Increase in functional abilities following a residential educational and neurorehabilitation programme in young adults with acquired brain injury

Abstract

OBJECTIVES: To characterize and determine the pre-injury and injury-related variables that are linked to the extent of functional recovery following rehabilitation at a mixed therapy and educational residential programme and whether these variables differ for traumatic brain injury (TBI) and non traumatic brain injury (nonTBI). METHODS: 106 young adults (age 16-36 years) with moderate-to-severe TBI who had attended and been discharged from the centre since 2002 were included. Clients received 5 hours of education and/or therapy each day. Functional level was assessed using the FIM + FAM. Regression analysis was used to determine possible predictors of functional independence at discharge. MAIN OUTCOMES AND RESULTS: Clients with TBI and nonTBI made clinically and statistically significant improvements in their functional abilities during their neurorehabilitation. For the combined TBI and nonTBI group, FIM + FAM scores at discharge were predicted by FIM + FAM at admission and length of stay. These two predictors explained 80% of the variance in the FIM + FAM score at discharge. CONCLUSION: Both clients with TBI and nonTBI benefited from a mixed inpatient neurorehabilitation programme. This benefit was predicted by their functional abilities at admission and the length of stay. These findings are of importance as it becomes increasingly necessary to demonstrate who will benefit from residential intensive neurorehabilitation as opposed to community therapy.

Neurorehabilitation of Traumatic Brain Injury (TBI): A Clinical Review

“…On the other hand, as reported based on observational data [94,95], longer rehabilitation stays can be associated with more important improvements as measured with DRS or FIM, respectively. Correspondingly, Foy and Somers could demonstrate an association between LOS and functional improvements in young adults participating in an in-patient programme with 5 h of therapy and/or education daily [96]. Nevertheless, this cannot be translated into simple LOS-related improvements; hypothetically, it could also imply that patients with less important progress during rehabilitation were dismissed earlier in those studies.…”

Intervenciones neuropsicológicas para la recuperación funcional de niños y adolescentes con traumatismo craneoencefálico. Revisión sistemática

“…Tradicionalmente se ha recomendado la terapia intensiva para generar beneficios más tempranos y notables (Cicerone et al, 2008;Foy & Somers, 2013;Zhu, Poon, Chan, & Chan, 2007), pero los resultados positivos encontrados tras las intervenciones y la ausencia de datos sobre la intensidad y frecuencia de sesiones en algunos estudios incluidos en esta revisión no permiten extraer una conclusión exacta en este aspecto. Este hecho, sumado a que factores como el sistema de salud, la disponibilidad de programas de rehabilitación, la heterogeneidad de los pacientes, los objetivos individuales y el apoyo familiar, inciden sobre la adherencia a la terapia, así como en el cumplimiento y la finalización del tratamiento en los tiempos predefinidos (Oberholzer & Müri, 2019), hace que la respuesta por la duración y la frecuencia de las sesiones, sea una condición que está ligada al ritmo de progreso del paciente y a las características individuales de la lesión.…”