The delicate balance of measuring outcomes to meet needs
Rehabilitation Cognition, behaviour, type of injury, patient history and environment are some of the variables involved in assessing the psychological and societal benefits of neurorehabilitation.
It used to be thought that the value of neurorehabilitation for pervasive problems after brain injury was minimal, but new research* further evidences functional, cognitive and behavioural improvements even in those conditions. This is one of the key findings of a study following 229 patients nationwide.
“We looked at ‘hidden disability’,” explains Dr Sara da Silva Ramos Research Fellow at the Brain Injury Rehabilitation Trust.
"45% of patients had severe imparements, but 65% experienced impacts on dialy life."
“Memory, attention and other cognitive problems can present as moderate, but in fact have a major impact on day-to-day life. We found that 45 per cent of patients were rated as having severe impairments, but 65 per cent rated as severe on a measure of impact on daily life.
“Measurements need to be identified for different problems, goals, and stages of rehabilitation to best gauge patient needs. Some people appear to recover very well in hospital but things break down when they go home and it all ‘sinks in’. By supporting families so that they can adapt in the home environment, for example, and not have to resort to emergency services frequently, neurorehabilitation both improves human outcomes and reduces long-term costs.”
* The Independent Neurorehabilitation Providers Alliance study compared the sensitivity of six measures, including the Mayo Portland Adaptability Inventory (Malec & Lezak, 2003) , and the St Andrews-Swansea Neurobehavioural Outcome Scale (Alderman et al., 2011).