MEASURING PROGRESS AND OUTCOME IN COMMUNITY REHABILITATION AFTER BRAIN INJURY WITH A NEW ASSESSMENT INSTRUMENT - THE BICRO-39 SCALES

Objective: Construction and validation of a new instrument, the Brain Injury Community Rehabilitation Outcome scales, to assess problems exp erienced by brain-injured patients living in the community. Design: Se venty-six items describing aspects of personal and social functioning were generated. Two hundred thirty-five patients and/or their carers ( separately) rated the items on 6-point scales, and patients retrospect ively rated their functioning before injury. Seven scales were derived from factor analysis; one was included a priori. Thirty-nine items wi th high factor loadings were retained. Test-retest reliability, interr ater reliability, and construct validity were examined in subsamples. Setting: Patients were recruited from four centers: two community-base d teams, a day-patient clinic, and an outpatient clinic. Patients: Of the patients, 127 had traumatic brain injury, 72 had cerebrovascular a ccidents, 15 had multiple sclerosis, and 21 had acquired brain injury of other origins. Mean time since brain injury was 2.6 years; mean age was 43 years; 164 were men and 71 were women. Results: All scales sho wed good test-retest reliability, and agreement between patient and ca rer ratings was moderate to high. They showed predicted moderate corre lations with other relevant scales. Postinjury scores differed signifi cantly from preinjury scores, and 6 of the 8 scales showed change over a period of recovery/rehabilitation. Conclusions: The scales appear r eliable and easy to complete. They may have utility as quantitative me asures of outcome for clinical and treatment evaluations. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Acad emy of Physical Medicine and Rehabilitation.