Multi-disciplinary rehabilitation for acquired brain injury in adults of working age

Abstract

Problems following ABI vary; different services are required to suit the needs of patients with different problems. Patients presenting acutely to hospital with moderate to severe brain injury should be routinely followed up to assess their need for rehabilitation. Intensive intervention appears to lead to earlier gains. The balance between intensity and cost-effectiveness has yet to be determined. Patients discharged from in-patient rehabilitation should have access to out-patient or community-based services appropriate to their needs. Those with milder brain injury benefit from follow-up, and appropriate information and advice. Not all questions in rehabilitation can be addressed by traditional research methodologies. There are important questions still to be answered and future research should employ the most appropriate methodology.

Vocational Rehabilitation after Acquired Brain Injury: A Swedish Study of Benefits and Costs

“…In the 2005 Cochrane review, the authors highlight the need for more individualized interventions as well as evaluation methods related to the varied nature of ABI, suggesting future research should be based on the fact that many questions remain to be answered regarding the effectiveness of rehabilitation interventions and that the methods might have to be alternative methodologies to Randomized Controlled Trials (RCTs) [19]. For example, there is a need to further explore cost-effectiveness and impact on quality of life for patients [10] [19].…”

“…For example, there is a need to further explore cost-effectiveness and impact on quality of life for patients [10] [19].…”

“…However, as Turner-Stokes et al [19] point out, "Problems following ABI vary. Consequently, different interventions and combinations of interventions are required to suit the needs of patients with different problems.…”

“…Rehabilitation for brain injury is such an individualized and long-term process that it can be difficult to draw general conclusions from research studies. In future, such questions will need to be set alongside practice-based evidence gathered from large systematic, longitudinal cohort studies conducted in the context of routine clinical practice" [19].…”

Home Physiotherapy: The Relevance of Social Determinants of Health in the Development of Physiotherapy in the Home Environment

“…Literature refers research studies and experiences in home physiotherapy envolving patients with diverse diagnosis. For some authors, people who have suffered a stroke or cerebral vascular accident (CVA) and have been discharged from hospital, should have access to patient or community services appropriate to their needs and may include home rehabilitation (Torsén et al, 2005;Turner-Stokes et al, 2005). The authors acknowledged that during home physiotheray other factors may influence the health outcomes, such as the physical and psycho-emotional aspects of the home (Hale et al, 2003).…”