Post-acute rehabilitation effects on functional outcome and discharge disposition of people with severe traumatic brain injury

Abstract

ABSTRACTObjective: This study’s purpose was to document the effect of post-acute rehabilitation on functional independence of adults with moderate or severe traumatic brain injury (TBI).Methods: Retrospective analysis of admission and discharge scores on the Northwick Park Dependency Score (NPDS) and Mayo-Portland Adaptability Inventory – Fourth Edition (MPAI-4) as well as discharge disposition was performed for 271 adults admitted to post-acute rehabilitation between 2012 and 2017.Results: Discharge disposition was home for 83.39% of cases. Home discharge cases admitted to rehabilitation significantly sooner after injury than supported living discharge cases. Also, home discharge cases achieved significantly better NPDS and MPAI-4 scores both at admission and discharge than supported discharge cases. Analyses split by program duration revealed cases with ≤90 day stays were closer to injury upon admission and had significantly better admission and discharge NPDS and MPAI-4 scores than those with longer stays. Although NPDS and MPAI-4 change scores for home versus supported living discharge did not differ significantly, change scores for home discharge cases with ≤90-day programs were significantly smaller than those with >90-day programs.Conclusion: Findings support the notion that providing intensive post-acute rehabilitation may increase the functional independence of people with moderate or severe TBI.