Functional outcomes of community-based brain injury rehabilitation clients

Curran, C.J.; Dorstyn, Diana; Polychronis, Con; Denson, Linley A.

doi:10.3109/02699052.2014.948067

Cited by 13 publications

(12 citation statements)

References 42 publications

(68 reference statements)

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“…Patient’s performance on measures of neurodisability, essentially participants’ Abilities and Adjustment to brain injury showed the most consistent improvements over time for the cohort. Using the MPAI-4’s standardized T scores for the total scale, the difference in T scores from induction to rehabilitation to 1.5 years follow-up was broadly similar to recent published work on comprehensive community rehabilitation for longer term cases ( Altman et al, 2010 ; Curran et al, 2014 ), and indeed the difference in T scores in the current study approaches that recently published for people with duration of ABI of more than 1 year ( Altman et al, 2013 ). This suggests a robust improvement across time on this measure in the context of people in continuing service in the current study.…”

Section: Discussionsupporting

confidence: 86%

Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation

et al. 2015

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Post-acute community-based rehabilitation is effective in reducing disability. However, while social participation and quality of life are valued as distal outcomes of neurorehabilitation, it is often not possible to observe improvements on these outcomes within the limited time-frames used in most investigations of rehabilitation. The aim of the current study was to examine differences in the sequence of attainments for people with acquired brain injury (ABI) undergoing longer term post-acute neurorehabilitation. Participants with ABI who were referred to comprehensive home and community-based neurorehabilitation were assessed at induction to service, at 6 months and again at 1.5 years while still in service on the Mayo-Portland Adaptability Index (MPAI-4), Community Integration Questionnaire, Hospital Anxiety and Depression Scale, and World Health Organisation Quality of Life measure. At 6 months post-induction to service, significant differences were evident in MPAI abilities, adjustment, and total neurodisability; and in anxiety and depression. By contrast, there was no significant effect at 6 months on more socially oriented features of experience namely quality of life (QoL), Community Integration and Participation. Eighteen month follow-up showed continuation of the significant positive effects with the addition of QoL-related to physical health, Psychological health, Social aspects of QoL and Participation at this later time point. Regression analyses demonstrated that change in QoL and Participation were dependent upon prior changes in aspects of neurodisability. Age, severity or type of brain injury did not significantly affect outcome. Results suggest that different constructs may respond to neurorehabilitation at different time points in a dose effect manner, and that change in social aspects of experience may be dependent upon the specific nature of prior neurorehabilitation attainments.

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Section: Discussionsupporting

confidence: 86%

Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation

et al. 2015

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“…The relatively young age and predominantly male cohort is consistent with other profiles of individuals seeking ABI services. 13–15 The majority of the cohort was born in Australia (64.7%), with 3.4% of clients of Aboriginal and/or Torres Strait Islander background. Most of the cohort lived in a major city (84.3%) and were between average disadvantage and least disadvantaged levels of the Socio-Economic Index for Areas Index of Relative Socioeconomic Disadvantage before admission (72.3%).…”

Section: Findings To Datementioning

confidence: 99%

“…A number of community-based neurorehabilitation cohort studies examining the outcomes of individuals with ABI after rehabilitation exist in Australia. 13–16 Two of these studies involved retrospective analysis of client data at discharge from community-based brain injury services in which individualised rehabilitation care was provided. The first study showed that ABI clients (n=63) who received rehabilitation services in Queensland between 2017 and 2018 had significantly improved physical outcomes compared with an historical ABI cohort who did not receive rehabilitation services between 2007 and 2009 (n=124).…”

Section: Introductionmentioning

confidence: 99%

“… 14 The second study, conducted with 47 ABI clients in South Australia from 2010 to 2013, demonstrated that outpatient rehabilitation significantly and immediately improved physical and psychosocial outcomes, although social well-being declined in the follow-up period. 13 Client experiences of community-based rehabilitation have also been examined, with one study surveying clients (n=79) and their families (n=39) experiences following attendance to a brain injury rehabilitation unit in New South Wales from 2015 to 2017. This study indicated that person-centred care was critical to an individuals’ experience of care across a number of post-acute services.…”

