Outcomes for traumatically brain-injured patients following post-acute rehabilitation programmes

Outcome studies from post-acute cognitive rehabilitation programmes vary widely and mostly emphasize changes in neuropsychological measures. More recently, the functional outcomes of patients following cognitive rehabilitation have been reported. This study describes the functional outcomes of 42 traumatically brain-injured patients (29 male, 13 female: average age 28.6 years, time post-injury 50.3 months) following treatment in a structured out-patient post-acute cognitive rehabilitation programme. The programme consisted of a minimum of 6 weeks of treatment and emphasized improvement of the patients' real-life functional abilities and psychological support. The treatment goals were individually established for each patient. Patient improvement was determined by the accomplishment of treatment goals and differences in pre- and post-treatment functional measures and speech pathology cognitive measures. Follow-up at 6, 12 and 18 months determined the maintenance of treatment effects. There was a significant improvement on patients' functional measures after treatment. Cognitive measures were not significantly different after treatment, but there was a trend towards improvement. Functional improvements were independent of age, neuropathological category, injury severity and time post-injury. It is concluded that post-acute traumatic brain injury treatment aimed at retraining real-life functional abilities exclusive of specific cognitive remediation can lead to long-term improvements in independence.