Long-term maintenance of gains obtained in postacute rehabilitation by persons with traumatic brain injury

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.