TRAUMATIC BRAIN INJURY - EFFICACY OF MULTIDISCIPLINARY REHABILITATION

Objective: To establish efficacy of a coordinated multidisciplinary re habilitation service for severe head injury, provided at Hunters Moor Regional Rehabilitation Centre. Design: A quasi-experimental design to compare treatment effects between two groups. The first group receive d a coordinated, multidisciplinary regional rehabilitation service; th e other, a single discipline approach provided by local, district hosp itals. Follow-up was for 2 years postinjury. Patients or Other Partici pants: Fifty-six consecutive severe head injury admissions, with an id entified main caregiver, referred for rehabilitation within 4 weeks of their injury. Main Outcome Measures: The Barthel index, the Functiona l Independence Measure (FIM), and the Newcastle Independence Assessmen t Form (NIAF), a newly developed, real-life, comprehensive measure. In addition, caregivers completed the General Health Questionnaire. Resu lts: The group that received coordinated multidisciplinary rehabilitat ion not only demonstrated significant gains throughout the study perio d but also maintained treatment effect after input ended. Furthermore, caregivers of this group had significantly reduced levels of distress . The comparison group, despite initial lower injury severity and shor ter hospital stay, did not demonstrate equivalent gains or any posttre atment effect. Conclusions: The results show the efficacy of a compreh ensive, specialist multidisciplinary regional service. There are signi ficant implications for service provision for people with severe traum atic head injury. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitat ion.