Related Experiment Video
Updated: Jun 7, 2026
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Effectiveness of community-based rehabilitation after traumatic brain injury for 489 program completers compared with
Irwin M Altman1, Shannon Swick, Devan Parrot
1Gentiva Rehab Without Walls, Phoenix, AZ, USA.
Objective:
To evaluate outcomes of home- and community-based postacute brain injury rehabilitation (PABIR).
Design:
Retrospective analysis of program evaluation data for treatment completers and noncompleters.
Setting:
Home- and community-based PABIR conducted in 7 geographically distinct U.S. cities.
Participants:
Patients (N=489) with traumatic brain injury who completed the prescribed course of rehabilitation (completed-course-of-treatment [CCT] group) compared with 114 who were discharged precipitously before program completion (precipitous-discharge [PD] group).
Intervention:
PABIR delivered in home and community settings by certified professional staff on an individualized basis.
Main Outcome Measures:
Mayo-Portland Adaptability Inventory (MPAI-4) completed by means of professional consensus on admission and at discharge; MPAI-4 Participation Index at 3- and 12-month follow-up through telephone contact.
Results:
Analysis of covariance (CCT vs PD group as between-subjects variable, admission MPAI-4 score as covariate) showed significant differences between groups at discharge on the full MPAI-4 (F=82.25; P<.001), Ability Index (F=50.24; P<.001), Adjustment Index (F=81.20; P<.001), and Participation Index (F=59.48; P<.001). A large portion of the sample was lost to follow-up; however, available data showed that group differences remained statistically significant at follow-up.
Conclusions:
Results provided evidence of the effectiveness of home- and community-based PABIR and that treatment effects were maintained at follow-up.
