Affiliations: [a] NeuroRestorative National Clinical Outcomes, Medical College of Georgia at Georgia Regents University, Augusta, GA, USA | [b] NeuroRestorative National Clinical Outcomes, Florida State University, College of Medicine, Tallahassee, FL, USA
Correspondence:
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Address for correspondence: Frank D. Lewis, National Director of Clinical Outcome Services, NeuroRestorative and Adjunct Assistant Professor, Georgia Regents University, 1227 Augusta West Parkway, Augusta, GA 30909, USA. Tel.: +1 706 496 1975; Frank.Lewis@neurorestorative.com
Abstract: BACKGROUND: There is increasing need for a well-organized continuum of post-hospital rehabilitative care to reduce long term disability resulting from acquired brain injury. OBJECTIVE: This study examined the effectiveness of four levels of post-hospital care (active neurorehabilitation, neurobehavioral intensive, day treatment, and supported living) and the functional variables most important to their success. METHODS: Participants were 1276 adults with acquired brain injury who were being treated in one of the four program levels. A Repeated Measures MANOVA was used to evaluate change from admission to discharge on the Mayo Portland Adaptability Inventory–4 T-scores. Regression analyses were used to identify predictors of outcome. RESULTS: Statistical improvement on the MPAI-4 was observed at each program level. Self-care and Initiation were the strongest predictors of outcome. CONCLUSION: The results support the effectiveness of a continuum of care for acquired brain injury individuals beyond hospitalization and acute in-hospital rehabilitation. It is particularly noteworthy that reduction in disability was achieved for all levels of programming even with participants whose onset to admission exceeded 7 years post-injury.
Keywords: Brain injury, continuum of care, neurologic outcomes, predictors, post-hospital rehabilitation
