Citation

Malec JF, Kean J. J. Neurotrauma 2015; 33(14): 1371-1379.

Affiliation

Indiana University School of Medicine, Physical Medicine and Rehabilitation , 4141 Shore Drive , Indianapolis, Indiana, United States , 46254 , 3173248469 ; jakean@indiana.edu.

Copyright

(Copyright © 2015, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2015.4080

PMID

26414433

Abstract

This study examined outcomes for Intensive Residential and Outpatient/Community-based post-inpatient brain injury rehabilitation (PBIR) programs compared to Supported Living programs. The goal of Supported Living programs was stable functioning (no change). Data were obtained for a large cohort of adults with acquired brain injury (ABI) from the OutcomeInfo national database, a web-based database system developed through NIH Small Business Technology Transfer (STTR) funding for monitoring progress and outcomes in PBIR programs primarily with the Mayo-Portland Adaptability Inventory (MPAI-4). Rasch-derived MPAI-4 measures for cases from 2008-2014 from 9 provider organizations offering programs in 23 facilities throughout the U.S. were examined. Controlling for age at injury, time in program, and time since injury on admission (chronicity), both Intensive Residential (n=205) and Outpatient/Community-based (n=2781) programs resulted in significant (approximately one standard deviation) functional improvement on the MPAI-4 Total score compared to Supported Living (n=101) programs (F=18.184, p<.001). Intensive Outpatient/Community-based programs showed greater improvements on MPAI-4 Ability (F=14.135, p<.001), Adjustment (F=12.939, p<.001), and Participation (F=16.679, p<.001) indices than Supported Living programs; whereas, Intensive Residential programs showed improvement primarily in Adjustment and Participation. Age at injury and time in program had small effects on outcome; the effect of chronicity was small to moderate. Examination of more chronic cases (>1 year post-injury) showed significant, but smaller (approximately ½ standard deviation) change on the MPAI-4 relative to Supported Living Programs (F=17.562, p<.001).

RESULTS indicate that Intensive Residential and Outpatient/Community-based PIBR programs result in substantial positive functional changes moderated by chronicity. Key Words: Adult Brain Injury, Rehabilitation, Outcome Measures.

Language: en