Article 19 Older Adults with Acquired Brain Injury: Functional Independence Measures after Inpatient Rehabilitation

2013 ◽  
Vol 94 (10) ◽  
pp. e9
Author(s):  
Vincy Chan ◽  
Brandon Zagorski ◽  
Daria Parsons ◽  
Angela Colantonio
Keyword(s):  
Older Adults ◽  
Brain Injury ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Functional Independence

scholarly journals Assessment of Intensive Inpatient Rehabilitation Program in Acquired Brain Injury Patients using UK FIM+FAM Scale: A Retrospective Study

2021 ◽  
Author(s):  
Harleen Uppal ◽  
Shipra Chaudhary ◽  
Siddharth Rai
Keyword(s):  
Brain Injury ◽  
Functional Outcome ◽  
Outcome Measure ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
P Value ◽  
Functional Outcome Measure ◽  
The Uk

Introduction: Acquired Brain Injury (ABI) can lead to a combination of physical, cognitive, and behavioural impairments and requires comprehensive and structured inpatient rehabilitation program. A multidisciplinary rehabilitation program can deal comprehensively with all these issues together rather than focussing on a single aspect like motor function. Number of people suffering from Traumatic Brain Injury (TBI) in India has been documented to be between 1.5 million to two million per year whereas out of this approximately one million die due to TBI. The rationale of the present study was to document the outcome of multidisciplinary inpatient rehabilitation program objectively using a standard functional outcome measure. Aim: To determine the change in functional outcomes of ABI patients being rehabilitated with a multidisciplinary inpatient neurorehabilitation program using UK version of Functional Independence Measure and Functional Assessment Measure (UK FIM+FAM). Materials and Methods: The retrospective observational study was conducted in Medanta Hospital, Gurugram, Haryana, India, from September 2017 to June 2018. Retrospective analysis of previously maintained data was done from June 2018 to November 2018. Data was collected from the Department of Neurorehabilitation. Demographic data was collected including age, sex, type of injury, time from injury to admission and duration of stay in the neurorehabilitation unit. Functional outcome measure used in the study was the UK FIM+FAM. Data was collected in paper forms and collated in Microsoft Excel and transferred to IBM® Statistical Package for the Social Sciences (SPSS)® version 22.0 (IBM Corp., Armonk, NY) for analysis. The UK FIM+FAM data was analysed as aggregate total scores and motor and cognitive subscales. Non parametric tests were used as UK FIM+FAM is an ordinal scale. The test used to measure the change in score was Wilcoxon Test. The p-value <0.05 was considered statistically significant. Results: Total number of patients who were analysed in the study were 45. Motor subset of scores showed significant improvement from admission (50) to discharge (72) (p-value=0.001). Similarly, the cognitive subset of scores also showed a significant improvement from admission (58) to discharge (68, p value=0.002). Apart from motor and cognitive subscales of UK FIM+FAM, change in score in sub divisions of self-care and transfers showed the maximum change with p-value=0.001. Other sub divisions of locomotion, sphincter, communication, psychological and cognition also showed a significant difference of p-value <0.05. Conclusion: A physiatrist led intensive interdisciplinary inpatient rehabilitation program for patients with ABI may significantly reduce residual disability and improve functional independence. Such a program is not only effective in high income countries but also in Low Middle Income Countries (LMIC).

Older Adults with Acquired Brain Injury: Outcomes After Inpatient Rehabilitation

2013 ◽  
Vol 32 (3) ◽  
pp. 278-286 ◽  
Author(s):  
Vincy Chan ◽  
Brandon Zagorski ◽  
Daria Parsons ◽  
Angela Colantonio
Keyword(s):  
Older Adults ◽  
Brain Injury ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Personnes Âgées ◽  
Nous Concluons ◽  
Base De Données ◽  
Résultats Fonctionnels ◽  
Injury Outcomes

RÉSUMÉCette étude a examiné un profil basé sur la population des personnes âgées atteintes des lésions cérébrales acquises (LCA), et de leur résultats fonctionnels, en réadaptation en milieu hospitalier au Canada. Les personnes âgées de 65 ans et plus qui ont été admises en réadaptation en milieu hospitalier de soins aigus pour un traumatisme cranio-cérébrale (TCC) (n = 1 214) ou une lésion cérébrale non pas traumatique (nTCC) (n = 1 530) ont été identifiées en Ontario de 2003/04 à 2009/10. Les caractéristiques démographiques et cliniques et les notes fonctionnelles totales de l’instrument (FIMMD) ont eté examinées. On a utilisé le Base de données sur les congés des patients (BDCP) et le Système nationale d’information sur la réadaptation (SNIR). Les résultats ont montré que les personnes plus âgées atteintes d’un traumatisme cranio-cérébrale (TCC) présentaient un niveau d’indépendence fonctionelle plus élevé que celles sans TCC à l’admission et à la sortie. Cependant, les deux groupes ont faits des gains importants (p = .001) et similaires (p > .05). Nous concluons que les personnes âgées avec TCC et nTCC font des gains similaires de réadaptation en milieu hospitalier. L’incapacité fonctionnelle initiale plus faible des patients nTCC à l’admission et les profils cliniques différents offrent des implications pour la répartition des soins et des ressources cliniques.

