Physical therapist Alicia Kempton practices balancing exercises with Richard Kinzer, a traumatic brain injury patient at The Ohio State Wexner Medical Center. While initial rehabilitation is important to putting TBI patients on a path to recovery, ongoing care, and support in the years after their injury is also critical to managing long-term symptoms. Courtesy of Wexner Medical Center
Millions of brain injuries occur every year in the U.S., yet many questions still have not been answered.
According to the CDC, over 200,000 people were hospitalized for traumatic brain injuries in 2019, and there were over 60,000 TBI-related deaths in 2020.
Dr. Jennifer Bogner, a professor in the Department of Physical Medicine and Rehabilitation in the College of Medicine at Ohio State, said a traumatic brain injury is defined as a brain injury caused by an external force, which results in damage and changes to the brain. Ohio State’s TBI Research Program is enrolling 35 subjects a year and has 1,400 subjects in the data set to learn more about patients with TBI, Bogner said.
“Things like moving vehicle crashes, falling, domestic violence or any type of violence that had occurred to the individual,” Bogner said. “Gunshot wounds could cause brain injuries too — gunshot wounds to the head.”
Bogner said mild brain injuries and concussions are “the same thing.”
Dr. Cynthia Beaulieu, a clinical neuropsychologist and associate professor in the Department of Physical Medicine and Rehabilitation, said the project is a “longitudinal following” of patients who have sustained moderate to severe traumatic brain injuries and were admitted into inpatient rehab.
“Those individuals have been followed since enrollment,” Beaulieu said. “Some of them are now approaching their 30-year period of follow up.”
Beaulieu said over 10,000 participants are being studied across the 16 model system studying traumatic brain injury.
“Over 20,000 encounters of data and a vast array of studies to look at,” Beaulieu said. “What are the factors that promote recovery? What are the changes over time? What are the factors that need to be considered?”
Nationwide, there are roughly 14,000 subjects enrolled in the research study, making it the largest longitudinal study in the world surrounding the long-term effects of severe TBI, according to the program’s website.
“Ohio State is one of the biggest contributors,” Bogner said.
A medical abstract is taken once the patient enters rehab and questions about what promotes the best recovery are factored into their care, Beaulieu said. The patients’ data is followed at the one- and two-year marks, then every five years after that.
“There’s a variety of questions, scales and measures that are used to track their progress over time,” Beaulieu said. “The whole goal of the model systems is to understand the current trajectory of traumatic brain injury.”
The research is compiled of data gathered across the 16 sites to find out what has been changing with patients over time, Beaulieu said.
“What we are finding is that traumatic brain injury is not a static, one-and-done type of event,” Beaulieu said. “It actually becomes more along the lines of a chronic condition, that means to really be proactively managed for the life of the individual, rather than a broken bone.”
TBIs are not healed within the commonly allotted six weeks given for injuries like broken bones, Beaulieu said.
“That is not what occurs with traumatic brain injury,” Beaulieu said. “It can have — and frequently does, when you’re in the moderate to severe range — a life altering event that becomes, eventually, a new normal for individuals, and that new normal then needs to also be tracked and periodically treated, reevaluated, assessed as the individual ages.”
