Evaluation of a community-based neuropsychological rehabilitation service for people with traumatic brain injury

Objectives: To determine whether a community-based, interdisciplinary, traumatic brain injury (TBI) team was more beneficial than existing services, and whether Early was better than Late intervention. Design: Subjects were consecutive hospital admissions. Assignment, to pre-discharge (Early), post-discharge (Late) intervention or control condition (existing services only), was by a prespecified timetable. Outcomes were compared at six months post-injury using logistic regression analyses. Results: 104 (73) of those eligible participated. Adjusting for potential confounding factors confirmed a clinically plausible superior outcome for both intervention groups compared to the control group in some areas but not others. These were not statistically significant (p > 0.01). Conclusions: The lack of evidence of effectiveness must be treated with caution due to limitations with certain design issues (e.g statistical power). Analysis of intervention data suggested that team-working took place but lack of experience may have hindered their efficacy at identifying all those in need of intervention.