Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery
<p><strong>Background</strong>: Sleep is important for consolidation of motor learning, but brain injury may affect sleep continuity and therefore rehabilitation outcomes.</p> <p><strong>Objective:</strong> This study aims to assess the relationship between...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
SAGE Publications
2020
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| _version_ | 1797062165759262720 |
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| author | Fleming, MK Smejka, T Henderson Slater, D van Gils, V Garratt, E Yilmaz Kara, E Johansen-Berg, H |
| author_facet | Fleming, MK Smejka, T Henderson Slater, D van Gils, V Garratt, E Yilmaz Kara, E Johansen-Berg, H |
| author_sort | Fleming, MK |
| collection | OXFORD |
| description | <p><strong>Background</strong>: Sleep is important for consolidation of motor learning, but brain injury may affect sleep continuity and therefore rehabilitation outcomes.</p>
<p><strong>Objective:</strong> This study aims to assess the relationship between sleep quality and motor recovery in brain injury patients receiving inpatient rehabilitation.</p>
<p><strong>Methods:</strong> Fifty-nine patients with brain injury were recruited from 2 specialist inpatient rehabilitation units. Sleep quality was assessed (up to 3 times) objectively using actigraphy (7 nights) and subjectively using the Sleep Condition Indicator. Motor outcome assessments included Action Research Arm test (upper limb function), Fugl-Meyer Assessment (motor impairment), and the Rivermead Mobility Index. The Functional Independence Measure (FIM) was assessed at admission and discharge by the clinical team. Fifty-five age- and gender-matched healthy controls completed one assessment.</p>
<p><strong>Results:</strong> Inpatients demonstrated lower self-reported sleep quality (P < .001) and more fragmented sleep (P < .001) than controls. For inpatients, sleep fragmentation explained significant additional variance in motor outcomes, over and above that explained by admission FIM score (P < .017), such that more disrupted sleep was associated with poorer motor outcomes. Using stepwise linear regression, sleep fragmentation was the only variable found to explain variance in rate of change in FIM (R2adj = 0.12, P = .027), whereby more disrupted sleep was associated with slower recovery.</p>
<p><strong>Conclusions:</strong> Inpatients with brain injury demonstrate impaired sleep quality, and this is associated with poorer motor outcomes and slower functional recovery. Further investigation is needed to determine how sleep quality can be improved and whether this affects outcome.</p> |
| first_indexed | 2024-03-06T20:41:41Z |
| format | Journal article |
| id | oxford-uuid:348229a6-933f-4c92-b673-cc30f1d8c748 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T20:41:41Z |
| publishDate | 2020 |
| publisher | SAGE Publications |
| record_format | dspace |
| spelling | oxford-uuid:348229a6-933f-4c92-b673-cc30f1d8c7482022-03-26T13:26:20ZSleep disruption after brain injury is associated with worse motor outcomes and slower functional recoveryJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:348229a6-933f-4c92-b673-cc30f1d8c748EnglishSymplectic ElementsSAGE Publications2020Fleming, MKSmejka, THenderson Slater, Dvan Gils, VGarratt, EYilmaz Kara, EJohansen-Berg, H<p><strong>Background</strong>: Sleep is important for consolidation of motor learning, but brain injury may affect sleep continuity and therefore rehabilitation outcomes.</p> <p><strong>Objective:</strong> This study aims to assess the relationship between sleep quality and motor recovery in brain injury patients receiving inpatient rehabilitation.</p> <p><strong>Methods:</strong> Fifty-nine patients with brain injury were recruited from 2 specialist inpatient rehabilitation units. Sleep quality was assessed (up to 3 times) objectively using actigraphy (7 nights) and subjectively using the Sleep Condition Indicator. Motor outcome assessments included Action Research Arm test (upper limb function), Fugl-Meyer Assessment (motor impairment), and the Rivermead Mobility Index. The Functional Independence Measure (FIM) was assessed at admission and discharge by the clinical team. Fifty-five age- and gender-matched healthy controls completed one assessment.</p> <p><strong>Results:</strong> Inpatients demonstrated lower self-reported sleep quality (P < .001) and more fragmented sleep (P < .001) than controls. For inpatients, sleep fragmentation explained significant additional variance in motor outcomes, over and above that explained by admission FIM score (P < .017), such that more disrupted sleep was associated with poorer motor outcomes. Using stepwise linear regression, sleep fragmentation was the only variable found to explain variance in rate of change in FIM (R2adj = 0.12, P = .027), whereby more disrupted sleep was associated with slower recovery.</p> <p><strong>Conclusions:</strong> Inpatients with brain injury demonstrate impaired sleep quality, and this is associated with poorer motor outcomes and slower functional recovery. Further investigation is needed to determine how sleep quality can be improved and whether this affects outcome.</p> |
| spellingShingle | Fleming, MK Smejka, T Henderson Slater, D van Gils, V Garratt, E Yilmaz Kara, E Johansen-Berg, H Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery |
| title | Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery |
| title_full | Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery |
| title_fullStr | Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery |
| title_full_unstemmed | Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery |
| title_short | Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery |
| title_sort | sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery |
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