|dc.identifier.citation||Melanie K Fleming, PhD, Tom Smejka, MSc, David Henderson Slater, Veerle van Gils, Emma Garratt, BSc, Ece Yilmaz Kara and Heidi Johansen-Berg. Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery.||en
|dc.description.abstract||Background and Aims: Sleep is important for consolidation of motor learning, but brain
injury may affect sleep continuity and therefore rehabilitation outcomes. This study aims to
assess the relationship between sleep quality and motor recovery in brain injury patients
receiving inpatient rehabilitation.
Methods: 59 patients with brain injury were recruited from two 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. 55 age and gender matched
healthy controls completed one assessment.
Results: Inpatients demonstrated lower self-reported sleep quality (p<0.001) and more
fragmented sleep (p<0.001) than controls. For inpatients, sleep fragmentation explained
significant additional variance in motor outcomes, over and above that explained by
admission FIM score (p<0.017), 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 = 0.03), whereby
more disrupted sleep was associated with slower recovery.
Conclusions: 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
|dc.description.sponsorship||Supported by the NIHR||en
|dc.title||Sleep disruption after brain injury is associated with worse motor outcomes and slower functional recovery.||en