Rehabilitation Treatment Variables that Affect Outcome After Brain Injury
David W. Ellis George Spivack Claire M. Spettell
Two studies were performed to examine the effects of temporal factors in rehabilitation and the effects of intensity of rehabilitation treatment on outcomes following traumatic brain injury. First, the effects of length of acute hospitalization on social disability and length of rehabilitation stay (LOS) were examined. Although severity of brain injury had the greatest effect on the patient's outcome, length of acute hospitalization also had a significant effect on social disability and length of rehabilitation. The second study examined the effects of length and intensity of rehabilitation on cognitive and physical outcomes. There was a significant interaction between length of stay and treatment outcome, with the long LOS group starting out more disabled at admission but improving to the same level as the short LOS group at discharge. A similar pattern of results was found for the effects of intensity of rehabilitation on physical outcomes. However, when cognitive outcomes were studied, a different pattern emerged. For short LOS patients, highand low-intensity treatment groups improved equally, but for the long LOS patients those treated more intensely made significantly more progress. The theoretical and clinical significance of these results is discussed.
This chapter discusses various factors that may affect treatment outcomes after traumatic brain injury (TBI). The conclusions are based on a review of the literature as well as two studies that we have done