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.
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