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Long-Term Maintenance of Gains Obtained in Postacute Rehabilitation by Persons with Traumatic Brain Injury

Sander, Angelle M. PhD*; Roebuck, Tresa M. PhD*; Struchen, Margaret A. PhD*; Sherer, Mark PhD, ABPP/Cn; High, Walter M. Jr. PhD*

Journal of Head Trauma Rehabilitation: August 2001 - Volume 16 - Issue 4 - p 356–373
Original Article

Objective: To investigate maintenance of gains after discharge from a postacute rehabilitation program.

Design: Longitudinal cohort study, with inclusion based on availability of subjects at three time points.

Setting: Comprehensive postacute rehabilitation program in the Southern United States.

Participants: Thirty-four persons with medically documented complicated mild to severe traumatic brain injury; primarily male Caucasians with some college.

Main Outcome Measures: Disability Rating Scale and the Community Integration Questionnaire completed at admission, discharge, and two follow-up time points.

Results: Repeated measures analyses, using time from injury to discharge as a covariate, revealed significant improvements on all measures from admission to discharge, with no significant change from discharge to either of the follow-up periods. However, substantial changes were noted in individual cases.

Conclusions: The results indicate that gains made by persons with traumatic brain injury during postacute rehabilitation are generally maintained at long-term follow-up, but changes occur in individual cases. Long-term services may help prevent decline in individual cases.

Assistant Professor (Sander)

Postdoctoral Fellow (Roebuck)

Assistant Professor (Struchen)

Assistant Professor (Sherer)

Assistant Professor (High)

* Department of Physical Medicine and Rehabilitation, TIRR Brain Injury Research Center, Baylor College of Medicine, Houston, Texas.

Department of Neuropsychology, Methodist Rehabilitation Center, Departments of Neurology and Psychiatry, University of Mississippi Medical Center, Jackson, Mississippi.

This work was partly supported by grants #H133A70015, #H133B40002, and #H133B990014 from the National Institute on Disability and Rehabilitation Research, United States Department of Education.

Address correspondence and reprint requests to: Angelle M. Sander, PhD, Brain Injury Research Center, 2455 South Braeswood, Houston, TX 77030. Phone 713-666-9550, Fax 713-383-5695. email:

© 2001 Lippincott Williams & Wilkins, Inc.