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Community-Based Rehabilitation Following Brain Injury: Comparison of a Transitional Living Program and a Home-Based Program

Published online by Cambridge University Press:  14 June 2012

Kate Hopman ,
Robyn L. Tate  and
Annie McCluskey
Kate Hopman
Affiliation:
Liverpool Brain Injury Rehabilitation Unit, Sydney, Australia
Robyn L. Tate*
Affiliation:
Rehabilitation Studies Unit, Northern Clinical School, Sydney Medical School, The University of Sydney, Australia
Annie McCluskey
Affiliation:
Faculty of Health Sciences, The University of Sydney, Australia
*
Address for correspondence: Professor Robyn Tate Professorial Research Fellow Rehabilitation Studies Unit, Northern Clinical School, Sydney Medical SchoolThe University of SydneyPO Box 6, Ryde NSW 1680Australia E-mail: rtate@med.usyd.edu.au
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Abstract

Background and aims: Community-based rehabilitation programs for people with a brain injury are diverse. Comparative program evaluation is required to identify optimal type, intensity and duration of programs. The aim of this study was to compare the effectiveness of two community-based rehabilitation programs using a set of standardised outcome measures.

Methods: The study used a quantitative, multicentre, longitudinal design. Persons with severe traumatic brain injury (TBI, n = 39) and acquired brain impairment (n = 2) were recruited from two residential, transitional living programs (TLU; n = 21) and two home-based community rehabilitation programs (CR; n = 20). Participants were assessed via interview at program entry, 2 months and 6 months later using a broad range of standardised measures. The quantity and types of intervention provided to study participants were recorded. Results: No significant differences were identified between the TLU and CR groups at baseline or 6-month follow-up. Two significant group-by-time interactions were identified on the Community Integration Questionnaire (CIQ). First, the CR group had significantly greater changes in productivity (p = .003; d = 1.0) compared to the TLU group over time; by contrast, the TLU group showed significantly greater improvements in social integration (p = .007; d = .86). The TLU participants received up to five times more intervention than the CR participants. This finding is significant considering the similar levels of improvement in function made by both TLU and CR participants.

Conclusions: Both TLU and CR groups improved on a range of measures. The TLU group however, received significantly more face-to-face interventions. Further examination of the relationship between participant contextual factors, such as coping style and self-esteem, and impairments such as challenging behaviour and decreased self-awareness, of people attending TLU and CR programs is required.

Keywords

Traumatic brain injurycommunity rehabilitationcommunity reintegrationtransitional livingprogram evaluationcohort study
Type
Articles
Information
Brain Impairment , Volume 13 , Issue 1: Transition to Community Living after Acquired Brain Injury , July 2012 , pp. 44 - 61
Copyright
Copyright © The Authors 2012

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