Measurement of the outcomes in acquired brain injury in a neurorehabilitation unit. A long-term study

Introduction. Following sudden brain damage, there is a loss of capabilities that affects the person's autonomy. Recovery from the physical, psychic and cognitive sequelae requires the application of multiple therapies, the outcomes of which need to be measured objectively. Our aim is to analyse the application of standardised instruments in determining the therapeutic outcomes in acquired brain injury. Patients and methods. We conducted a retrospective descriptive observational study lasting 13 months. Both epidemiological and clinical data were analysed: elapsed time since onset, degree of independence (Barthel index), presence of spasticity and treatment with botulinum toxin. Outcomes were measured using Goal Attainment Scaling and the Rehabilitation Complexity Scale, pre-and post-treatment. Results. We reviewed a total of 45 patients, 60% of them having suffered a stroke. Spasticity was present in 19 patients, and 42% were treated with botulinum toxin infiltration. All of them underwent goal-setting treatment; in 84% of the cases more than one goal was planned, and the most prevalent was gait re-education. With the use of the scales it was observed that the patients with the greatest initial complexity had more difficulty to achieve the goals that had been set, although there was a higher degree of improvement in comparison to their prior status. Conclusion. The initial situation in terms of dependence and the degree of complexity of the needs of patients with brain damage correlate with the final situation after a programme of neurorehabilitation therapy. This reflects the importance of using scales like Goal Attainment Scaling and the Rehabilitation Complexity Scale, pre-and post-treatment.