Activities of daily living retraining and goal attainment during posttraumatic amnesia.

Abstract

OBJECTIVE: It is uncertain whether therapy delivered during Post Traumatic Amnesia (PTA) following traumatic brain injury can be effective. This study used goal attainment scaling (GAS) to assess gains in activities of daily living (ADL) retraining during PTA and explored occupational therapists' perspectives on therapy delivery. METHOD: Forty-nine rehabilitation inpatients were provided with manualised ADL retraining during PTA. GAS goals were developed, scored at PTA emergence and their association with Functional Independence measure (FIM) examined. Four therapists were interviewed and thematic analysis conducted. RESULTS: From 104 GAS goals, 90% were achieved, T-scores changed significantly following intervention. Mean post-intervention T-score of 61.44 (SD=11.45) correlated significantly with FIM. Therapists highlighted benefits of therapy in PTA for therapeutic alliance, skill-building and meaningful occupation without agitation, noting fatigue as a challenge. CONCLUSION: GAS captured meaningful positive individual change following ADL retraining during PTA. Therapists indicated the intervention was generally beneficial and feasible.