Effectiveness of community-based rehabilitation after traumatic brain injury for 489 program completers compared with those precipitously discharged.
OBJECTIVE
To evaluate outcomes of home- and community-based postacute brain injury rehabilitation (PABIR).


METHODS
Retrospective analysis of program evaluation data for treatment completers and noncompleters.


METHODS
Home- and community-based PABIR conducted in 7 geographically distinct U.S. cities.


METHODS
Patients (N=489) 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).


METHODS
PABIR delivered in home and community settings by certified professional staff on an individualized basis.


METHODS
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 (F=82.25; P<.001), Ability Index (F=50.24; P<.001), Adjustment Index (F=81.20; P<.001), and Participation Index (F=59.48; 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.
Gentiva Rehab Without Walls, Phoenix, AZ, USA.
Irwin M
IM
Altman
Shannon
S
Swick
Devan
D
Parrot
James F
JF
Malec
D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D001930:Brain Injuries / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D055812:Community-Based Participatory Research / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008603:Mental Health; D010351:Patient Discharge; D011379:Prognosis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D015599:Trauma Severity Indices; D014481:United States