Rehabilitation Outcomes After Anoxic Brain Injury: A Case-Controlled Comparison With Traumatic Brain Injury
Received 29 June 2009; accepted 21 September 2009. published online 19 November 2009.
Objective
To investigate the functional outcomes of patients with anoxic brain injury (AnBI) compared with control patients with traumatic brain injury (TBI) during inpatient rehabilitation.
Design
Matched case-controlled design.
Setting
Inpatient neurorehabilitation program.
Participants
Fifteen patients with AnBI and 15 patients with TBI.
Methods
Data of 15 patients with a primary diagnosis of AnBI were retrospectively reviewed and matched to 15 patients with TBI admitted within the same time frame on age, acute care length of stay, and functional status at admission.
Main Outcome Measure
Functional outcome was assessed by the use of the Functional Independence Measure (FIM).
Results
Compared with the control patients with TBI, patients with AnBI achieved significantly lower FIM motor gain (16.3 ± 15.6 versus 5.7 ± 10.7, respectively) and efficiency scores (0.27 ± 0.28 versus 0.06 ± 0.13), discharge FIM cognition scores (25.9 ± 5.9 versus 21.7 ± 7.3), total FIM gain (22.5 ± 19.6 versus 9.1 ± 12.1), and total FIM efficiency scores (0.39 ± 0.38 versus 0.10 ± 0.16; all P < .05).
Conclusions
Results suggest a slower rate of recovery for patients with AnBI compared with TBI, with physical recovery being slower than cognitive recovery as measured by the FIM during inpatient rehabilitation when matched according to preinjury characteristics and functional status at rehabilitation admission. Future studies on larger samples of patients with AnBI and TBI that use a case-controlled design and longer-term outcome measurement are warranted to further clarify the differences in functional outcomes between these groups and to assess whether optimal rehabilitation interventions differ for these groups.
aNeuro Rehabilitation Program, Toronto Rehabilitation Institute; and the Division of Physiatry, University of Toronto, Toronto, ON, Canada M5G 2A2†
bNeuro Rehabilitation Program, Toronto Rehabilitation Institute, Toronto, ON, Canada‡
cNeuro Rehabilitation Program, Toronto Rehabilitation Institute; and the Division of Physiatry, University of Toronto, Toronto, ON, Canada§
Address correspondence to N.K.C., Neuro Rehabilitation Program, Toronto Rehabilitation Institute, 550 University Avenue, Toronto, ON, Canada M5G 2A2
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Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org
This research was supported by the Physicians' Services Foundation Inc. Equipment and space were funded with grants from the Canada Foundation for Innovation and the Province of Ontario. The views expressed here do not necessarily reflect those of the Ontario Ministry of Health and Long-Term Care.
ABSTRACT