Measuring recovery of orientation during acute rehabilitation for traumatic brain injury: value and expectations of recovery.
OBJECTIVE
To further evaluate the use of the orientation log (O-Log) in an acute rehabilitation program for adults with traumatic brain injury (TBI), specifically focusing on prediction of rehabilitation outcome, possible use of the O-Log to promote recovery, and development of templates of orientation recovery.


METHODS
Stepwise discriminant function analysis was used in one study and ANOVA based on between-groups comparisons in another. Confidence intervals were established in the third study.


METHODS
Acute rehabilitation hospital.


METHODS
Samples were taken from an overall pool of 389 subjects with predominantly severe TBI based on Glasgow Coma Scale score.


RESULTS
A combination of initial O-Log performance, time since injury, and number of O-Log assessments correctly predicted resolution of disorientation for 76% of the sample. Individuals attaining orientation before discharge achieved higher discharge scores on functional measures. Administration of the O-Log 3 versus 5 times a week did not result in more rapid resolution of disorientation. A similar pattern of steady improvement in orientation was evident for mild-moderate and severe injury cases across 10 administrations.


CONCLUSIONS
Recovery of orientation provides important information about recovery following TBI and is predictive of rehabilitation outcome. More frequent administration of a formal orientation measure does not seem to expedite the recovery of orientation, which on average seems to progress at a steady pace in a rehabilitation setting regardless of the time since injury or severity of injury.
Alderso
Amy L
AL
Inpatient Neuropsychology, Acquired Brain Injury Program, Shepherd Center, Atlanta, Georgia 30309-1402, USA.
Novack
Thomas A
TA
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001930:Brain Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D005069:Evaluation Studies as Topic; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D009949:Orientation / Q000502:physiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016896:Treatment Outcome