Research Projects


With an estimated annual incidence rate of 1.7 million, traumatic brain injury is a leading cause of death and disability in the United States. Annually, brain injury accounts for 53,000 deaths, 325,000 hospitalizations and more than one million visits to U. S. emergency rooms. Brain injury causes drastic life changes, with losses affecting survivors, their families, and society. An estimated 5.3 million people in the United States live with permanent brain injury-related disabilities. Estimates place the annual indirect and direct financial costs above $75 billion.

Traumatic Brain Injury Model Systems (TBIMS) and other researchers have expended considerable energy delineating outcomes. For example, researchers have thoroughly documented postinjury memory disturbance, executive skills dysfunction, slowness, visual dysfunction, poor coordination, impaired self-awareness, and behavioral disorders. Recent studies have identified a high prevalence of depression, with many survivors reporting feelings of hopelessness, diminished self-esteem, and social isolation. Undoubtedly brain injury also affects couples and family systems. Caregivers commonly describe emotional distress, lack of respite, financial stress, and lack of community support.

The Virginia TBIMS program utilizes rigorous scientific methods to examine the benefits of the Resilience and Adjustment Intervention (RAI). The RAI examines a structured, curriculum-based approach to improve survivors’ resilience and adjustment. We are also collecting data for the National Database and participating in two Collaborative Module projects (Return to Driving and Caregiver Resilience).

Home to this TBIMS program is Virginia Commonwealth University (VCU), a major provider of brain injury acute care and medical rehabilitation services for more than three decades. We have been an active collaborator in the brain injury model system program since 1987. Since program inception, we have: extended our system of care; developed new partnerships with service providers and advocacy organizations; improved outcome measurement techniques; and explored the development of innovative interventions. Consumer involvement, community-based rehabilitation, relevance, and active dissemination to consumer and professional audiences have been cornerstones of program development and implementation.

Centrally located in Virginia, the university is a major provider of medical services to a large, culturally diverse population. As the state’s largest single provider, VCU Health provides nearly one-third of Virginia’s indigent care. Uninsured patients represent 20 percent of all patients treated, substantiating our strong commitment to serve persons regardless of ability to pay. The VCU Rehabilitation Center is a components of the VCU Health, a major state-supported teaching institution. The more than 350 model systems manuscripts published by our interdisciplinary research team in the past 30 years substantiates assertions that the urban, academic health center setting is ideal for scientific research, innovation, collaboration, and dissemination.



The recovery process after TBI can be difficult because of cognitive, behavioral, and emotional changes. Changes may include memory loss, attention problems, as well as behavior and emotional changes. 

The VCU Adjustment and Resilience Program was developed to help survivors learn how to better adjust to having a brain injury. Participants meet regularly with a rehabilitation professional, and receive information about brain injury, recovery, and how to get better. Participants will also be asked to fill out questionnaires. Enrollment is now open for those who qualify. All participates must be 18 or older. 

If you are interested in participating, please call Nancy Hsu at 804-828-3705 or toll free at 866-296-6904 or email

Resilience and Adjustment Flyer



Since 1987, model system researchers have been working hard to learn more about the effects of brain injury. They collect information from emergency room records, acute care physicians, and rehabilitation physicians. They also collect information from persons with brain injury. Information relating to the following categories is collected for the national database and analyzed -

  • injury severity – CT scan results, Glasgow Coma Scale scores, types of surgery 
  • cause of injury 
  • duration of hospitalization and rehabilitation 
  • rehabilitation progress – ability to carry out activities of daily living independently 
  • work status before and after injury

Information from the database has helped model systems researchers learn how recovery is affected by factors such as age, cause of injury, injury severity and duration of hospitalization. As more information is entered into the database, researchers have greater opportunities to learn about effective treatment approaches. More information abou the National Database can be found at

The contents of this website were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DPTB0005). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this website do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.