Outcomes of a community-based treatment programme for people with acquired brain injury in the chronic phase: a pilot study

Figures & data

Figure 1. Flow of people with ABI through the study. T0: prior to the start of the programme; T1: one year after the start of the programme.

Table 1. Demographic characteristics of people with ABI (n = 62).

Characteristic	Outcome
Sex: Males, n (%)	35 (57)
Age in years, mean ± SD (range)	52.4 ± 11.6 (22–76)
Education level: n (%)^a
Low	43 (69)
Medium	13 (21)
High	2 (3)
Employment status: n (%)
Employed, before injury	45 (73)
Employed, at start of Brainz programme	6 (10)
Type of household: n (%), n = 61
One-person	17 (28)
Multi-person	42 (69)
Not specified	2 (3)

^aHighest educational level achieved; Low = primary school, lower vocational education; Medium = secondary school, secondary vocational education; High = higher education.

Table 2. Medically relevant characteristics of people with ABI (n = 61).

Characteristic	Outcome
Time since injury in years, mean ± SD (range)	5.2 ± 4.5 (1–19)
Age at injury in years, mean ± SD (range)	47.1 ± 13.8 (18–73)
Cognitive functioning (MoCA), mean ± SD (range), n = 59	23.9 ± 4.1 (7–30)
Cause of injury: n (%)
Traumatic brain injury	15 (25)
Stroke	33 (54)
Brain tumour	5 (8)
More than one of above-mentioned	5 (8)
Other^a	4 (5)

MoCA: Montreal Cognitive Assessment (scores 0–30; score of < 26 = mild cognitive impairment).

^aHypoxia (n = 2), inflammation (n = 1), not specified (n = 1).

Table 3. Mean scores on the primary outcome measures.

Questionnaire	N	T0 measurement mean ± SD	T1 measurement mean ± SD	t	p-value
Person with ABI
Participation (USER-P)
Frequency	47	29.9 ± 9.2	31.4 ± 9.4	1.5	.145
Restrictions	46	69.1 ± 19.4	71.4 ± 15.1	1.1	.275
Satisfaction	47	57.2 ± 17.0	65.9 ± 13.6	3.4	.001*
Need of care questionnaire
Perceived difficulties in daily life	47	4.6 ± 2.4	3.6 ± 2.2	−3.0	.005*
Perceived difficulties for which person is in need of care	43	3.7 ± 2.1	2.7 ± 1.9	−3.2	.003*
Self-esteem (RSES)	47	13.5 ± 5.6	11.3 ± 4.4	−2.9	.006*
Family caregiver
Perceived burden of care (CSI)	24	7.9 ± 3.6	6.1 ± 3.7	3.4	.002*

T0: prior to the start of the programme; T1: one year after the start of the programme; USER-P: Utrecht Scale for Evaluation of Rehabilitation-Participation (scores 0–100; higher = better participation); Need of Care Questionnaire (scores 0–10; higher = more difficulties/in need of care); RSES: Rosenberg Self-Esteem Scale (scores 0–30; higher = higher self-esteem); CSI: Caregiver Strain Index (scores 0–13; higher = higher burden).

*Significant difference between T0 and T1 measurement scores, p < .01.

Table 4. Median scores on the goal attainment thermometer, per module.

Cognitive module	N	Median (IQR)	Range	Z^a	p-value
Dealing with change
How well do you score now? (prior to module)	37	3.8 (2.25)	0–7	5.0	.000*
How well do you intend to score at the end of the module?	36	8 (2.0)	1–10	2.8	.006*
How well do you score now, after having completed the module?	37	7 (2.0)	3–10	–	–
Getting a grip on your energy
How well do you score now? (prior to module)	14	3 (2.3)	1–6	3.2	.001*
How well do you intend to score at the end of the module?	14	8 (2.0)	4–10	1.1	.278
How well do you score now, after having completed the module?	14	7.5 (2.38)	3–9	–	–
Thinking and doing
How well do you score now? (prior to module)	8	5 (2.0)	2–6	2.5	.012
How well do you intend to score at the end of the module?	8	8 (0.0)	7–9	1.9	.059
How well do you score now, after having completed the module?	8	7.8 (1.0)	7–8	–	–

Range of thermometer scores 1–10.

^aThe intended score (“How well do you intend to score at the end of the module?”) and the score at the start of the module are compared to the score at the end of the module.

*Significant difference between scores, p < .01.

Table 5. Mean scores on the secondary outcome measures.

Questionnaire	N	T0 measurement mean ± SD	T1 measurement mean ± SD	t	p-value
Person with ABI
Functional status (COOP/WONCA)
Physical fitness	47	2.9 ± 1.1	2.5 ± 1.0	2.1	.038
Feelings	47	2.6 ± 1.2	2.4 ± 0.9	0.8	.406
Daily activities	47	2.6 ± 1.1	2.3 ± 1.2	1.6	.128
Social activities	47	2.4 ± 1.3	2.1 ± 1.2	1.5	.151
Overall health	47	2.9 ± 0.9	2.9 ± 0.9	0.1	.890
Neuropsychiatric symptoms (NPI-Q, frequency x severity)	22	24.8 ± 15.9	15.3 ± 16.9	3.6	.002*
Balance (Berg Balance Scale)	31	50 (9)^a	54 (5)^a	4.2^b	.000*
Functional mobility (10 metre timed walking test, walking speed in m/s)	27	1.1 (0.7)^a	1.3 (0.7)^a	3.0^b	.003*
Family caregiver
Life satisfaction (as measured by domain “life as a whole” of LiSat-9)	24	4.0 ± 1.3	4.5 ± 0.9	2.5	.022

T0: prior to the start of the programme; T1: one year after the start of the programme; COOP/WONCA: Darthmouth COOP Functional Health Assessment Charts/World Organisation of Family Doctors (scores 1–5; lower = better health); NPI-Q: Neuropsychiatric Inventory-Questionnaire (scores 1–144; higher = higher frequency and severity); Berg Balance Scale (scores 0–56; higher = better balance); LiSat-9: Life Satisfaction Questionnaire-9 (scores 0–5; higher = more satisfaction).

^aMedian (IQR); ^bZ statistic.

*Significant difference between T0 and T1 measurement scores, p < .01.