Document Detail


Progress assessed with the mayo-portland adaptability inventory in 604 participants in 4 types of post-inpatient rehabilitation brain injury programs.
MedLine Citation:
PMID:  22200388     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To compare progress in 4 types of post-inpatient rehabilitation brain injury programs.
DESIGN: Quasiexperimental observational cohort study.
SETTING: Community and residential.
PARTICIPANTS: Individuals (N=604) with acquired brain injury.
INTERVENTIONS: Four program types within the Pennsylvania Association of Rehabilitation Facilities were compared: intensive outpatient and community-based rehabilitation (IRC; n=235), intensive residential rehabilitation (IRR; n=78), long-term residential supported living (SLR; n=246), and long-term community-based supported living (SLC; n=45). With the use of a commercial web-based data management system developed with federal grant support, progress was examined on 2 consecutive assessments.
MAIN OUTCOME MEASURE: Mayo-Portland Adaptability Inventory (MPAI-4).
RESULTS: Program types differed in participant age (F=10.69, P<.001), sex (χ(2)=22.38, P<.001), time from first to second assessment (F=20.71, P<.001), initial MPAI-4 score (F=6.89, P<.001), and chronicity (F=13.43, P<.001). However, only initial MPAI-4 score and chronicity were significantly associated with the second MPAI-4 rating. On average, SLR participants were 9.1 years postinjury compared with 5.1 years for IRR, 6.0 years for IRC, and 6.8 years for SLC programs. IRR participants were more severely disabled per MPAI-4 total score on admission than the other groups. Controlling for these variables, program types varied significantly on second MPAI-4 total score (F=5.14, P=.002). Both the IRR and IRC programs resulted in significant functional improvement across assessments. In contrast, both the SLR and SLC programs demonstrated relatively stable MPAI-4 scores.
CONCLUSIONS: Results are consistent with stated goals of the programs; that is, intensive programs resulted in functional improvements, whereas supported living programs produced stable functioning. Further studies using data from this large, multiprovider measurement collaboration will potentially provide the foundation for developing outcome expectations for various types of postacute brain injury programs.
Authors:
Vicki Eicher; Mary Pat Murphy; Thomas F Murphy; James F Malec
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  93     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  100-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
ReMed, Paoli, PA.
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