Post-acute Rehabilitation for People With Traumatic Brain Injury: A Model Description and Evaluation of the Liverpool Hospital Transitional Living Program

Abstract

Transitional Living Programs (TLPs) have been a standard component of traumatic brain injury (TBI) rehabilitation services for over two decades. The twofold aim of this study was to describe a TLP service model, and to examine the efficacy of standardised TBI-specific outcome scales for TLPs. A consecutive series of 50 residents admitted to the TLP over an 18-month period were administered a number of outcome measures at both admission and discharge. Mean duration of PTA for the sample was 60 days and average length of stay was 7 weeks. Measures included the Sydney Psychosocial Reintegration Scale (SPRS), the Mayo-Portland Adaptability Inventory (MPAI), the Brain Injury Community Rehabilitation Outcome (BICRO) scales and the Assessment of Living Skills and Resources Scale (ALSAR). Results showed significant improvements in the global scores for the SPRS, MPAI and ALSAR from admission to discharge. In contrast, a number of the BICRO scales exhibited floor or ceiling effects. Correlational analysis found moderate to strong associations between the SPRS, MPAI and ALSAR across a number of functional domains. Results to date show promise in identifying measures that are able to detect change over the course of a TLP admission. The findings lay the foundation for ongoing research into the effectiveness of such programs.