Patterns of agitated behaviour during acute brain injury rehabilitation

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

Research output: Contribution to journalArticlepeer-review

20 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) evaluated behaviour during three nursing shifts (morning, afternoon, night). Severity of agitation, peak intensity and concomitant behaviours 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 agitated behaviours (between 313 concomitant behaviours per person); the most common behaviours were representative of the ABS Disinhibition sub-scale. Weekly peak intensity ranged from 1455 on the ABS. Mean ABS scores were highest during the afternoon shift and lowest at night. Improved cognition was associated with resolving agitated behaviour; while persistent agitated behaviour was associated with low levels of cognition. Minimal agitated behaviour was observed in participants who emerged from post-traumatic amnesia. Conclusions: Agitated behaviour during acute brain injury rehabilitation has a complex clinical presentation. High levels of agitation 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 was related to consistently higher levels of agitated behaviour and vice-versa.

Original languageEnglish
Pages (from-to)1214-1221
Number of pages8
JournalBrain Injury
Issue number10
Publication statusPublished - Sep 2010
Externally publishedYes


  • Agitation
  • Cognition
  • Post-traumatic amnesia
  • Rehabilitation

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