Team-based rehabilitation after mild traumatic brain injury – description of the clinical pathway

ABSTRACT

Purpose

Describe clinical practice, inter-disciplinary clinical pathway and core principles of care within a mild traumatic brain injury (mTBI) rehabilitation team.

Methods

An observational study examined inter-disciplinary practice, nested within an observational trial investigating team-based mTBI rehabilitation. Data were collected to describe clinical service over 12 months. Activity data quantified clinical sessions per participant, mode of service delivery and content of sessions using custom-designed codes. The clinical team gathered narrative data to confirm the inter-disciplinary clinical pathway and individual discipline practice.

Results

168 participants entered the rehabilitation program during the 12 months. A single Allied Health Screening Assessment identified patient priorities. Occupational Therapy (OT) and Physiotherapy (PT) provided the majority of clinical sessions; the team also comprised Social Work, Rehabilitation Medicine, Speech Pathology and Clinical Psychology. Telehealth was the most common service delivery mode (54%). Median session numbers per participant ranged 1–4 for all disciplines; mean/maximum occasions of service were highest for PT (6.9/44) and OT (6.8/39).

Conclusion

A small proportion of participants received much higher number of sessions, consistent with intractable issues after mTBI. High attendance rates indicate the predominantly telehealth-delivered model was feasible. The clinical approach included early prioritizing of discipline input and follow-up after discharge.

KEYWORDS:

• Concussion
• post-concussion symptoms
• head injury
• physical therapy
• telerehabilitation

Acknowledgments

This work was grant funded by the Lifetime Support Authority of South Australia (grant GA00052). The funders played no role in the design, conduct, or reporting of this study. Dr Maggie Killington’s leadership in design and analysis of the parent study is acknowledged. Thanks to the Central Adelaide Local Health Network and South Australian Brain Injury Rehabilitation Service for their support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2024.2347570

Additional information

Funding

The work was supported by the Lifetime Support Authority of South Australia [GA00052].