Abstract Reprint: Effectiveness of Community-Based Rehabilitation After Traumatic Brain Injury

489 Program Completers Compared With Those Precipitously Discharged

© 2010 by the American Congress of Rehabilitation Medicine


Irwin M. Altman, PhD, MBA, Shannon Swick, MA, Devan Parrot, BS, James F. Malec, PhD, ABPP-Cn, Rp


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. Arch Phys Med Rehabil 2010; 91:1697-704.

Objective: To evaluate outcomes of home- and communitybased 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 (N489) 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 (F82.25; P.001), Ability Index (F50.24; P.001), Adjustment Index (F81.20; P.001), and Participation Index (F59.48; 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: Brain injuries; Rehabilitation.

© 2010 by the American Congress of Rehabilitation Medicine