title: Efficacy of a functionally-based neurorehabilitation programme: a retrospective case-matched study of rehabilitation outcomes following traumatic brain injury.
abstract: OBJECTIVE
  To investigate the efficacy of a functionally-based neurorehabilitation programme.
  
  
  METHODS
  Retrospective, case-matched cohort design.
  
  
  METHODS
  An inpatient acquired brain injury (ABI) service at a post-acute rehabilitation facility. In 2001, a functionally-based rehabilitation model was introduced that streams patients into neurocognitive (NC) and neurophysical (NP) treatment groups based on predominant functional deficits.
  
  
  METHODS
  Sixty-nine patients with TBI admitted to the ABI service before implementation of the functionally-based programme comprised a historical control group. These patients were individually case-matched to 69 participants admitted after the functionally-based programme began. Rehabilitation outcomes were compared between matched patients treated before and after implementation of the programme.
  
  
  METHODS
  Rehabilitation length of stay (RLOS), Functional Independence Measure (FIM) and Disability Rating Scale (DRS) at rehabilitation discharge and FIM efficiency.
  
  
  RESULTS
  At discharge, the NP-stream had a significantly higher FIM motor efficiency compared to the historical control (0.41 vs. 0.29; p = 0.01). The NC-stream had significantly less disability, as measured by the DRS, compared to its control (3.63 vs. 5.05; p = 0.01).
  
  
  CONCLUSIONS
  This study presents preliminary evidence that a rehabilitation programme that targets functional needs rather than diagnosis may be useful in improving function after traumatic brain injury.
authors.affiliation: Research Department, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada. nora.cullen@uhn.ca
authors.forename: Nora
authors.initials: N
authors.lastname: Cullen
authors.forename: Kalyani
authors.initials: K
authors.lastname: Vimalesan
authors.forename: Christina
authors.initials: C
authors.lastname: Taggart
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D002170:Canada / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000592:standards; D026741:Physical Therapy Modalities; D015397:Program Evaluation; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000592:standards; D012189:Retrospective Studies; D016896:Treatment Outcome