Efficacy of a functionally-based neurorehabilitation programme: a retrospective case-matched study of rehabilitation outcomes following traumatic brain injury.

OBJECTIVE

To investigate the efficacy of a functionally-based neurorehabilitation programme.

DESIGN

Retrospective, case-matched cohort design.

SETTING

An inpatient acquired brain injury (ABI) service at a post-acute rehabilitation facility. In 2001, a functionally-based rehabilitation model was introduced that streams patients into neurocognitive (NC) and neurophysical (NP) treatment groups based on predominant functional deficits.

METHODS

Sixty-nine patients with TBI admitted to the ABI service before implementation of the functionally-based programme comprised a historical control group. These patients were individually case-matched to 69 participants admitted after the functionally-based programme began. Rehabilitation outcomes were compared between matched patients treated before and after implementation of the programme.

OUTCOME MEASURES

Rehabilitation length of stay (RLOS), Functional Independence Measure (FIM) and Disability Rating Scale (DRS) at rehabilitation discharge and FIM efficiency.

RESULTS

At discharge, the NP-stream had a significantly higher FIM motor efficiency compared to the historical control (0.41 vs. 0.29; p = 0.01). The NC-stream had significantly less disability, as measured by the DRS, compared to its control (3.63 vs. 5.05; p = 0.01).

CONCLUSIONS

This study presents preliminary evidence that a rehabilitation programme that targets functional needs rather than diagnosis may be useful in improving function after traumatic brain injury.