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Published in: Neurological Research and Practice 1/2024

Open Access 01-12-2024 | Research article

Effects of transsectoral long-term neurorehabilitation

Authors: Mareike Schrader, Annette Sterr, Tobias Strank, Stephan Bamborschke, Christian Dohle

Published in: Neurological Research and Practice | Issue 1/2024

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Abstract

Background

Acquired brain injuries are among the most common causes of disability in adulthood. An intensive rehabilitation phase is crucial for recovery. However, there is a lack of concepts to further expand the therapeutic success after the standard rehabilitation period. Hereafter, the characteristics of a transsectoral, multiprofessional long-term neurorehabilitation concept and its effects on outcome at different ICF levels are described.

Methods

The P.A.N. Center for Post-Acute Neurorehabilitation combines living with 24/7 support of pedagogical staff with on-site outpatient therapy and medical care. A secondary data analysis was conducted on the records of all patients with completeted P.A.N. treatment between 01.01.2015 and 09.04.2022. Outcome parameters included demographic characteristics, diagnostics, Barthel Index (BI), the German scale „Hilfebedarf von Menschen mit Behinderung für den Lebensbereich Wohnen “ (HMBW), the Canadian Occupational Performance Measure (COPM) and the destination after discharge. For BI and discharge destination, potential determinants of therapy success are evaluated.

Results

168 patients were enrolled in the analyses. Significant improvements were observed in the BI (p < .001), with median values increasing from 55 to 80 points. The HMBW showed a significant decrease in the need for assistance in everyday living (p < .001), individual basic care (p < .001), shaping social relationship (p = .003) and communication (p < .001). Significant improvements were reported in the COPM total score for performance (p < .001) and satisfaction (p < .001). 72% of the patients were able to move in a community living arrangement with moderate need for support. Main predictive factor for discharge destination was the initial cognitive deficit. The comparison of the third-person scales BI and HMBW with the self-reported COPM showed that individually formulated patient goals are only insufficiently reflected in these global scales.

