Journal CME, April 2022: Functional motor improvement during inpatient rehabilitation among older adults with traumatic brain injury-Functional motor improvement

Functional motor improvement - article.pdf

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This study investigates motor function improvements in older adults with traumatic brain injury (TBI) receiving inpatient rehabilitation therapy. The retrospective cohort study utilized probabilistically linked Medicare administrative data and the National Trauma Data Bank. The investigation aimed to determine the proportion of patients demonstrating minimal detectable change (MDC) and minimally clinically important difference (MCID) in motor function from admission to discharge. It also identified factors linked to achieving MCID and favorable functional status at discharge.<br /><br />Key findings reveal that 84.1% of patients achieved the MDC threshold, and 68.6% achieved the MCID threshold from admission to discharge. Factors positively affecting the probability of achieving MCID were better cognitive function at admission, lower comorbidity burden, and longer lengths of stay, especially among patients with lower initial motor function scores. Age was associated with lower FIM-M discharge scores but did not significantly impact achieving MCID.<br /><br />Moreover, the study found that older adults, including those with initial low functional status, could achieve meaningful motor function improvements with sufficient length of stay in rehabilitation. This suggests the importance of IRF care and the need to consider baseline functional status and comorbidity burden in care planning for older patients with TBI, rather than focusing solely on the severity of the acute injury.<br /><br />The study concluded that older adults benefit from intensive rehabilitation, and functional and cognitive status should guide treatment planning. This underscores the need for better discharge planning and management to enhance recovery and outcomes for older adults with TBI. Additional research is necessary to further understand long-term outcomes and refine rehabilitation strategies for this population.

Keywords

motor function improvements

older adults

traumatic brain injury

inpatient rehabilitation

retrospective cohort study

Medicare data

National Trauma Data Bank

minimal detectable change

minimally clinically important difference

functional status