Poster 3: Effectiveness of Community-Based Rehabilitation After Traumatic Brain Injury for 489 Program Completers Compared to Those Precipitously Discharged

Abstract

Objective: To evaluate outcomes of home- and community-based postacute brain injury rehabilitation. Design: Retrospective analysis of program evaluation data for treatment completers and noncompleters. Setting: Home- and community-based postacute brain injury rehabilitation conducted in 7 geographically distinct U.S. cities. Participants: 489 individuals with traumatic brain injury who completed the prescribed course of rehabilitation (CR) compared to 114 who were precipitously discharged prior to program completion (PD). Interventions: Postacute brain injury rehabilitation delivered in home- and community-settings by certified professional staff on an individualized basis. Main Outcome Measures: Mayo-Portland Adaptability Inventory (MPAI-4) completed by 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 (CR vs PD = between-subjects variable; admission MPAI-4 score = covariate) showed significant differences between groups at discharge on the full MPAI-4 (F=82.25, P<.0001), Abilities Index (F=50.24, P<.0001), Adjustment Index (F=81.20, P<.0001), and Participation Index (F=59.48, P<.0001). A large portion of the sample was lost to follow-up; however, available data showed group differences remained statistically significant at follow-up. Conclusions: Results provide evidence of the effectiveness of home- and community-based postacute brain injury rehabilitation and that treatment effects are maintained at follow-up.