Abstract
Altman IM, Swick S, Parrot D, Malec JF. Effectiveness of community-based rehabilitation
after traumatic brain injury for 489 program completers compared with those precipitously
discharged.
Objective
To evaluate outcomes of home- and community-based postacute brain injury rehabilitation
(PABIR).
Design
Retrospective analysis of program evaluation data for treatment completers and noncompleters.
Setting
Home- and community-based PABIR conducted in 7 geographically distinct U.S. cities.
Participants
Patients (N=489) with traumatic brain injury who completed the prescribed course of
rehabilitation (completed-course-of-treatment [CCT] group) compared with 114 who were
discharged precipitously before program completion (precipitous-discharge [PD] group).
Intervention
PABIR delivered in home and community settings by certified professional staff on
an individualized basis.
Main Outcome Measures
Mayo-Portland Adaptability Inventory (MPAI-4) completed by means of professional consensus
on admission and at discharge; MPAI-4 Participation Index at 3- and 12-month follow-up
through telephone contact.
Results
Analysis of covariance (CCT vs PD group as between-subjects variable, admission MPAI-4
score as covariate) showed significant differences between groups at discharge on
the full MPAI-4 (F=82.25; P<.001), Ability Index (F=50.24; P<.001), Adjustment Index (F=81.20; P<.001), and Participation Index (F=59.48; P<.001). A large portion of the sample was lost to follow-up; however, available data
showed that group differences remained statistically significant at follow-up.
Conclusions
Results provided evidence of the effectiveness of home- and community-based PABIR
and that treatment effects were maintained at follow-up.
Key Words
List of Abbreviations:
ANCOVA (analysis of covariance), CARF (Commission on Accreditation of Rehabilitation Facilities), CCT (completed-course-of-treatment), GCS (Glasgow Coma Scale), LOC (loss of consciousness), LOS (length of stay), MPAI-4 (Mayo-Portland Adaptability Inventory), PABIR (postacute brain injury rehabilitation), PD (precipitous-discharge), PTA (posttraumatic amnesia), RCT (randomized controlled trial), TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article info
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
