The investigation of treatment outcomes for adults with chronic brain injury following intensive multidisciplinary treatment

Although communication sciences and disorders (COMD) research supports intensive treatment for individuals with chronic brain injury, funding to provide these services is limited. This study explored the use of interdepartmental university resources to provide an intensive, multidisciplinary chronic brain injury program. Methodologically, treatment regimes were designed with clinical faculty as practicum experiences for COMD master’s degree students. Subjects with a single onset head injury or cerebral vascular accident greater than one year were recruited to participate in the Intensive Treatment, Weekly Treatment or Control Groups. Pre, Post, and Post-Post Testing were used to measure cognitive-linguistic, quality of life and physical function. Additionally, treatment groups participated in electronic Experience Sampling Method (ESM) probes which queried their perception of happiness, tiredness, stress, and communication satisfaction throughout treatment using a Palm Zire 31 Personal Data Assistant. Both treatment programs were contextually-oriented, stressing functional multi-modality communication and compensatory techniques. Three hours of small and medium group COMD treatment were administered to the Weekly Group once weekly. The six subjects in the Intensive Group received a 35 hour weekly program including: COMD (12 hours), modified Tai Chi (3 hours), and psychological support for them and caregivers (4 ¼ hours). One-way repeated measures analysis of variance with partial eta squared effect size was used to analyze measures in the standardized battery. Intensive Group cognitive linguistic function appeared to significantly differ from the other groups on the Communication Activities of Daily Living-2 and Aphasia Diagnostic Profile Writing subtest suggestive of functional communication gains. Results of the ESM probes indicate that the Intensive Group was reportedly more happy and satisfied with their communication than the Weekly Group. The participants of the Intensive Group appeared to physically benefit from 3 weeks of modified Tai Chi in rate of ambulation. Limitations of the study, including self selection of treatment condition and differing severity across treatment groups, must be addressed by expanding the subject pool in follow-up research