scholarly journals Cognitive and Functional Outcomes following Inpatient Rehabilitation in Patients with Acquired Brain Injury: A Prospective Follow-up Study

2017 ◽  
Vol 08 (03) ◽  
pp. 357-363 ◽  
Author(s):  
Maitreyi Patil ◽  
Anupam Gupta ◽  
Meeka Khanna ◽  
Arun B. Taly ◽  
Amit Soni ◽  
...  
Keyword(s):  
Brain Injury ◽  
Functional Outcomes ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Cognitive Status ◽  
Functional Impairments ◽  
Follow Up Study ◽  
Cognitive Retraining

ABSTRACT Objectives: To study the effects of cognitive retraining and inpatient rehabilitation to study the effects of cognitive retraining and inpatient rehabilitation in patients with acquired brain injury (ABI). Design and Setting: This was a prospective follow-up study in a neurological rehabilitation department of quaternary research hospital. Patients and Methods: Thirty patients with ABI, mean age 36.43 years (standard deviation [SD] 12.6, range 18–60), mean duration of illness 77.87 days (SD 91.78, range 21–300 days) with cognitive, physical, and motor-sensory deficits underwent inpatient rehabilitation for minimum of 14 sessions over a period of 3 weeks. Nineteen patients (63%) reported in the follow-up of minimum 3 months after discharge. Type of ABI, cognitive status (using Montreal Cognitive assessment scale [MoCA] and cognitive Functional Independence Measure [Cog FIM]®), and functional status (motor FIM®) were noted at admission, discharge, and follow-up and scores were compared. Results: Patients received inpatient rehabilitation addressing cognitive and functional impairments. Baseline MoCA, motor FIM, and Cog FIM scores were 15.27 (SD = 7.2, range 3–30), 31.57 (SD = 15.6, range 12–63), and 23.47 (SD = 9.7, range 5–35), respectively. All the parameters improved significantly at the time of discharge (MoCA = 19.6 ± 7.4 range 3–30, motor FIM® = 61.33 ± 18.7 range 12–89, Cog FIM® =27.23 – 8.10 range 9–35). Patients were discharged with home-based programs. Nineteen patients reported in follow-up and observed to have maintained cognition on MoCA (18.8 ± 6.8 range 6–27), significantly improved (P < 0.01) on Cog FIM® (28.0 ± 7.7 range 14–35) and motor FIM® =72.89 ± 16.2 range 40–96) as compare to discharge scores. Conclusions: Cognitive and functional outcomes improve significantly with dedicated and specialized inpatient rehabilitation in ABI patients, which is sustainable over a period.

Patient inclusion in goal setting during early inpatient rehabilitation after acquired brain injury

2011 ◽  
Vol 26 (2) ◽  
pp. 165-173 ◽  
Author(s):  
Catherine Dalton ◽  
Rachel Farrell ◽  
Annette De Souza ◽  
Evelyn Wujanto ◽  
Ann McKenna-Slade ◽  
...  
Keyword(s):  
Brain Injury ◽  
Goal Setting ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation

Right people, right time? a qualitative study of service access experiences of adults with acquired brain injury following discharge from inpatient rehabilitation

2020 ◽  
pp. 1-16
Author(s):  
Michele Foster ◽  
Melissa Legg ◽  
Eloise Hummell ◽  
Letitia Burridge ◽  
Kirsty Laurie
Keyword(s):  
Brain Injury ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Service Access ◽  
Personal Recovery ◽  
Structured Interviews ◽  
Perceived Needs ◽  
Specialist Services ◽  
Positive Experiences

