Societal Participation of People With Traumatic Brain Injury Before and During the COVID-19 Pandemic: A NIDILRR Traumatic Brain Injury Model Systems Study.
Umesh M Venkatesan, Leah M Adams, Amanda R Rabinowitz and 11 others
PMID 36736808WHAT IT FOUND
People with traumatic brain injury reported significantly less community involvement during the pandemic compared to before.
However, their levels of productivity and social relations remained stable. Pre-existing factors like disability severity and income continued to predict participation outcomes similarly in both periods.
Key findings
01Participants reported lower scores on the 'Out and About' subscale during the pandemic compared to the pre-pandemic period, indicating reduced community involvement.
02Scores for Productivity and Social Relations did not differ significantly between the pre-pandemic and pandemic periods.
03Disability severity and household income were consistent predictors of participation levels across both time periods.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used a cross-sectional comparison of different individuals in the pre-pandemic and pandemic groups, rather than tracking the same people over time. This means we cannot see how individual trajectories changed. The PART-O measure assesses the frequency of participation but not the quality or meaningfulness of the experience. A patient might have gone to the same number of places but felt less safe or satisfied. Participants who could not self-report data were excluded, meaning the sample likely underrepresents individuals with very severe TBI or significant cognitive impairments. The study did not control for local government policies or public health restrictions, which varied widely by region and time, potentially confounding the 'pandemic effect'.
Declared interests
The study was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the stable Productivity and Social Relations scores as evidence that the pandemic had no impact on these patients. The lack of change may reflect that these individuals already had low baseline participation due to their injury, so the additional pandemic restrictions did not further reduce these specific metrics. The significant drop in 'Out and About' scores confirms that community involvement was affected, and patients may still be struggling to reintegrate into public life.