Date of Presentation
5-2-2024 12:00 AM
College
Rowan-Virtua School of Osteopathic Medicine
Poster Abstract
BACKGROUND/PURPOSE
Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].
DESIGN
A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 – 2023 and excluded outpatient and pediatric populations. Articles were classified into two categories: those addressing either acute or subacute rehabilitation. Outcome measures included disability ratings, physical independence, independence with ADLs, social re-integration inside and outside of home, cognitive recovery, and general mobility, FIM scores, and HSQ-12 scores. Articles examined included meta-analyses, clinical trials, comparative studies, and other literature reviews.
FINDINGS
Sixteen articles addressed outcomes after acute rehabilitation [5, 8-22]. They suggest: 1) improved functional independence, cognition, and odds of discharge to home with earlier intensive acute rehabilitation following TBI, and 2) better FIM scores and HSQ-12 scores compared to those who were discharged from acute care to long term care.
Only one article addressed outcomes after subacute rehabilitation [23].
DISCUSSION/CONCLUSIONS
Acute rehabilitation programs lack uniformity in data collection methods, comprehensive metrics for outcome measurements, and homogenous and well-defined rehabilitation structures [24-27]. Our study suggests there is little-to-no data to support that subacute rehabilitation facilities have improved patient outcomes over acute rehabilitation. In conclusion, current research critically lacks information regarding outcomes after subacute rehabilitation. As trends move towards increased utilization of subacute rehabilitation services, future research must focus on outcomes in patient populations at the subacute rehabilitation level.
Keywords
Traumatic Brain Injury, TBI, Acute Rehabilitation, Subacute Rehabilitation, Treatment Outcome, Quality of Life, Rehabilitation, Adult
Disciplines
Medicine and Health Sciences | Neurology | Occupational Therapy | Pathological Conditions, Signs and Symptoms | Physical Therapy | Physiotherapy | Sports Medicine | Therapeutics
Document Type
Poster
Included in
Neurology Commons, Occupational Therapy Commons, Pathological Conditions, Signs and Symptoms Commons, Physical Therapy Commons, Physiotherapy Commons, Sports Medicine Commons, Therapeutics Commons
Examining the Differences in Functional Outcomes for Patients with Traumatic Brain Injury After Acute Rehabilitation and Subacute Rehabilitation: A Review of the Literature
BACKGROUND/PURPOSE
Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].
DESIGN
A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 – 2023 and excluded outpatient and pediatric populations. Articles were classified into two categories: those addressing either acute or subacute rehabilitation. Outcome measures included disability ratings, physical independence, independence with ADLs, social re-integration inside and outside of home, cognitive recovery, and general mobility, FIM scores, and HSQ-12 scores. Articles examined included meta-analyses, clinical trials, comparative studies, and other literature reviews.
FINDINGS
Sixteen articles addressed outcomes after acute rehabilitation [5, 8-22]. They suggest: 1) improved functional independence, cognition, and odds of discharge to home with earlier intensive acute rehabilitation following TBI, and 2) better FIM scores and HSQ-12 scores compared to those who were discharged from acute care to long term care.
Only one article addressed outcomes after subacute rehabilitation [23].
DISCUSSION/CONCLUSIONS
Acute rehabilitation programs lack uniformity in data collection methods, comprehensive metrics for outcome measurements, and homogenous and well-defined rehabilitation structures [24-27]. Our study suggests there is little-to-no data to support that subacute rehabilitation facilities have improved patient outcomes over acute rehabilitation. In conclusion, current research critically lacks information regarding outcomes after subacute rehabilitation. As trends move towards increased utilization of subacute rehabilitation services, future research must focus on outcomes in patient populations at the subacute rehabilitation level.