A team of researchers at The Ohio State University College of Medicine (OH, USA) published a series of studies together in the journal Archives of Physical Medicine & Rehabilitation, which compared the effectiveness of different approaches to therapy on TBI rehabilitation.
The effectiveness of inpatient rehabilitation for TBI appears to be influenced by the specific therapeutic approach used, patient engagement and family involvement. Treatment that uses real-life activities, targets higher-level functions and engages the patient seems to have the greatest impact on patient’s lives,” commented group leader, Jennifer Bogner (The Ohio State University). “More research is needed to confirm our findings and determine how they might best be used by inpatient rehabilitation facilities to provide the most cost-effective care.”
The researchers used a statistical method called propensity scores as an alternative to randomized clinical trials when they evaluated the comparative effectiveness of rehabilitation practices.
Using the TBI Practice-Based Evidence dataset, which includes sources of observational data from more than 1800 TBI cases, the team compared the effectiveness of different therapeutic approaches.
The four different studies investigated:
- The effectiveness of therapy that uses real-life activities.
- The effectiveness of advanced therapy that targets functions or abilities at the highest level needed for successful community integration, for example ambulating over uneven surfaces.
- The effect on patient rehabilitation when their family attended therapy with them at least 10% of the time.
- The effect of patient engagement with their treatment on time spent in therapy.
The findings from the study suggest that increased time spent on therapy that uses real-life activity increased the likelihood of the patient participating in the community within the year, furthermore, those who received more advanced therapy became more independent.
The researchers also discovered that engaging patients in their treatment and involving family both increased effectiveness of TBI rehabilitation.
Traumatic brain injuries are a major cause of death and disability in the United States. Our researchers at the college have discovered when therapy is challenging and involves the family, it can lead to better outcomes,” commented Dr. K. Craig Kent, Dean of the College of Medicine at The Ohio State University. “The more the patient is engaged, the more successful the rehabilitation can be.”
Sources: Hade EM, Bogner J, Corrigan JD, Horn SD, Peng J. Comparative Effectiveness of Inpatient Rehabilitation Interventions for Traumatic Brain Injury: Introduction. Arch. Phys. Med. Rehabil. doi:10.1016/j.apmr.2019.04.007 (2019) (Epub ahead ofprint);