Factors predicting rehabilitation outcomes after severe acquired brain injury in trauma stroke and anoxia populations A cohort study

Severe acquired brain injury has long-term physical and
cognitive effects. Identifying patient variables predictive of
recovery in different brain injury populations would
generate improved prognostic information and help
rehabilitation teams set appropriate therapeutic goals. This
cohort study of 447 NHS neurorehabilitation inpatients
aimed to identify functional and cognitive predictors of
recovery following severe acquired brain injury caused by
trauma, stroke and anoxia. Motor and cognitive impairment
ratings were collected at admission and discharge using the
Functional Independence Measure and Functional
Assessment Measure (FIM+FAM), and injury-related and
demographic data were collated from medical records.
Predictors of physical, cognitive and overall recovery were
identified via hierarchical regression analyses. Several key
findings emerged. Firstly, on-admission motor skills
predicted functional and overall outcomes across groups.
Secondly, on-admission social interaction skills predicted
cognitive discharge outcomes in stroke and trauma, and
overall outcomes for stroke, but did not predict anoxia
outcomes. Thirdly, age predicted all forms of recovery for
stroke only. Further group-specific factors were also
identified as predicting motor and cognitive recovery,
indicating that factors key to the rehabilitation trajectory
may differ between populations. These variables should be
considered in rehabilitation goal planning, although further
research is required to explore their contributions to recovery.