Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA.
Arch Phys Med Rehabil. 2011 Dec;92(12):1974-8. doi: 10.1016/j.apmr.2011.07.199.
To explore the relationship between point of entry into a comprehensive day treatment (CDT) program and outcomes after acquired brain injury (ABI). We hypothesized that participants entering our program 0 to 6 months postinjury would demonstrate greater declines in neurobehavioral sequelae and improvements in residential/vocational independence than those entering >6 to 12 and >12 to 24 months postinjury.
Retrospective examination of admission, discharge, and 1-year follow-up data from a CDT program.
A large Midwestern academic medical center.
Adult CDT participants with traumatic brain injuries (TBI) (n=54) or cerebrovascular accidents (CVAs) (n=29).
A CDT rehabilitation program.
Portland Adaptability Inventory/Mayo-Portland Adaptability Inventory (percent change scores between admission and discharge) and the Independent Living and Vocational Independence Scales.
Time since injury was categorically coded into the 3 aforementioned point of entry groups. A 2 (injury type) × 3 (point of entry) between subjects analysis of covariance revealed a significant main effect for the point of entry (P<.001). Post hoc tests indicated that individuals entering the program 0 to 6 months postinjury demonstrated significantly greater treatment gains than those entering 6 to 12 or 12 to 24 months postinjury. Within group chi-square analyses revealed that a significantly higher percentage of the early entry participants were living and working independently at discharge and 1-year follow-up.
Entry into a CDT program (0-6mo postinjury) is associated with significantly greater declines in neurobehavioral sequelae and improvements in residential and vocational independence in participants with TBI or CVA. Sustainable modest treatment gains were also observed in the late entry groups, suggesting that these individuals also benefit significantly from CDT program participation.
探讨全面日间治疗（CDT）项目入组时间与获得性脑损伤（ABI）后结局的关系。我们假设，在受伤后 0-6 个月进入我们项目的参与者在神经行为后遗症方面表现出更大的下降，在居住/职业独立性方面表现出更大的改善，而在受伤后 6-12 个月和 12-24 个月进入项目的参与者则表现出更大的下降。
对 CDT 项目的入组、出院和 1 年随访数据进行回顾性检查。
中西部一所大型学术医疗中心。
有创伤性脑损伤（TBI）（n=54）或脑血管意外（CVA）（n=29）的成年 CDT 参与者。
CDT 康复计划。
波特兰适应能力量表/梅奥-波特兰适应能力量表（入组和出院之间的百分比变化得分）和独立生活和职业独立量表。
受伤时间被分类为上述 3 个入组时间组。2（损伤类型）×3（入组时间）的受试者间协方差分析显示，入组时间有显著的主效应（P<.001）。事后检验表明，在受伤后 0-6 个月进入项目的个体比在 6-12 个月或 12-24 个月进入项目的个体表现出显著更大的治疗获益。组内卡方分析显示，早期入组的参与者在出院和 1 年随访时，有更高比例的人独立生活和工作。
在 TBI 或 CVA 患者中，进入 CDT 项目（受伤后 0-6 个月）与神经行为后遗症的显著下降以及居住和职业独立性的显著改善相关。在晚期入组组中也观察到可持续的适度治疗获益，这表明这些个体也从 CDT 项目的参与中显著受益。
