Amy L Alderso1, Thomas A Novack. 1. Inpatient Neuropsychology, Acquired Brain Injury Program, Shepherd Center, Atlanta, Georgia 30309-1402, USA.
Abstract
OBJECTIVES: To further evaluate the use of the orientation log (O-Log) in an acute rehabilitation program for adults with traumatic brain injury (TBI), specifically focusing on prediction of rehabilitation outcome, possible use of the O-Log to promote recovery, and development of templates of orientation recovery. DESIGN: Stepwise discriminant function analysis was used in one study and ANOVA based on between-groups comparisons in another. Confidence intervals were established in the third study. SETTING: Acute rehabilitation hospital. PATIENTS: Samples were taken from an overall pool of 389 subjects with predominantly severe TBI based on Glasgow Coma Scale score. RESULTS: A combination of initial O-Log performance, time since injury, and number of O-Log assessments correctly predicted resolution of disorientation for 76% of the sample. Individuals attaining orientation before discharge achieved higher discharge scores on functional measures. Administration of the O-Log 3 versus 5 times a week did not result in more rapid resolution of disorientation. A similar pattern of steady improvement in orientation was evident for mild-moderate and severe injury cases across 10 administrations. CONCLUSIONS: Recovery of orientation provides important information about recovery following TBI and is predictive of rehabilitation outcome. More frequent administration of a formal orientation measure does not seem to expedite the recovery of orientation, which on average seems to progress at a steady pace in a rehabilitation setting regardless of the time since injury or severity of injury.
OBJECTIVES: To further evaluate the use of the orientation log (O-Log) in an acute rehabilitation program for adults with traumatic brain injury (TBI), specifically focusing on prediction of rehabilitation outcome, possible use of the O-Log to promote recovery, and development of templates of orientation recovery. DESIGN: Stepwise discriminant function analysis was used in one study and ANOVA based on between-groups comparisons in another. Confidence intervals were established in the third study. SETTING: Acute rehabilitation hospital. PATIENTS: Samples were taken from an overall pool of 389 subjects with predominantly severe TBI based on Glasgow Coma Scale score. RESULTS: A combination of initial O-Log performance, time since injury, and number of O-Log assessments correctly predicted resolution of disorientation for 76% of the sample. Individuals attaining orientation before discharge achieved higher discharge scores on functional measures. Administration of the O-Log 3 versus 5 times a week did not result in more rapid resolution of disorientation. A similar pattern of steady improvement in orientation was evident for mild-moderate and severe injury cases across 10 administrations. CONCLUSIONS: Recovery of orientation provides important information about recovery following TBI and is predictive of rehabilitation outcome. More frequent administration of a formal orientation measure does not seem to expedite the recovery of orientation, which on average seems to progress at a steady pace in a rehabilitation setting regardless of the time since injury or severity of injury.
Authors: Ronald T Seel; John D Corrigan; Marcel P Dijkers; Ryan S Barrett; Jennifer Bogner; Randall J Smout; William Garmoe; Susan D Horn Journal: Arch Phys Med Rehabil Date: 2015-08 Impact factor: 3.966