Discussion

The data show that a highly coordinated, trans-sectoral 24/7 approach of goal-oriented practice as pursued at P.A.N. is feasible and effective. We assume that the success of the intervention is due to the high intensity of therapies delivered over a long time and its interlink with real world practice. For a comprehensive analysis of rehabilitation success, it is necessary to record and evaluate individual patient goals, as these are not always reflected in the commonly used global scales.
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Literature
2.
go back to reference James, S. L., Theadom, A., Ellenbogen, R. G., Bannick, M. S., Montjoy-Venning, W., Lucchesi, L. R., et al. (2019). Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18, 56–87. https://doi.org/10.1016/S1474-4422(18)30415-0CrossRef James, S. L., Theadom, A., Ellenbogen, R. G., Bannick, M. S., Montjoy-Venning, W., Lucchesi, L. R., et al. (2019). Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18, 56–87. https://​doi.​org/​10.​1016/​S1474-4422(18)30415-0CrossRef
3.
go back to reference Feigin, V. L., Stark, B. A., Johnson, C. O., Roth, G. A., Bisignano, C., Abady, G. G., et al. (2021). Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology, 20, 795–820. https://doi.org/10.1016/S1474-4422(21)00252-0CrossRef Feigin, V. L., Stark, B. A., Johnson, C. O., Roth, G. A., Bisignano, C., Abady, G. G., et al. (2021). Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology, 20, 795–820. https://​doi.​org/​10.​1016/​S1474-4422(21)00252-0CrossRef
5.
go back to reference Bundesarbeitsgemeinschaft für Rehabilitation, editor. Empfehlungen zur Neurologischen Rehabilitation von Patienten mit schweren und schwersten Hirnschädigungen der Phasen B und C. Frankfurt/Main: Bundesarbeitsgemeinschaft für Rehabilitation (1999). Bundesarbeitsgemeinschaft für Rehabilitation, editor. Empfehlungen zur Neurologischen Rehabilitation von Patienten mit schweren und schwersten Hirnschädigungen der Phasen B und C. Frankfurt/Main: Bundesarbeitsgemeinschaft für Rehabilitation (1999).
10.
go back to reference Zein, K., & Saal, S. (2017). Ambulante Nachsorge von chronischen Schlaganfallpatienten mit Physiotherapie, Ergotherapie und Logopädie Long-term care for stroke patients 12 months after discharge with physiotherapy, occupational therapy and speech therapy. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, 27, 275–284.CrossRef Zein, K., & Saal, S. (2017). Ambulante Nachsorge von chronischen Schlaganfallpatienten mit Physiotherapie, Ergotherapie und Logopädie Long-term care for stroke patients 12 months after discharge with physiotherapy, occupational therapy and speech therapy. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, 27, 275–284.CrossRef
13.
go back to reference Weltgesundheitsorganisation, editor (2001) International classification of functioning, disability and health: ICF. Geneva: World Health Organization. Weltgesundheitsorganisation, editor (2001) International classification of functioning, disability and health: ICF. Geneva: World Health Organization.
14.
go back to reference Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The barthel index. Maryland State Medical Journal, 14, 16–65. Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The barthel index. Maryland State Medical Journal, 14, 16–65.
15.
go back to reference Heuschmann, P. U., Kolominsky-Rabas, P. L., Nolte, C. H., Hünermund, G., Ruf, H.-U., Laumeier, I., et al. (2005). Untersuchung der Reliabilität der deutschen Version des Barthel-Index sowie Entwicklung einer postalischen und telefonischen Fassung für den Einsatz bei Schlaganfall-Patienten. Fortschritte der Neurologie Psychiatrie, 73, 74–82. https://doi.org/10.1055/s-2004-830172CrossRefPubMed Heuschmann, P. U., Kolominsky-Rabas, P. L., Nolte, C. H., Hünermund, G., Ruf, H.-U., Laumeier, I., et al. (2005). Untersuchung der Reliabilität der deutschen Version des Barthel-Index sowie Entwicklung einer postalischen und telefonischen Fassung für den Einsatz bei Schlaganfall-Patienten. Fortschritte der Neurologie Psychiatrie, 73, 74–82. https://​doi.​org/​10.​1055/​s-2004-830172CrossRefPubMed
16.
go back to reference Schönle, P. W. (1995). The Early Rehabilitation Barthel Index–an early rehabilitation-oriented extension of the Barthel Index. Rehabilitation (Stuttg), 34, 69–73.PubMed Schönle, P. W. (1995). The Early Rehabilitation Barthel Index–an early rehabilitation-oriented extension of the Barthel Index. Rehabilitation (Stuttg), 34, 69–73.PubMed
17.
go back to reference Metzler, H. (1997). Hilfebedarf und Selbstbestimmung. Eckpunkte des Lebens im Heim für Menschen mit Behinderung. Zeitschrift Für Heilpädagogik, 48, 406–411. Metzler, H. (1997). Hilfebedarf und Selbstbestimmung. Eckpunkte des Lebens im Heim für Menschen mit Behinderung. Zeitschrift Für Heilpädagogik, 48, 406–411.
18.
go back to reference Law, M., Baptiste, S., Carswell, A., Law, M. C., Dehnhardt, B., & George, S., et al. (2015). COPM: Canadian Occupational Performance Measure, 5th Edition. Vol. 3. vollständig überarb. Aufl. 2015. Idstein: Schulz-Kirchner. Law, M., Baptiste, S., Carswell, A., Law, M. C., Dehnhardt, B., & George, S., et al. (2015). COPM: Canadian Occupational Performance Measure, 5th Edition. Vol. 3. vollständig überarb. Aufl. 2015. Idstein: Schulz-Kirchner.
24.
25.
28.
go back to reference Robert Bosch Stiftung. Memorandum Kooperation der Gesundheitsberufe. Qualität und Sicherung der zukünftigen Gesundheitsversorgung. n.d. Robert Bosch Stiftung. Memorandum Kooperation der Gesundheitsberufe. Qualität und Sicherung der zukünftigen Gesundheitsversorgung. n.d.
Metadata
Title
Effects of transsectoral long-term neurorehabilitation
Authors
Mareike Schrader
Annette Sterr
Tobias Strank
Stephan Bamborschke
Christian Dohle
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Neurological Research and Practice / Issue 1/2024
Electronic ISSN: 2524-3489
DOI
https://doi.org/10.1186/s42466-023-00302-3

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