AI Article Synopsis
Article Abstract
Background: The Defence Medical Rehabilitation Centre Headley Court is the UK military rehabilitation unit. A pilot study identified the Mayo-Portland Adaptability Inventory-4 (MPAI-4) as the most appropriate rehabilitation outcome measure in young military patients with acquired brain injury.
Methods: MPAI-4 scores were prospectively recorded for patients on admission and discharge. At 4 months, independent living and employment status were recorded. Inclusion criteria were all new admissions with traumatic brain injury (TBI). Before injury, all patients were fully employed and lived independently.
Results: In a 3-year period from April 2011, there were 91 TBI patients with complete admission-discharge episodes: by US Department of Defense criteria, 21 were mild, 35 were moderate, and 35 were severe. There was a significant positive relationship between TBI severity and MPAI-4 score on admission (χ = 12.77, df = 2, p = 0.0017).Median age was 27 years, and median duration of admission was 63 days. Employment and independent living status were available for 79 patients at 4 months. Seventy-three patients (92%) were in community-based employment, with 64 (81%) employed in a competitive or transitional work; 6 (8%) were unemployed or in sheltered work. Sixty-nine (87%) were living independently, and 10 (13%) were living with support in their own home, with no one requiring institutional care.Complete MPAI-4 scores were available for 79 patients. There were statistically and clinically significant improvements in MPAI-4 scores between admission and discharge for the overall group: median admission T score was 40.0 (95% confidence interval, 36.0-42.0) and on discharge was 31.0 (95% confidence interval, 27.0-36.0), a nine-point change (Z = 6.53, p < 0.0001). These improvements with rehabilitation were sustained when patients were subdivided by TBI severity or MPAI-4 limitations.
Conclusion: This study demonstrates significant functional improvements in military TBI patients following intensive inpatient multidisciplinary rehabilitation, which includes substantial vocational rehabilitation. At 4 months, 92% were employed, and 87% were living independently.
Level Of Evidence: Therapeutic study, level V; prognostic/epidemiologic study, level IV.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/TA.0000000000000721 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Role and Outcomes of Supported Community Living Programs in Post-Hospital Brain Injury Rehabilitation Programs.
J Head Trauma Rehabil
January 2025
Author Affiliations: Director of Performance Improvement and Quality Management (Mr Logan), Analytics (Mr Walters), On With Life, Ankeny, Iowa; Foundation to Advance Brain Rehabilitation (FABR), Wilmington, Delaware and Physical Medicine and Rehabilitation (Drs Parrott and Malec), Indiana University School of Medicine, Indianapolis, Indiana; National Director of Outcomes, Collage Rehabilitation Partners, Paoli, Pennsylvania (Dr Altman); Quality Management, ReMed Recovery Care Centers, Paoli, Pennsylvania (Ms Eicher); Senior Director of Clinical Services, Bancroft NeuroRehab, Cherry Hill, New Jersey (Dr McGrath); Clinical Operations, Pate NeuroRehabilitation/Rehab Without Walls, Irving, Texas (Dr Salisbury); and Department of Psychology, Mayo Clinic, Rochester, Minnesota (Dr Malec).
Objectives: (1) To determine the proportion of participants admitted to supported community living (SCL) programs over the course of 5 years who improve, decline, or maintain functioning and community integration and (2) to examine the associations of time since injury, time in program, and age to their functional trajectory.
Setting: Data from SCL programs serving individuals with acquired brain injury (ABI).
Participants: 104 individuals with traumatic brain injury (TBI), stroke, or other ABI.
Evaluation of Posthospital Brain Injury Rehabilitation Outcomes With Quasi-Experimental Controls.
J Head Trauma Rehabil
January 2025
Author Affiliations: Foundation to Advance Brain Rehabilitation (FABR), and Psychiatry and Psychology, Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana (Dr Parrott); Pate NeuroRehabilitation/Rehab Without Walls, Irving, Texas (Dr Salisbury); Collage Rehabilitation Partners, Paoli, Pennsylvania (Dr Altman); On With Life, Ankeny, Iowa (Mr Logan); Bancroft NeuroRehab, Cherry Hill, New Jersey (Dr McGrath); On With Life, Ankeny, Iowa (Mr Walters); Foundation to Advance Brain Rehabilitation (FABR); Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana; and Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Dr Malec).
