Progress assessed with the Mayo-Portland Adaptability Inventory in 604 participants in 4 types of post-inpatient rehabilitation brain injury programs

Vicki Eicher, Mary Pat Murphy, Thomas F. Murphy, James F. Malec

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: To compare progress in 4 types of post-inpatient rehabilitation brain injury programs. Design: Quasiexperimental observational cohort study. Setting: Community and residential. Participants: Individuals (N=604) with acquired brain injury. Interventions: Four program types within the Pennsylvania Association of Rehabilitation Facilities were compared: intensive outpatient and community-based rehabilitation (IRC; n=235), intensive residential rehabilitation (IRR; n=78), long-term residential supported living (SLR; n=246), and long-term community-based supported living (SLC; n=45). With the use of a commercial web-based data management system developed with federal grant support, progress was examined on 2 consecutive assessments. Main Outcome Measure: Mayo-Portland Adaptability Inventory (MPAI-4). Results: Program types differed in participant age (F=10.69, P<.001), sex (χ 2=22.38, P<.001), time from first to second assessment (F=20.71, P<.001), initial MPAI-4 score (F=6.89, P<.001), and chronicity (F=13.43, P<.001). However, only initial MPAI-4 score and chronicity were significantly associated with the second MPAI-4 rating. On average, SLR participants were 9.1 years postinjury compared with 5.1 years for IRR, 6.0 years for IRC, and 6.8 years for SLC programs. IRR participants were more severely disabled per MPAI-4 total score on admission than the other groups. Controlling for these variables, program types varied significantly on second MPAI-4 total score (F=5.14, P=.002). Both the IRR and IRC programs resulted in significant functional improvement across assessments. In contrast, both the SLR and SLC programs demonstrated relatively stable MPAI-4 scores. Conclusions: Results are consistent with stated goals of the programs; that is, intensive programs resulted in functional improvements, whereas supported living programs produced stable functioning. Further studies using data from this large, multiprovider measurement collaboration will potentially provide the foundation for developing outcome expectations for various types of postacute brain injury programs.

Original languageEnglish
Pages (from-to)100-107
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Volume93
Issue number1
DOIs
StatePublished - Jan 2012

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Brain Injuries
Inpatients
Rehabilitation
Equipment and Supplies
Organized Financing
Information Systems
Observational Studies
Cohort Studies
Outpatients
Outcome Assessment (Health Care)
insulin receptor-related receptor

Keywords

  • Brain injuries
  • Outcome measure
  • Rehabilitation

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Progress assessed with the Mayo-Portland Adaptability Inventory in 604 participants in 4 types of post-inpatient rehabilitation brain injury programs. / Eicher, Vicki; Murphy, Mary Pat; Murphy, Thomas F.; Malec, James F.

In: Archives of Physical Medicine and Rehabilitation, Vol. 93, No. 1, 01.2012, p. 100-107.

Research output: Contribution to journalArticle

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abstract = "Objective: To compare progress in 4 types of post-inpatient rehabilitation brain injury programs. Design: Quasiexperimental observational cohort study. Setting: Community and residential. Participants: Individuals (N=604) with acquired brain injury. Interventions: Four program types within the Pennsylvania Association of Rehabilitation Facilities were compared: intensive outpatient and community-based rehabilitation (IRC; n=235), intensive residential rehabilitation (IRR; n=78), long-term residential supported living (SLR; n=246), and long-term community-based supported living (SLC; n=45). With the use of a commercial web-based data management system developed with federal grant support, progress was examined on 2 consecutive assessments. Main Outcome Measure: Mayo-Portland Adaptability Inventory (MPAI-4). Results: Program types differed in participant age (F=10.69, P<.001), sex (χ 2=22.38, P<.001), time from first to second assessment (F=20.71, P<.001), initial MPAI-4 score (F=6.89, P<.001), and chronicity (F=13.43, P<.001). However, only initial MPAI-4 score and chronicity were significantly associated with the second MPAI-4 rating. On average, SLR participants were 9.1 years postinjury compared with 5.1 years for IRR, 6.0 years for IRC, and 6.8 years for SLC programs. IRR participants were more severely disabled per MPAI-4 total score on admission than the other groups. Controlling for these variables, program types varied significantly on second MPAI-4 total score (F=5.14, P=.002). Both the IRR and IRC programs resulted in significant functional improvement across assessments. In contrast, both the SLR and SLC programs demonstrated relatively stable MPAI-4 scores. Conclusions: Results are consistent with stated goals of the programs; that is, intensive programs resulted in functional improvements, whereas supported living programs produced stable functioning. Further studies using data from this large, multiprovider measurement collaboration will potentially provide the foundation for developing outcome expectations for various types of postacute brain injury programs.",
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