Effectiveness of a multidisciplinary rehabilitation program for persons with acquired brain injury and executive dysfunction

Abstract

Purpose: The purpose of this study is to explore the effects of a multidisciplinary acquired brain injury rehabilitation out-patient program (5 d/week for 7 weeks) on improvements to participants’ activity and participation outcomes related to meal preparation and to determine whether gains are maintained at 3 and 6 months post program.

Methods: A single case experimental design with repeated measures pre- and post-intervention with 7 adult participants with ABI and executive dysfunction (4 females, mean age 38 ± 10.1 years) was used.

Results: A strong improvement effect between pre and post phases was found for number of errors on the Cooking Task for 6/7 participants; four participants showed significant improvement immediately after the program and at 3 and 6 months post. Six out of seven participants improved significantly on the Instrumental Activities of Daily Living Profile and four participants improved between the post and 6 month follow-up. Four out of seven participants showed significantly improved Life Habits scores pre- versus post-program.

Conclusions: Significant improvements were observed in activity and participation outcomes related to preparing a meal in adults with ABI and executive dysfunction who participated in a 7-week multidisciplinary rehabilitation out-patient program. Treatment gains were maintained for the majority of participants at 3 and 6 months following the program.

Implication of Rehabilitation

• A 7-week multidisciplinary rehabilitation out-patient program appears to improve activities and participation; the effects are sustainable after 6 months.

• A detailed description of the therapeutic interventions provided during the cooking activity should help clinicians better understand what specific functions are solicited or required during a particular activity.

• Knowledge from this study may help guide clinicians in their work within this complex area of rehabilitation.

Keywords:

• Effectiveness
• acquired brain injury
• rehabilitation
• participation

Acknowledgements

The authors thank the participants, the program therapists and the evaluators who assessed the subjects.

Disclosure statement

Three of the authors participated in the rehabilitation program; however, assessors were not in the program.

Additional information

Funding

The first author received scholarship funding from ‘France Traumatisme Crânien-Société Française de Médecine Physique et de Réadaptation’, the ‘Fondation des Gueules Cassées’, the ‘Fond Européen et Francophone le Développement de la Recherche en Ergothérapie’, the ‘Région Ile de France’ as well as from the Mission recherche de la direction de la recherche, des études, de l’évaluation et des statistiques (MiRe-DREES), the Caisse Nationale de Solidarité pour l’Autonomie (CNSA) and the Institut de Recherche en Santé Publique IReSP (ReSP-11-HAND1–17; France); as well as from the ‘Université de Montréal’ and the ‘Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal’ (Canada).