Research Reports - The effect of age on rehabilitation outcome after traumatic brain injury

Neurorehabil Neural Repair. 2014 Aug 4

Pedersen AR(1), Severinsen K(2), Nielsen JF(2)

Background. The impact of age on rehabilitation outcome after traumatic brain
injury (TBI) as measured by changes in the Functional Independence Measure (FIM)
has been addressed in several seemingly conflicting reports. Differences may be
explained by different study populations and different ways of analyzing data.
Objective. To investigate the role of data analysis in the interpretation of the
age effect on rehabilitation outcome after TBI by comparing classical analyses of
the total FIM score with a new item-wise analysis that unfolds the comprehensive
amount of information contained in the FIM measurement otherwise concealed by the
total score. Methods. We analyzed admission and discharge FIM data from 411
consecutive TBI patients admitted to inpatient rehabilitation during 1998-2011 by
both methods. Results. The classical analysis indicated similar rehabilitation
outcome in the 18 to 39, 40 to 64, and 65+ years age groups, which could be
explained by selection of strong elderly patients and/or methodological problems
with classical data analyses, whereas the item-wise analysis demonstrated
profound age effect on most FIM items throughout the age interval covered.
Conclusions. The item-wise analysis meets requirements of proper data analysis,
avoids concealing diversity in rehabilitation outcome behind the total FIM score,
and provides a flexible, informative, and clinically relevant data analysis.

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