Examination of Post-Hospital Residential Brain Injury Rehabilitation OutcomesAcross the Age Spectrum

Objectives: To evaluate change in functional independence observed admission to discharge from post-hospital brain injury residential rehabilitation programs among a large group of chronic TBI adults and children and to determine the impact of participant age on those outcomes. Methods: Six hundred and fifty one adults and children with moderate to severe traumatic brain injury (TBI) were assigned to one of six groups based on age: (1) 5-17, (2) 18-29, (3) 30-39, (4) 40-49, (5) 50-59, and (6) 60 and older. Functional status was assessed at admission and discharge with the MPAI-4. Differences among groups were evaluated using conventional parametric tests. Rasch analysis established reliability and construct validity of MPAI-4 data. Results: Rasch analysis demonstrated satisfactory construct validity and internal consistency (Person reliability=0.90-0.94, Item reliability=0.99) for the admission and discharge MPAI-4s. Controlling for LOS and onset-to- admission interval, a RM MANCOVA revealed that each age group showed significant improvement in MPAI-4 Abilities, Adjustment, and Participation indices from admission to discharge (p<0.001). Improvement observed from admission to discharge was not significantly different across age groups. Conclusions: Post-hospital residential brain injury rehabilitation was effective in reducing disability for participants in each age group. Age was not a factor in rehabilitative outcome. The oldest participants on average realized a reduction in disability equivalent to that observed in the youngest participants independent of length of stay duration.