Effectiveness of rehabilitation icn rehabilitation

Whilst there is no definitive (study-based) proof that appropriate traumatic brain injury rehabilitation is effective, many in the legal profession are of the opinion that if properly managed, rehabilitation does work and increasingly strong evidence has emerged over the last twenty years to this effect.

Much research has been done into the effects of rehabilitation:

  • A study in 1988 (Morgan et al) established that patients given early rehabilitation stayed in hospital a shorter time (25 against 45 days) and had a better functional outcome at discharge.
  • A team of experts (Mackey et al) compared matched groups of severely head injured patients and reported substantial benefits for those who received rehabilitation, for example, 94% were discharged home (rather than having to be sent to chronic care or a nursing facility) compared to only 57% of the patients who did not.
  • An analysis of data in 1990-1991 (by Hall and Wright) showed that the length of inpatient stay was an average of 28 days for early admissions and 60 days for late admissions; also, on long-term follow up the early-admitted patients were only mildly disabled whereas the others were moderately disabled with substantially worse social functioning.
  • One of a number of studies by Cope, Cole, et al ("Brain Injury: analysis of outcomes in a post-acute rehabilitation system" - 1991 Brain Injury, Vol V, no. 2, 111 to 125). reported on an analysis of their total experience in providing comprehensive rehabilitation to brain injured patients in a co-ordinated system of post-acute programmes. The study population numbered 173, and the follow-up rate was 83.8%. Outcome was assessed on the basis of three particular measures, namely residential status, productivity and dependency. The following significant results were found:
    • Increase in residence at home From 44.8% to 69.7%
    • Increase in competitive activity From 5.6% to 34.5%.
    • Decrease in no productive activity From 92.3% to 27.6%.
    • Increase in independence for 24 hour period From 25% to 78.6%.
    • Decrease in 24 hour care From 32.6% to 13.8%.
    • Average reduction in hours per day care From 10.2 hours to 3.8 hours.
  • A study (Haffey, Abrams, et al in the 1991 Journal of Head Trauma Rehabilitation) found a 71% employment rate for a population who participated in a work re-entry programme, against less than 40% for the comparison groups which received only inpatient or day-treatment rehabilitation.