Section: Introductionmentioning

confidence: 99%

“…18 This enables longitudinal examination of the needs and outcomes of individuals with ABI over 29 years, making this the longest follow-up of individuals with ABI undergoing post-acute care in Australia to date. 13–15 The aim of the ABI-RESTaRT research programme will focus on understanding the complex health and social needs of people with ABI during post-acute care, and identify predictors of short-term and long-term outcomes to facilitate effective service planning and delivery.…”

Section: Introductionmentioning

confidence: 99%

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Cohort profile: the Acquired Brain Injury Community REhabilitation and Support Services OuTcomes CohoRT (ABI-RESTaRT), Western Australia, 1991–2020

Mann¹,

Troeung²,

Wagland³

et al. 2021

BMJ Open

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Purpose Transition back into the community following acute management of acquired brain injury (ABI) is a critical part of recovery. Post-acute rehabilitation and transitional care can significantly improve outcomes. The Acquired Brain Injury Community REhabilitation and Support Services OuTcomes CohoRT (ABI-RESTaRT) is a novel whole-population cohort formed to better understand the needs of individuals with ABI receiving post-acute rehabilitation and disability services in Western Australia (WA), and to improve their outcomes. To do this a unique combination of (1) internal clinical/rehabilitation data, and (2) externally linked health data from the WA Data Linkage System was used, including hospitalisations, emergency department presentations, mental health service use and death records, to measure longitudinal needs and outcomes of individuals with ABI over 29 years, making this the largest, most diverse post-acute ABI cohort in Australia to date. Participants Whole-population cohort of individuals (n=1011) with an ABI who received post-acute community-based neurorehabilitation or disability support services through Brightwater Care Group from 1991 to 2020. Findings to date Comprehensive baseline demographic, clinical and rehabilitation data, outcome measures and linked health data have been collected and analysed. Non-traumatic brain injury (eg, stroke, hypoxia) was the main diagnostic group (54.9%, n=555), followed by traumatic brain injury (34.9%, n=353) and eligible neurological conditions (10.2%, n=103). Mean age at admission was 45.4 years, and 67.5% were men (n=682). The cohort demonstrated significant heterogeneity, socially and clinically, with differences between ABI groups across a number of domains. Future plans ABI-RESTaRT is a dynamic whole-population cohort that will be updated over time as individuals enrol in the service. Future analyses will assess longitudinal brain injury outcomes, the changing health and social needs of individuals with ABI and evaluate and inform post-acute services to best support these individuals. Registration This cohort is not linked to a clinical trial, and is not registered.

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Community-based rehabilitation.

Kuipers

Doig

2019

Handbook of Rehabilitation Psychology (3rd Ed.).

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The World Confederation for Physical Therapy (WCPT) supports the development of community based rehabilitation (CBR) as a means of empowering people with disabilities to maximise their physical, mental and social abilities. 1 Community change is often necessary to promote and fulfil the human rights of people with disabilities and allow them to become active members of their communities. WCPT recognises that CBR extends beyond health and rehabilitation and encompasses educational, social, vocational and economic strategies. Collaboration between agencies, sectors and professionals is vital at all levels to support this comprehensive approach to rehabilitation. Health professionals practise with individuals and local communities as partners in service planning, operation and monitoring. Physical therapists are equipped through their education to practise in both urban and rural settings and have important contributions to make in CBR. These include:

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Functional outcomes of community-based brain injury rehabilitation clients

Abstract: The data support the need for continuity of care, including ongoing emotional support, to cater to the complex and dynamic needs of the ABI population. However, these results need to be considered in the context of a small sample size and quasi-experimental design.

Cited by 13 publications

References 42 publications

Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation

Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation

Cohort profile: the Acquired Brain Injury Community REhabilitation and Support Services OuTcomes CohoRT (ABI-RESTaRT), Western Australia, 1991–2020

Community-based rehabilitation.

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