Effectiveness of Post-Hospital Intensive Residential Rehabilitation after Acquired Brain Injury: Outcomes of 256 Program Completers Compared to Participants in a Residential Supported Living Program.

Post-hospital residential brain injury rehabilitation outcomes research is a complicated undertaking because of the custom-tailoring of interventions needed to meet the complex and unique need of each individual. As such, there tends to be great variability across program settings, which generally limits large-scale intervention studies. Growing literature demonstrates that post-hospital residential programs are beneficial. The main criticisms of this work include the absence of randomized-controlled studies, lack of clear definition of treatment types/settings, and small sample sizes. This study is a retrospective analysis of program evaluation data for a large, multi-site, national provider of post-hospital residential brain injury rehabilitation services. Specifically, outcome of participants completing Intensive Residential Rehabilitation (IRR) were compared to participants in the Residential Supported Living (RSL) program. Results demonstrate that participants in the IRR program improve and that participants in the RSL group preserve functional ability over time, suggesting that each program is effective in achieving its intended outcome. The IRR treatment group achieved significantly better outcomes than those in the same setting not receiving the intervention. To isolate treatment effects of IRR, a subsample of participants across program types were matched on time post-injury, age, and sex. The treatment effect of IRR was strengthened in this analysis, suggesting that chronicity alone does not account for the variance between the two groups.

Outcomes of post-acute rehabilitation for persons with brain injury.

OBJECTIVES: To examine the impact of multifaceted rehabilitation services on functional outcomes after traumatic brain injury (TBI) for individuals with significant physical and cognitive difficulties, as well as those with added behavioural complications. DESIGN: Cohort, non-randomized, intervention study with a pre-test-post-test, follow-up design. SETTING: Community integrated post-acute rehabilitation centre. PARTICIPANTS: Individuals with primarily severe TBI receiving post-acute neurorehabilitation services (NR, n = 129) as well as similarly impaired individuals with additional antagonistic/disruptive behaviours receiving neurobehavioural services (NB, n = 76). INTERVENTIONS: Multi-faceted behavioural and cognitive therapy methods delivered individually and in groups. MAIN OUTCOME MEASURE: The Functional Area Outcome Menu (FAOM), a behaviourally anchored 5-step scale rated by rehabilitation teams at three time periods. CONCLUSIONS: The rehabilitation treatment model achieved significant functional gains of approximately 1.5 levels for neuropsychologically-impaired adults with and without associated behavioural and substance problems.