To perform multidimensional rehabilitation functional assessment in patients of different ages with moderate-to-severe traumatic brain injury (TBI), analyze differences in motor function, muscle tone, range of motion (ROM), balance, and language/cognitive function, and provide a reference for age-stratified rehabilitation interventions.

A total of 1 200 patients with moderate-to-severe TBI admitted to the Neurosurgery Department of Shifang People's Hospital and the Neurosurgery Department of West China Hospital, Sichuan University, from January 2014 to December 2023 were retrospectively enrolled. According to age, patients were divided into an elderly group (60-80 years, n=160), a middle-aged group (45-59 years, n=680), and a young group (<45 years, n=360). Multidimensional rehabilitation functional assessments were performed at the beginning and at the end of the rehabilitation program, including Brunnstrom motor assessment, Ashworth scale, ROM evaluation, Bobath assessment, and language/cognitive impairment assessment. Based on the degree of change in each scale at the end of rehabilitation, functional assessment results and differences across various dimensions were compared among the different age groups.

Brunnstrom motor assessment showed that motor function improved significantly from baseline in all three groups after rehabilitation, with higher rates of good recovery in the young and middle-aged groups than in the elderly group, while the proportion of poor recovery was highest in the elderly group (P<0.05). Ashworth evaluation showed the favorable recovery rate for muscle spasticity in the elderly group was lower than that in both the middle-aged and young groups, with statistically significant differences (P<0.05). ROM assessment: All three groups achieved ROM recovery; the favorable recovery rate was significantly lower in the elderly group than in the middle-aged and young groups (P<0.05). Bobath evaluation showed all three groups demonstrated significant improvements in sitting and standing balance functions compared to initial assessments. However, no statistically significant differences were observed in the favorable balance status rates among the groups at the end of rehabilitation (P>0.05). In terms of language and cognition, the proportions of patients whose language-cognitive function scores improved from the 7-17 range to the 18-28 range were 87.5% in the elderly group, 95.5% in the middle-aged group, and 97.2% in the young group. Pairwise comparisons among these three age groups all demonstrated statistically significant differences (P<0.05).

Multidimensional rehabilitation functional assessment comprehensively reflects the rehabilitation status of moderate-to-severe TBI patients, revealing significant differences across age groups. Specifically, elderly patients show relatively insufficient recovery in spasticity relief and joint ROM restoration, while middle-aged and young patients demonstrate more prominent advantages in motor function and language-cognitive recovery. Clinical practice should emphasize the role of differential analysis in multidimensional assessments across age groups, enabling the development of age-stratified, individualized rehabilitation strategies based on assessment outcomes.