Activity-related quality of life in rehabilitation and traumatic brain injury

Objectives: To review approaches to assessment of quality of life (QOL) outcomes in rehabilitation, focusing particularly on traumatic brain injury (TBI), and to introduce the concept of activity-related QOL. Data Sources: A conceptual review, based on extensive searches of MEDLINE, PsychInfo, and other information sources. Study Selection: Studies indexed under QOL and brain injury. Data Extraction: Literature search on key words quality of life and traumatic brain injury. Data Synthesis: Past research in rehabilitation and TBI has concentrated largely on assessment of function or activity. Although research on QOL after TBI remains limited, many studies have made inferences about QOL without actually assessing it. Persons with TBI experience serious long-enduring problems with QOL. Progress has been made in measurement of QOL and understanding of predictors of QOL after TBI. Conclusions: Future research in rehabilitation would do well to consider not only activity outcomes but also the affective quality of everyday life, and the connections between the two. Measures of activity-related QOL may provide a more sensitive, valid, and useful evaluation of rehabilitative therapies than other approaches. Further research is needed to improve measurement and interpretation of QOL assessments. By assessing both objective and subjective features of outcomes, outcomes assessment becomes more complete and potentially more useful.