Early Intensive Rehabilitation for Patients with Traumatic Brain Injury: A Prospective Pilot Trial

World Neurosurg. 2020 May:137:e183-e188. doi: 10.1016/j.wneu.2020.01.113. Epub 2020 Jan 27.

Abstract

Objective: To investigate the effects of early intensive rehabilitation management on the recovery of motor function and activities of daily living in patients with moderate traumatic brain injury.

Methods: Eighty-seven patients (age range, 18-65 years) with traumatic brain injury that met the enrollment criteria were randomly divided into 2 groups. Group 1 received early and high-intensity rehabilitation management (from 7 days after injury, 7 d/wk, 4 times/d, 1 h/session) for 4 weeks; group 2 received ordinary rehabilitation (from 14 days after injury, 5 d/wk, 2 times/d, 1 h/session) for 4 weeks. The Fugl-Meyer Assessment (FMA, motor function) and Barthel Index (BI) were used to assess the daily living functional state before treatment, 3 months after injury, and 6 months after injury. The Glasgow Coma Scale (GCS) was used to assess outcomes 6 months after injury.

Results: Three months after rehabilitation, the FMA (motor function) score was significantly higher in the early intensive intervention group versus the control group (59.83 ± 11.87 vs. 44.56 ± 8.32, respectively; P < 0.05); no significant between-group differences were found in the GCS score or BI score (P > 0.05). Six months after rehabilitation, the FMA score and BI score were significantly higher in the early intensive intervention group versus the control group (FMA: 73.18 ± 16.55 vs. 57.86 ± 10.67, P < 0.01; BI: 87.17 ± 13.85 vs. 60.68 ± 11.98, P < 0.01, respectively). The GCS score was higher in the early intensive intervention group versus the control group (4.24 ± 0.91 vs. 3.43 ± 0.88, P < 0.05, respectively) 6 months after injury.

Conclusions: Early intensive rehabilitation management might be more beneficial for neurologic function and activities of daily living in patients with moderate traumatic brain injury.

Keywords: Barthel Index; Fugl-Meyer Assessment; Glasgow Outcome Scale; Rehabilitation management; Traumatic brain injury.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Brain Injuries, Traumatic / physiopathology
  • Brain Injuries, Traumatic / rehabilitation*
  • Early Medical Intervention / methods
  • Female
  • Glasgow Coma Scale
  • Humans
  • Male
  • Middle Aged
  • Neurological Rehabilitation / methods*
  • Pilot Projects
  • Prospective Studies
  • Recovery of Function*