Quality of life among brain injury patients before, during, and after COVID-19 pandemic

Abstract

Introduction: Acquired Brain Injury (ABI) has many physical, cognitive, and emotional difficulties. The COVID-19 pandemic significantly disrupted rehabilitation services for ABI patients. This research project is aimed at studying the impact of the pandemic on quality of life for ABI patients, specifically the effect of injury type (TBI vs. mTBI) and sex. Method: The current study was a retrospective cohort study, which utilised secondary data from 767 patients with an acquired brain injury (ABI) who were referred to ABI rehabilitation services (ABIRS) in Dorset (UK) from 2018 to 2024. Patients completed a quality of life questionnaire using a 36-item short-form health survey (SF-36). The data were grouped into three time periods: pre, during, and post-pandemic, and were analysed descriptively using ANOVA and non-parametric pairwise comparisons. Results: Throughout the pandemic, patients with ABI had notable improvements in physical and social functioning, and a reduction in pain level, as opposed to the periods before and after the pandemic. However, once societal restrictions were lifted, these improvements returned to pre-pandemic levels. Female patients reported lower quality of life in all domains except role limitation physical and emotional. mTBI patients faced more challenges with energy and pain compared to TBI patients. No meaningful interactions were determined between injury type, sex, and COVID-19. Discussion: The pandemic provided a temporary opportunity for an improved quality of life, likely to a decrease in social pressures and obligations, but this was short-lived after the end of the pandemic, highlighting the need for flexible rehabilitation service options. Female and mTBI patients had worse outcomes, emphasising the importance of considering injury type and sex in intervention plans. The current study suggests developing tele-rehabilitation options and a flexible care model, which could lead to better outcomes after ABI rehabilitative services.