Outcomes of a community-based treatment programme for people with acquired brain injury in the chronic phase: a pilot study

Abstract

The objective of the study was to evaluate the outcomes of Brainz, a low intensity community-based treatment programme for people with acquired brain injury (ABI). Participants were 62 people with sustained ABI (5.2 years post-injury, SD = 4.5) and 35 family caregivers. Participants attended two to five cognitive and physical group modules and received two hours of individual home treatment every two weeks. Primary outcomes for people with ABI were participation, perceived difficulties in daily life and need of care, level of goal attainment, and self-esteem. Primary family caregiver outcome was perceived burden of care. Attrition rate of people with ABI was 24% (n = 15), and of family caregivers was 31% (n = 11). People with ABI were more satisfied with the level of their participation after completing Brainz (p < .01), but showed no change in participation frequency or in restrictions (both ps > .01). They perceived fewer difficulties in daily life and less need of care (both ps < .01). Also, in two cognitive modules people improved on their goal achievement (p < .01). However, their self-esteem was reduced (p < .01). Caregiver burden was reduced (p < .01). This study has provided preliminary evidence of the effectiveness of a combined group-based clinical and individual home-based treatment programme, but more research is needed, preferably in larger controlled studies.

One-year follow-up results of a community-based treatment programme for people with acquired brain injury in the chronic phase

“…As Brainz is adapted to the patients' individual needs, its duration varies from 28 weeks (two group modules and home training) to 42 weeks (five group modules and home training). For more information on the intervention, please consult Middag et al [6].…”

“…Official approval was requested but deemed unnecessary by the Medical Ethics Committee of Maastricht University Medical Centre as all measurements were conducted as part of routine clinical practice, see Middag-van Spanje et al [6]. All participants gave written informed consent to participate in the effect study.…”

“…A comparison can be made with the results of the original effect study (Middag-van Spanje et al [6]), which looked into the effects of the Brainz intervention on personal outcomes (such as physical fitness when one of the physical modules was selected and caregiver burden for patients who received informal care) as well as general outcomes (such as participation and need of care). In the current follow-up study, only the general primary outcome measures and one of the secondary outcome measures on general health (COOP/WONCA) were administered to assess longterm effects.…”

“…Moreover, self-esteem of participants showed a significant decrease after programme cessation, which was no longer the case at follow-up measurement. The paper on the effect study of Brainz [6] proposed several explanations for the increase in satisfaction of participants with their level of societal participation regardless of change(s) in the frequency of participation and experienced participation restrictions. First, it was hypothesised that patient satisfaction with level of participation was enhanced because of the number of activities that were performed as a part of participating in Brainz, without altering the frequency of activities or the level of perceived participation restrictions outside the programme.…”

“…This programme is offered in the chronic phase and consists of group sessions at care institutions as well as individual training sessions at the patients' home. In a recent pilot study, Brainz demonstrated to significantly improve satisfaction of patients with societal participation, and reduce perceived difficulties in daily life and need of care one year after the start of the programme [6]. However, patients also reported a lower level of self-esteem after treatment termination, which could be attributed to gaining more insight into their own functioning after having participated.…”