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获得性脑损伤后出院后强化住院康复的有效性:256名项目完成者与住院支持生活项目参与者的结果比较。

Effectiveness of Post-Hospital Intensive Residential Rehabilitation after Acquired Brain Injury: Outcomes of 256 Program Completers Compared to Participants in a Residential Supported Living Program.

作者信息

Groff April R, Malec James, Braunling-McMorrow Debra

机构信息

Learning Services Corporation, Lawrenceville, Georgia.

Rehabilitation Hospital of Indiana, Indianapolis, Indiana.

出版信息

J Neurotrauma. 2020 Jan 1;37(1):194-201. doi: 10.1089/neu.2018.5944. Epub 2019 Sep 6.

DOI:10.1089/neu.2018.5944
PMID:31210092
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6921288/
Abstract

Post-hospital residential brain injury rehabilitation outcomes research is a complicated undertaking because of the custom-tailoring of interventions needed to meet the complex and unique need of each individual. As such, there tends to be great variability across program settings, which generally limits large-scale intervention studies. Growing literature demonstrates that post-hospital residential programs are beneficial. The main criticisms of this work include the absence of randomized-controlled studies, lack of clear definition of treatment types/settings, and small sample sizes. This study is a retrospective analysis of program evaluation data for a large, multi-site, national provider of post-hospital residential brain injury rehabilitation services. Specifically, outcome of participants completing Intensive Residential Rehabilitation (IRR) were compared to participants in the Residential Supported Living (RSL) program. Results demonstrate that participants in the IRR program improve and that participants in the RSL group preserve functional ability over time, suggesting that each program is effective in achieving its intended outcome. The IRR treatment group achieved significantly better outcomes than those in the same setting not receiving the intervention. To isolate treatment effects of IRR, a subsample of participants across program types were matched on time post-injury, age, and sex. The treatment effect of IRR was strengthened in this analysis, suggesting that chronicity alone does not account for the variance between the two groups.

摘要

由于需要针对每个个体的复杂独特需求进行量身定制干预措施,院后住院脑损伤康复结果研究是一项复杂的工作。因此,各项目环境之间往往存在很大差异,这通常限制了大规模干预研究。越来越多的文献表明,院后住院项目是有益的。这项工作的主要批评意见包括缺乏随机对照研究、治疗类型/环境缺乏明确界定以及样本量小。本研究是对一家大型、多地点、全国性的院后住院脑损伤康复服务提供商的项目评估数据进行的回顾性分析。具体而言,将完成强化住院康复(IRR)的参与者的结果与接受住宿支持生活(RSL)项目的参与者进行了比较。结果表明,IRR项目的参与者有所改善,而RSL组的参与者随着时间的推移保持了功能能力,这表明每个项目在实现其预期结果方面都是有效的。IRR治疗组取得的结果明显优于同一环境中未接受干预的参与者。为了分离IRR的治疗效果,对不同项目类型的参与者子样本在受伤时间、年龄和性别上进行了匹配。在该分析中,IRR的治疗效果得到了加强,这表明仅慢性损伤并不能解释两组之间的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/6921288/a99044e7544e/neu.2018.5944_figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/6921288/7985f9c2d3ba/neu.2018.5944_figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/6921288/56ccdefa8123/neu.2018.5944_figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/6921288/7c82cfdfe72a/neu.2018.5944_figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/6921288/a99044e7544e/neu.2018.5944_figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/6921288/7985f9c2d3ba/neu.2018.5944_figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/6921288/56ccdefa8123/neu.2018.5944_figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/6921288/7c82cfdfe72a/neu.2018.5944_figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/6921288/a99044e7544e/neu.2018.5944_figure4.jpg

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Neurologic continuum of care: Evidence-based model of a post-hospital system of care.神经系统连续护理:基于证据的出院后护理系统模型。
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Outcome prediction in home- and community-based brain injury rehabilitation using the Mayo-Portland Adaptability Inventory.
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