Vestibular Dysfunction