Dissertation February 13th 2025 New PhD – MD Håkon Øgreid Moksnes
Håkon Øgreid Moksnes defended his thesis “Injury-related factors, functional outcomes, rehabilitation needs, and service provision in the first year following moderate-to-severe traumatic injuries” for the degree of PhD at the University of Oslo.
The committee consisted of first opponent Associate Professor Kristine Pape, Norwegian University of Science and Technology, second opponent Medical Doctor Mathilde Chevignard, Hôpitaux de Saint Maurice and chair of the evaluation committee Associate Professor Knut Magne Augestad, University of Oslo.
Main supervisor was senior consultant Torgeir Hellstrøm, Department of Physical Medicine and Rehabilitation, and co-supervisors Nada Andelic, Helene L. Søberg and Olav Røise all from Oslo University Hospital.
Summary of the thesis:
Traumatic injuries are a common cause of disability. Few studies examined the functioning of the overall group that sustained moderate-to-severe injuries. It is also unclear if patient’s needs for rehabilitation after injury are met with sufficient services.
This thesis aimed to assess the patients’ functioning and the frequency of unmet rehabilitation needs within the first year following moderate and severe traumatic injury.
Patients from two trauma centres in Norway – Oslo University Hospital and the University Hospital of North Norway, were included in a study and followed the first year after injury. The injury severity was assessed by the New Injury Severity Score.
After one year, half of the patients still experienced disabilities. Patients with known pre-injury diseases and those who sustained a higher number of injuries had an increased risk of lower functioning both 6 and 12 months after the injury. On the contrary - the group of patients that sustained a severe injury to the chest had a better functioning at these follow-ups.
Many patients were found to have unmet rehabilitation needs in the post-acute phase where they had returned to their community. At 6 months 2/3 of patients had unmet needs. Most often, this was caused by inadequate provision of rehabilitation services – e.g. not enough rehabilitation disciplines or to low intensity, including inadequate vocational rehabilitation and social- and family support.
After one year, a substantial proportion of patients still had unmet needs for such services. At 6 months there was a higher risk of unmet rehabilitation needs for patients living in less central areas and for patients with profound injury severity or severe head injury. One year after the injury, patients at younger age or with more pre-injury diseases had more unmet needs for rehabilitation.
To conclude, there is a critical need to enhance the rehabilitation services for patients in the first year after moderate and severe traumatic injuries.