Abstract:
Objective: To determine if successful participants along different postacute brain injury (BI) rehabilitation pathways differ on demographic, injury-related, disability, and outcomes variables.

Design: Secondary analysis of pre-, post-, and 1-year follow-up data obtained in a previous study of specialized vocational services for persons with BI.

Setting: Outpatient BI rehabilitation clinic.

Participants: 114 persons with acquired BI.

Outcome Measures: Demographic and injury-related variables; Mayo-Portland Adaptability Inventory (MPAI); Vocational Independence Scale; .success. as defined by community-based employment (CBE) at 1-year follow-up. Interventions: Participants in three distinct rehabilitation pathways were studied: specialized vocational services only (SVS); SVS and a 3-hour/week Community Reintegration Outpatient Group (CROG); SVS and 6-hour/day Comprehensive Day Treatment (CDT).

Results: Percent (77-85%) in CBE at 1-year follow-up did not differ among the three pathways. CDT participants had more limited educational backgrounds, were less recently injured, and demonstrated greater disability and more impaired self-awareness than those receiving limited intervention (LI; i.e., SVS or CROG). MPAI scores for LI participants who were unsuccessful were similar in level to successful participants in
CDT. Logistic regression models were developed to predict probability of success with LI and CDT.

Conclusion: Different rehabilitation pathways result in CBE for a large percentage of persons with BI if intensity of service is appropriately matched to the severity of disability, time since injury, and other participant characteristics.