The therapeutic value of cranioplasty in individuals with brain injury.

PRIMARY OBJECTIVE

To examine the effect of cranioplasty on recovery.

RESEARCH DESIGN

Retrospective cohort study.

METHOD AND PROCEDURES

Retrospective chart review conducted in 2011 and 2012 on adult inpatients with craniectomy who completed a continuous episode of inpatient rehabilitation before and after receiving their cranioplasty. Patients were matched 1:1 or age, gender, functional level at admission, injury severity and length of stay with inpatients who completed rehabilitation before cranioplasty. Main outcome measures include FIM (Functional Independence Measure) and FIM efficiency [(FIM discharge - FIMadmission)/number of days in rehabilitation]. To examine within and between group differences, analyses included paired and independent t-tests, Pearson correlations and chi-square analyses.

RESULTS

Twenty-six individuals (13 from the cranioplasty group and 13 from the comparison group) were analysed. FIM efficiency increased following cranioplasty [0.29 to 0.61; t(12) = -2.77, p = 0.017]. The mean FIM efficiency for the cranioplasty group was below that of the comparison group prior to cranioplasty [0.28 ± 0.37 and 0.39 ± 0.32, p = .41], but increased following cranioplasty [0.61 ± 0.71 and 0.39 ± 0.32, p = .32]. An improvement in FIM efficiency following cranioplasty was more commonly seen among individuals with less severe brain injuries (75%, χ = 3.8, df = 1, p = 0.053).

CONCLUSION

Rate of recovery increased following cranioplasty and exceeded that of the comparison group suggesting that cranioplasty may contribute to improvement.