This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Rice-Oxley, M. Articles by Turner-Stokes, L. Search for Related Content PubMed PubMed Citation Articles by Rice-Oxley, M. Articles by Turner-Stokes, L. Pubmed/NCBI databases Medline Plus Health Information Stroke Traumatic Brain Injury Social Bookmarking                         What's this?

Effectiveness of brain injury rehabilitation

St Richard's Hospital, Chichester, West Sussex, UK

Lynne Turner-Stokes

Regional Rehabilitation Unit, Northwick Park Hospital, Harrow, Middlesex, UK

Despite the problems posed by diversity of condition and the lack of agreement among researchers over what outcome to measure, there is now increasingly robust evidence for the effectiveness of rehabilitation in brain-injured populations.

Meta-analysis has demonstrated clearly that stroke units provide a better outcome than management on a general medical ward, at the level of survival, discharge destination and dependency. The extent of this advantage may be summarized in the following terms. For every 100 patients treated in a stroke unit, four deaths and two institutional admissions are avoided, and five patients are discharged home. This benefit appears to arise from a combination of good-quality acute management and the coordinated input of a multidisciplinary team. Therapy programmes are shown to be of benefit and intensive therapy programmes of somewhat greater benefit.

Smaller numbers and heterogeneity among the head-injured population tend to confound randomized controlled trial designs, but there is no good reason to suppose that brain injury resulting from trauma should be less responsive to similar good management principles than that arising from stroke.

In any event, we have progressed to a stage where the weight of evidence supports the notion that rehabilitation is effective, and nontreatment controls are ethically no longer acceptable. It is time now to unravel the threads of rehabilitation and consider which are the critical components. There are still many opportunities for comparison of different models for delivery of care, and the existing evidence for these is discussed.

Clinical Rehabilitation, Vol. 13, No. 1 suppl, 7-24 (1999)
DOI: 10.1191/026921599668051623


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				E. M.J. Steultjens, J. Dekker, L. M. Bouter, J. C.M. van de Nes, E. H.C. Cup, C. H.M. van den Ende, F. Landi, and R. Bernabei Occupational Therapy for Stroke Patients: A Systematic Review * Occupational Therapy for Stroke Patients: When, Where, and How? Stroke, March 1, 2003; 34(3): 676 - 687. [Abstract] [Full Text] [PDF]

				I. M Proot, H. H. Abu-Saad, G. G. Van Oorsouw, and J. J. Stevens Autonomy in Stroke Rehabilitation: the perceptions of care providers in nursing homes Nursing Ethics, January 1, 2002; 9(1): 36 - 50. [Abstract] [PDF]

				M. Hodes, B K MacDonald, C J Mummery, and D Heaney Health needs of asylum seekers and refugees BMJ, July 28, 2001; 323(7306): 229 - 229. [Full Text]

				S. Thornhill, G. M Teasdale, G. D Murray, J. McEwen, C. W Roy, and K. I Penny Disability in young people and adults one year after head injury: prospective cohort study BMJ, June 17, 2000; 320(7250): 1631 - 1635. [Abstract] [Full Text]