The efficacy of early rehabilitation after traumatic brain injury (TBI)

This study aimed to evaluate the efficacy of commencing activities of daily living skills retraining during posttraumatic amnesia (PTA) (Treatment condition) following traumatic brain injury, compared with withholding such training until following PTA emergence (Treatment as Usual). The impact of delivering the systematic manualised activities of daily living intervention, provided by trained Occupational Therapists, on functional independence was the primary outcome measure, with length of stay, PTA duration, community integration, and agitated behaviour during PTA also analysed. Furthermore, goal attainment scaling outcomes within the Treatment group were explored and qualitative interviews completed with treating clinicians. Participants allocated to Treatment received individual ADL skills retraining during PTA provided by qualified occupational therapists. The treatment group showed greater gains in functional independence during their hospital stay than the Treatment as Usual Group. Participants allocated to the treatment group showed significantly greater gains on the Functional Independence Measure between baseline and PTA emergence. Gains were maintained at discharge from inpatient rehabilitation. Amount of therapy received each day for participants within the Treatment group was not significantly associated with their daily agitation scores. Goal Attainment Scaling scores improved significantly from baseline to PTA emergence.