Objective: To further evaluate, using quasi-experimental methodologies, posthospital brain injury rehabilitation outcomes described in an accompanying report of a large observational study ( n = 2120).
Setting: Data from Intensive Rehabilitation (IR: Residential Neurobehavioral, Residential Neurorehabilitation, Home and Community Neurorehabilitation, Day Treatment, Outpatient Neurorehabilitation) and Supported Living (SL) programs serving individuals with acquired brain injury (ABI).
Participants: Two hundred twenty-eight individuals with traumatic brain injury, stroke, or other ABI in propensity score analysis; 1344 in analysis by extent of recommended treatment completed (TC) rating.
Outcomes of Six Specific Types of Post-Hospital Brain Injury Rehabilitation Programs.
J Head Trauma Rehabil
January 2025
Author Affiliations: Director of Clinical Operations, Pate NeuroRehabilitation/Rehab Without Walls, Irving, Texas (Dr Salisbury); Data Scientist, Foundation to Advance Brain Rehabilitation (FABR), Wilmington, Delaware, and Associate Research Professor, Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana (Dr Parrott); Director of Analytics, On With Life, Ankeny, Iowa (Mr Walters); Senior Director of Clinical Services Bancroft NeuroRehab, Cherry Hill, New Jersey (Dr McGrath); Director of Performance Improvement and Quality Management, On With Life, Ankeny, Iowa (Mr Logan); National Director of Outcomes, Collage Rehabilitation Partners, Paoli, Pennsylvania (Dr Altman); and Chief Scientific Officer, Foundation to Advance Brain Rehabilitation (FABR), Wilmington, Delaware, Senior Research Professor Emeritus, Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, and Emeritus Professor of Psychology, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Dr Malec).
Objective: Evaluate outcomes of intensive posthospital brain injury rehabilitation programs compared to supported living (SL) programs; explore variations in outcome by diagnostic category (traumatic brain injury, stroke, and other acquired brain injury [ABI]) and specific program type.
Setting: Data were obtained from Residential Neurobehavioral, Residential Neurorehabilitation, Home and Community Neurorehabilitation, Day Treatment, Outpatient Neurorehabilitation, and SL programs serving individuals with ABI.
Participants: A total of 2120 individuals with traumatic brain injury, stroke, or other ABI participated in this study.
Return to work after out of hospital cardiac arrest, insights from a prospective multicentric French cohort.
Resuscitation
June 2024
Groupe Hospitalier privé Ambroise Paré-Hartmann, Département Recherche Innovation, 92200 Neuilly-Sur-Seine, France; AfterROSC Network Group, Paris, France.
Rationale: About 60 to 70% of out-of-hospital cardiac arrest (OHCA) survivors who worked before cardiac arrest return to work within one year but the precise conditions for this resumption of professional activity remain little known. The objective of this study was to assess components of return to work among OHCA survivors.
Patients And Methods: We used the French national multicentric cohort AfterRosc to include OHCA survivors admitted between April 1st 2021 and March 31st 2022, discharged alive from the Intensive Care Unit (ICU), and who were less than 65 years old.
Distinguishing Characteristics of Admissions to Various Types of Posthospital Brain Injury Rehabilitation Programs.
J Head Trauma Rehabil
January 2025
Author Affiliations: Pate NeuroRehabilitation/Rehab Without Walls, Irving, TX (Dr Salisbury); Foundation to Advance Brain Rehabilitation (FABR) (Dr Parrott and Dr Malec); Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN (Dr Parrott and Dr Malec); Collage Rehabilitation Partners, Paoli, PA (Dr Altman); ReMed Recovery Care Centers, Paoli, PA (Ms Eicher); On With Life, Ankeny, IA (Mr Logan and Mr Walters), Bancroft NeuroRehab, Cherry Hill, NJ (Dr McGrath), Mayo Clinic, Rochester, MN (Dr Malec).
Objective: Describe and compare the demographic characteristics and disability profiles of individuals admitted to 6 types of posthospital brain injury rehabilitation (PHBIR) programs.
Setting: Data from Residential Neurobehavioral, Residential Neurorehabilitation, Home and Community Neurorehabilitation, Day Treatment, Outpatient Neurorehabilitation, and Supported Living programs serving individuals with acquired brain injury (ABI).
Participants: Two thousand twenty-eight individuals with traumatic brain injury (TBI), stroke, or other ABI.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!