Outcome after Participation in a Residential Post-Acute Brain Injury Rehabilitation Program: A Comparison between Traumatic Brain Injury and Stroke

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2013-05

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Abstract

Objective: The current study was the first, to our knowledge, to compare outcomes of patients with traumatic brain injury (TBI) and stroke who participated in a residential post-acute brain injury rehabilitation (PABIR) program. The aims of this study were to (1) describe the characteristics of TBI and stroke patients presenting to the PABIR level of care, (2) compare the effectiveness of PABIR for patients with TBI versus stroke, and (3) examine those factors which predicted successful outcome from PABIR in these patients.

Participants and Methods: Participants were 72 patients with TBI and 42 patients with stroke who participated in a residential PABIR program. Disability Rating Scale (DRS) and Supervision Rating Scale (SRS) scores were collected upon admission, discharge, and six-month follow-up. The Craig Handicap Assessment and Reporting Technique – Short Form (CHART-SF) was collected at six-month follow-up.

Results: Results from two split-plot, repeated measure ANCOVAs revealed that both TBI and stroke patients demonstrated improvements in DRS and SRS scores from admission to discharge, and gains were well-maintained at six-month follow-up. Regression results revealed that, after controlling for covariates, stroke etiology was related to poorer DRS, SRS, and CHART-SF Mobility outcomes at six-month follow-up, but these relationships dissipated once covariates and age were included in the models. Only CHART-SF Physical Independence was uniquely related to etiology above and beyond covariates and age.

Conclusions: Both TBI and stroke patients experienced improvements in disability and independence level over the course of PABIR. While stroke patients may be vulnerable to poorer outcomes in several domains, these differences are largely related to the disparity in age between the two groups.

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Keywords

Traumatic brain injury, Stroke, Post-acute rehabilitation, Rehabilitation outcome, Brain injury rehabilitation, Acquired brain injury

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