Abstract Purpose: The intention of this paper is to develop the personal concept of appropriate access. We report on the service access experiences and opportunities of adults with an acquired brain injury after leaving inpatient rehabilitation. The benefits of appropriate access underpin standards in early and long-term recovery, though users’ access needs are highly personal. Methods: The study used a qualitative design involving 16 semi-structured interviews with Australian adults with an acquired brain injury after discharge from inpatient brain rehabilitation. Data were thematically analysed. Results: Three main themes were derived from the analysis. Theme 1 shows that participants valued being steered to services that providers thought appropriate for them early after discharge from inpatient rehabilitation. Theme 2 highlights the tensions between timing and personal recovery and perceived needs. Theme 3 captures participants’ insights into the challenges of gaining access vis-a-vis what the system offers and the enablers of actualising appropriate access. Conclusion: The positive experiences of being directed to specialist services early after discharge suggest that continuity of care constitutes appropriateness of access for participants in this study. However, it is also clear that continuity should not displace flexibility in the timing of services, to accord with individuals’ perceived needs. This, in addition to enablement of access opportunities, through funding and transport, are important in maintaining a personalised approach.

scholarly journals Influence of Sex and Age on Inpatient Rehabilitation Outcomes Among Older Adults With Traumatic Brain Injury

2010 ◽  
Vol 91 (1) ◽  
pp. 43-50 ◽  
Author(s):  
James E. Graham ◽  
Dawn M. Radice-Neumann ◽  
Timothy A. Reistetter ◽  
Flora M. Hammond ◽  
Marcel Dijkers ◽  
...  
Keyword(s):  
Older Adults ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Outcomes

scholarly journals Rehabilitation Outcomes in Subjects with West Nile Neuro-Invasive Disease

2021 ◽  
Vol 11 (10) ◽  
pp. 1253
Author(s):  
Komal Patel ◽  
Brian D. Greenwald ◽  
Rosanna C. Sabini
Keyword(s):  
Brain Injury ◽  
Assisted Living ◽  
Functional Decline ◽  
Skilled Nursing Facility ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
The United States ◽  
Functional Independence ◽  
West Nile ◽  
Rehabilitation Facility

West Nile Virus (WNV) is the most common mosquito borne cause of viral encephalitis in the United States. Physical and neuro-cognitive recovery from WNND may be prolonged or incomplete leading to chronic cognitive inefficiencies and functional decline. There continues to be no effective treatment of WNV and current management is primarily supportive. The objective of this review is to evaluate the functional outcomes and role of rehabilitation services in subjects with WNND. The charts of five subjects admitted to an acute inpatient brain injury rehabilitation facility from June to December 2012 were retrospectively reviewed. (Mean, Range)-Age (64.8, 43–78 years), Admission Functional Independence Measure (FIM) (45.2, 14–63), Discharge FIM (82.2, 61–100), FIM score gain (37, 24–60), Cognitive FIM gain (7, 1–18), Mobility FIM gain (17.4, 13–20), ADL FIM gain (12.6, 4–23); acute brain injury inpatient rehabilitation facility length of stay (LOS) (17.8, 14–21 days); acute hospital LOS (15, 10–22 days). Of the five subjects, three were discharged home, one was discharged to a skilled nursing facility, and one was discharged to an assisted living facility. Subjects with WNND have significant functional decline across all FIM subcategories and may benefit from a course of brain injury-specific acute inpatient rehabilitation.

scholarly journals Self-Awareness Moderates the Association Between Executive Dysfunction and Functional Independence After Acquired Brain Injury

2020 ◽  
Vol 35 (7) ◽  
pp. 1059-1068
Author(s):  
Dolores Villalobos ◽  
José M Caperos ◽  
Álvaro Bilbao ◽  
Umberto Bivona ◽  
Rita Formisano ◽  
...  
Keyword(s):  
Executive Function ◽  
Brain Injury ◽  
Significant Interaction ◽  
Declarative Memory ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Common Symptom ◽  
Self Awareness ◽  
Moderator Effect ◽  
Low Levels

Abstract Objective Impaired self-awareness (SA) is a common symptom after suffering acquired brain injury (ABI) which interferes with patient’s rehabilitation and their functional independence. SA is associated with executive function and declarative memory, two cognitive functions that are related to participants’ daily living functionality. Through this observational study, we aim to explore whether SA may play a moderator role in the relation between these two cognitive processes and functional independence. Method A sample of 69 participants with ABI completed a neuropsychological assessment focused on executive function and declarative memory which also included a measure of SA and functional independence. Two separated linear models were performed including functional independence, SA, and two neuropsychological factors (declarative memory and executive function) derived from a previous principal component analysis. Results Moderation analysis show a significant interaction between SA and executive function, reflecting an association between lower executive functioning and poorer functional outcome, only in participants with low levels of SA. Notwithstanding, declarative memory do not show a significant interaction with SA, even though higher declarative memory scores were associated with better functional independence. Conclusions SA seems to play a moderator effect between executive function, but not declarative memory, and functional independence. Accordingly, participants with executive deficits and low levels of SA might benefit from receiving specific SA interventions in the first instance, which would in turn positively impact on their functional independence.

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