We continually assess and evaluate the outcome of our rehabilitation programmes and commission research to further understanding of areas in need of advancement. Here we have provided an outcome evaluation report for a series of adults that have completed our home-based programme and a report on a survey that we commissioned to investigate the long-term impact of rehabilitation on children following a severe traumatic brain injury.
Patients with severe traumatic brain injury encounter limitations when trying to resume their previous lifestyle. Therefore, it is of great importance to the patient and their families to seek improvements in areas of concern in their daily lives. In addition, the results of such improvements are of interest to the case managers, lawyers and insurers that seek to optimise gains in the functional, emotional behavioural and vocational spheres of their clients recovery.
Our study into the effects of home-based rehabilitation, using the BICRO scale as a quantitative measure, has shown significant improvements in all measured categories between initial and final testing at the end of a home-based rehabilitation programme. Previous research indicates that self-report scales, of which BICRO is a typical example, tend to understate actual improvements and given this under-reporting effect, the significant improvements reported become very satisfactory.
Childhood is a constant adaptation to new demands and any physical insult to a childs brain may cause damage that has a manifestly negative effect on skills acquisition. Without effective rehabilitation most children with a severe traumatic brain injury require a high level of long term care and are unlikely to achieve remunerative employment during their working lives.
Trauma need not be the last word, as early coordinated intervention has shown to be the most beneficial approach for both the brain injured child and their insurer. Rehabilitation increases the likelihood of future employment and a more independent lifestyle, considerably improving the quality of life for the injured child and their family. These benfits will impact favourably on the eventual size of the award, so the financial cost of rehabilitation is a prudent investment for insurers.
The Brain Injury Community Rehabilitation Outcome scale is a well established and widely used quantitative measure for determining the level of handicap experienced by patients with neurological disease or acquired brain-injury and evaluating the outcome of rehabilitation.
The scales take the form of a self-administered questionnaire, with subjective ratings tapping limitations that people with brain injury experience when trying to resume their previous lifestyle. The BICRO scales may be described as a 'problem list' of handicap symptoms, based on the assumption that the more of these symptoms are present in a given client, the greater their subjective sense of disadvantage, the higher their level of handicap and the greater their level of care needs.
The scale is comprised of 6 self-rating scales, with between 2 and 6 areas of questioning each:
The BICRO scale is only suitable for clients who have already been discharged from hospital and are living in the community trying to cope with the demands of daily life.