title: An evaluation of the strategic approach to the rehabilitation of traumatic brain injury (TBI) patients.
abstract: BACKGROUND
  The objective of our study was to evaluate a goal-driven strategic plan for the step-by-step rehabilitation of traumatic brain injury (TBI) patients, with effectiveness measured in terms of quality of life, as compared to patients treated according to a standard, progressive rehabilitation program.
  
  
  METHODS
  We studied 40 patients after TBI awakened from a long-term coma. The patients were divided into two equal groups: a control group (n=20) involving patients treated before the introduction of the strategic approach, and an experimental group (n=20) involving patients rehabilitated under the strategic approach. In evaluating the effectiveness of rehabilitation we used a structured interview with clinical observation and a scale for assessing the quality of life of patients after TBI.
  
  
  RESULTS
  The deterioration in the quality of life of TBI patients is mainly related to difficulties in satisfying physiological needs, self-care, reduced mobility and disorders of cognitive, regulatory, and social functions. In both groups, the feature most susceptible to rehabilitation related change was movement, while the least susceptible functions were associated with the use of different means of transport. This change is significantly greater in persons in the experimental group, as compared to controls.
  
  
  CONCLUSIONS
  We found that a rehabilitation program controlled by a strategic plan, with the cooperation of the patient, is more effective in improving the quality of life, as the patient is more self-motivated to individually designed objectives.
authors.affiliation: College of Physiotherapy, Wroclaw, Poland. w.tomaszewski@wp.pl
authors.forename: Wiesław
authors.initials: W
authors.lastname: Tomaszewski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Mańko
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012046:Rehabilitation / Q000379:methods*; D055815:Young Adult