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. 2025 Dec 1;63(12):922-928.
doi: 10.1097/MLR.0000000000002228. Epub 2025 Oct 16.

Rehabilitation Outcomes of Service Members and Veterans With Mild-to-Moderate Traumatic Brain Injury

Jolie N Haun  1   2 , Justin T McDaniel  3 , Risa Nakase-Richardson  4   5 , Tali Schneider  1   6 , Julie McMahon-Grenz  1 , Rachel C Benzinger  1 , Sharon Barton  7 , Roberto Sandoval  8 , Karen M Skop  9   10 , Clara Dismuke-Greer  11 , Jerome Sabangan  11 , Kimberly Samson  11 , Daniel W Klyce  12   13   14 , Yvonne Friedman  9 , Leah R Gause  15 , Shannon R Miles  16   17 , Linda M Picon  18 , Rachel M Lackow  19 , Mary Jo Pugh  19
Affiliations

Rehabilitation Outcomes of Service Members and Veterans With Mild-to-Moderate Traumatic Brain Injury

Jolie N Haun et al. Med Care. .

Abstract

Objective: We sought to examine changes in mild-to-moderate TBI-related symptoms among service members and veterans (SM/Vs) following participation in a 5-site inpatient rehabilitation program with the US Department of Veterans Affairs between 7/1/2022 and 5/30/2024.

Methods: Neurobehavioral outcomes, posttraumatic stress disorder (PTSD) symptoms, pain interference, and lifestyle behaviors related to brain injury were assessed at baseline, discharge, and a 6-month follow-up. Mixed effects linear regression models, adjusting for key patient characteristics, were estimated to determine changes in TBI-related outcomes across the 3 time points.

Results: Mean participant age, for those with complete data (n = 127), was 41.64 years (SD = 5.57), with a mean of 7.45 deployments (SD = 3.12) and 16.32 concussive events (SD = 7.21). Participants were predominantly White (73.23%) Special Operations personnel (82.68%). TBI-related outcomes, including neurobehavioral symptoms, pain interference, PTSD, and brain injury adaptability, decreased significantly from baseline to discharge (b = -14.36, SE = 1.03; b = -3.79, SE = 0.49; b = -11.14, SE = 1.27; b = -2.41, SE = 0.41), with Cohen's d effect sizes of 1.14, 0.71, 0.69, and 0.56, respectively. Six-month follow-up, TBI-related outcomes remained statistically and practically below baseline levels in all measures except adaptability.

Conclusions and relevance: Findings illustrate an interdisciplinary, inpatient rehabilitation program for mild-to-moderate TBI yields significant improvements in TBI-related symptoms that are common among SM/Vs and are sustained at 6 months postdischarge.

Keywords: Traumatic brain injury; implementation science; inpatient; rehabilitation; service members; veterans; veterans affairs.

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Conflict of interest statement

The authors declare no conflict of interest.

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