• Arch Phys Med Rehabil · Apr 1999

    Comparative Study Clinical Trial

    Residential and home-based postacute rehabilitation of individuals with traumatic brain injury: a case control study.

    • B Willer, J Button, and R Rempel.
    • State University of New York at Buffalo, USA.
    • Arch Phys Med Rehabil. 1999 Apr 1; 80 (4): 399-406.

    ObjectivesTo compare the outcomes of severely brain-injured individuals treated in a postacute residential rehabilitation program with a matched sample of individuals receiving limited services in their homes or on an outpatient basis.DesignControlled study using a matched design in a before-and-after trial and a 1-year follow-up trial.SettingA postacute community-based residential rehabilitation program or in the homes of patients.Patients And Other ParticipantsThe treatment group included all persons admitted consecutively for rehabilitation to the postacute residential program over a 3-year period (n = 23). All subjects had severe traumatic brain injury. The comparison group was selected from the roster of a support group on the basis of a systematic matching procedure. Matching variables included gender, age, length of coma, time since injury, and level of disability. Subjects of the two groups were matched on an individual basis.Main Outcome MeasuresA functional assessment instrument (modified Health andActivity Limitations Survey [HALS]) and the Community Integration Questionnaire (CIQ).ResultsIndividuals with traumatic brain injury who received residential-based postacute rehabilitation displayed a statistically significant increase in functional abilities when compared with a traditional (home-based) service group. More specifically, treatment subjects showed significantly greater improvement in motor skills and cognitive abilities. Treatment subjects also showed greater improvement in community integration, although this may have been accounted for by initial group differences.ConclusionsPostacute rehabilitation appears to be effective in improving function for individuals with severe brain injury. Residential-based services appear to produce greater functional improvement, whereas home-based services are more effective at maintaining community integration.

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