Long-Term Functional Outcomes in Military Service Members and Veterans after Traumatic Brain Injury/Polytrauma Inpatient Rehabilitation

Publication date: Available online 1 September 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Max Gray, Joyce Chung, Fatima Aguila, T. Gavin Williams, Jeffrey K. Teraoka, Odette A. Harris
ObjectiveTo determine the impact of the established Polytrauma/TBI infrastructure on immediate post-treatment functional gains, the long-term sustainability of any gains and participation-related community reintegration outcomes in a baseline cohort of patients eight years post-admission.DesignRetrospective review and prospective repeated measures of an inception cohort.SettingVeterans Affairs Palo Alto, Polytrauma Rehabilitation Center (PRC)Participants44 patients consecutively admitted to the PRC inpatient rehabilitation unit during its first full Fiscal Year, 2006.InterventionsThe PRC infrastructure and the formalized rehabilitation for Polytrauma/TBI.Main Outcome MeasuresFunctional Independence Measure scores at admission, discharge, 3 months and 8 years post discharge; participation-related socioeconomic factors reflecting community reintegration eight years after admission.ResultsFunctional gains were statistically significantly increased from admission to discharge. Improvements were maintained at both 3 months post-discharge and 8 years post-discharge. The socio-economic data collected at 8 year follow-up showed greater than 50% either competitively employed or continuing their education and 100% living in a non-institutionalized setting.ConclusionsThis study addresses a concern regarding the long-term functional outcomes of rehabilitation patients treated by the established infrastructure of the Polytrauma System of Care inpatient rehabilitation centers. The results suggest that Polytrauma/TBI rehabilitation care utilizing a comprehensive, integrated approach is effective and durable in achieving functional gains and successful community reintegration within our initial PRC cohort. Follow-up of subsequent FY cohorts would add to the validity of these outcome findings.



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