Unmet Needs for Community-Based Rehabilitation the First 12 Months Postinjury in a Traumatic Brain Injury Population with Moderate-to-Severe Trauma-a Longitudinal Cohort Study.

The study describes who had unmet needs, not what would fix them. No treatment was tested, so it cannot show that adding therapy improves anyone's recovery. The unmet need score depends on a clinician's 6-month estimate of what each person needed, which the authors say may have been too high because specialists underestimated how much people improve between 6 and 12 months. Patients also had to recall a year of services, which people with a brain injury may not do accurately. No profession-specific information was available, so the paper cannot say whether the missing therapy was physiotherapy, occupational therapy or speech-language therapy, or which discipline should change what it does. Inclusion took place during the first wave of COVID-19, which may have reduced the services on offer. The group was heavily injured (mean New Injury Severity Score 31.3 and 84.3% with serious to critical head injuries), so the numbers may not apply to people with milder injuries. 21% were lost to follow-up, although those who dropped out did not differ from those who stayed on age, sex, education, head injury severity or where they lived. All patients came from two Norwegian trauma centres, so the community services described may not resemble yours.

The authors state that the investigators have no financial or nonfinancial disclosures to make in relation to this project. The text supplied carries no separate funding statement, so who paid for the work is not stated here.

Do not read this as evidence that more therapy would improve recovery after traumatic brain injury. The study counted who reported unmet needs and which patients were more likely to, and it tested no treatment. The need ratings were also clinician estimates made at 6 months, which the authors say may have overestimated what people actually required.