Home Rehabilitation May Help Those With Brain Injuries
David Cifu, MD, who reviewed the study for WebMD, agrees. Cifu, the Herman J Flax Professor and chairman of the Department of Physical Medicine and Rehabilitation at Virginia Commonwealth University, says that only patients who got a high score on a standardized evaluation exam were chosen for this study.
"This sample is not indicative of the brain-injured population at large," he says. "This is a very specific population of military active-duty personnel, and all of them were highly functional before entering the study."
The only patients in which a significant difference was seen for the hospital and home rehabilitation programs were those who had been unconscious for more than an hour after their initial injuries. Patients in this group who underwent the in-hospital program returned to work at a rate of 80%, compared to 58% for those who underwent the home program. This may show that hospital rehabilitation is beneficial to a select few of the traumatically brain-injured.
Cifu believes this study has little applicability for most of the population. And because the patients were evaluated at the beginning of therapy and then a year later, he says, it is impossible to judge what impact the therapy actually had.
"Measurements need to be taken immediately before and after intervention," he says. "This study is suggestive that in the [period immediately after a] brain injury, intensity of services does not have a great impact on one year outcomes. The intense services may have helped them get better more rapidly, but at a year it kind of all evens out."