A Comparison of Rehabilitation Outcome Measures for Traumatic Brain Injury

Abstract

This study evaluates the appropriateness, responsiveness, and predictive ability of the Modified Barthel Index (MBI), the Disability Rating Scale (DRS), the Barry Rehabilitation In-patient Screening of Cognition (BRISC), and the Glasgow Coma Scale (GCS) for 78 patients with traumatic brain injury referred for in-patient rehabilitation. Appropriateness was evaluated by examining means, standard deviations, coefficients of variation, and ceiling and floor effects. Responsiveness was determined by examining paired t-test results for admission and discharge scores, and on the basis of an effect size calculation. Predictive power was evaluated by performing two stepwise regressions with length of rehabilitation and total length of hospital stay. The results suggest that although the DRS and GCS have some advantages, notably in low ceiling and floor effects, overall the MBI is the most effective measure, particularly for prediction, with a moderate coefficient of determination (r2 = 0.42) and no significant differences between predicted and real length of hospital stay.