Efficacy of a post-acute interval inpatient neurorehabilitation programme for severe brain injury

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Abstract
Background: Patients with severe acute brain injury often suffer from prolonged limitations in the activities of daily living (ADL) after completion of initial neurorehabilitation. Objective: To analyse the efficacy of an inpatient interval rehabilitation programme (IRP) focused on patient goals in the chronic disease state. Methods: Retrospective longitudinal cohort study of IRP patients. Clinical scoring of ADLs was performed weekly during inpatient treatment. IRP success was rated with the Goal Attainment Scale. Regression analysis was used to identify factors that influence IRP success. Results: Data from 125 patients (50.4 years) were analysed. Delay between discharge from acute/sub-acute rehabilitation and admission to IRP was 552 days. IRP lasted for 46 days and 37% of rehabilitation attempts were rated as successful. A significant increase in FIM scores from 33 ± 22 to 36 ± 24 points (p < 0.001) occurred. Higher ADL scores at discharge from acute/sub-acute rehabilitation and decannulation of a tracheostomy tube as the primary IRP goal made an IRP success more likely. Conclusions: Even several years after severe acute brain injury, an ICF-oriented IRP can lead to ADL improvements and achievement of specific goals. If confirmed by prospective trials, this strategy should be incorporated in healthcare systems.

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