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Titre : | An Observational Cohort Study of the Role of Level of Effort in Post-Acute Brain Injury Rehabilitation (2023) |
Auteurs : | David M. Anders ; Daniel M. Logan ; Jean A. Shelton ; G. Joseph Walters ; Sarah Perry ; Knute D. Carter ; James F. Malec |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 104, n° 2, 2023) |
Article en page(s) : | 211-217 |
Note générale : | https://doi.org/10.1016/j.apmr.2022.07.013 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Accident vasculaire cérébral (AVC) ; Lésions encéphaliques ; Réadaptation |
Résumé : | Objective To investigate the role of participant level of effort (LoE) on outcome in post-acute brain injury rehabilitation with the hypothesis that greater effort is associated with more positive outcomes. Design Observational cohort study. Setting Comprehensive integrated rehabilitation program for brain injury within a skilled nursing facility. Participants Consecutive admissions with acquired brain injury (N=101). Interventions Individualized interdisciplinary brain injury rehabilitation; therapist rating of participant LoE with Acquired Brain Injury LoE Scale (ABI-LoES) during physical therapy, occupational therapy, and speech and language pathology sessions. Main Outcome Measures Mayo-Portland Adaptability Inventory, fourth edition (MPAI-4); Supervision Rating Scale (SRS). Results Linear regression showed that discharge MPAI-4 Total T scores were significantly associated with mean ABI-LoES rating, admission MPAI-4 Total T scores, age at admission, and days from injury but not with standard deviation of ABI-LoES rating, sex, injury type, length of stay, or treatment before or during the COVID-19 pandemic. Discharge SRS scores were significantly associated with mean ABI-LoES rating, admission SRS scores, and age. A 1-unit increase in mean ABI-LoES rating was associated with 5.1-unit lower discharge MPAI-4 Total T scores and 1.5 lower discharge SRS scores, after controlling for other variables. Logistic regression showed that the odds of achieving a minimal clinically important difference on the MPAI-4 were 8.34 times higher with each 1-unit increase in mean ABI-LoES rating after controlling for other variables. Admission MPAI-4 was negatively associated with mean ABI-LoES rating (?=?0.07, t=?8.85, P<.0001 conclusions after controlling for nonmodifiable variables average abi-loes rating is positively associated with outcome. initial level of disability negatively mean rating.> |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S000399932200541X |