Patterns of agitated behaviour during acute brain injury rehabilitation

Melissa T. Nott, Christine Chapparo, Robert Heard, Ian J. Baguley

Research output: Contribution to journalArticle

19 Citations (Scopus)


Objective: To monitor daily shift-by-shift changes in agitated behaviour during adult brain injury rehabilitation.Design: A prospective, descriptive study.Methods: Eight participants were monitored daily for up to 28 days. The Agitated Behaviour Scale (ABS) evaluatedbehaviour during three nursing shifts (morning, afternoon, night). Severity of agitation, peak intensity and concomitantbehaviours were calculated. Shift differences and patterns of behavioural changes were analysed.Results: Four hundred and seven recordings were taken with the ABS. All participants demonstrated multiple agitatedbehaviours (between 3ï'½13 concomitant behaviours per person); the most common behaviours were representative of theABS Disinhibition sub-scale. Weekly peak intensity ranged from 14ï'½55 on the ABS. Mean ABS scores were highest duringthe afternoon shift and lowest at night. Improved cognition was associated with resolving agitated behaviour; whilepersistent agitated behaviour was associated with low levels of cognition. Minimal agitated behaviour was observed inparticipants who emerged from post-traumatic amnesia.Conclusions: Agitated behaviour during acute brain injury rehabilitation has a complex clinical presentation. High levels ofagitation observed during the afternoon shift may be associated with low levels of structured activities available at that time,higher levels of environmental stimuli during visiting times and increased cognitive fatigue. Lower cognitive ability wasrelated to consistently higher levels of agitated behaviour and vice-versa.Keywords: Agitation, cognition, rehabilitation, post-traumatic amnesia
Original languageEnglish
Pages (from-to)517-524
Number of pages8
JournalBrain Injury
Issue number10
Publication statusPublished - 2010

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