This study describes the course of the recovery of functional skills in adults with severe head injuries during a 2-year period. Eighty head-injured patients admitted to an inpatient rehabilitation unit were included in this study. Length of coma could be ascertained for 78 of the patients. These subjects were then divided into two groups by coma length (i.e., less than or equal to 14 days coma and greater than or equal to 15 days coma) as defined by the Glasgow Coma Scale. All 80 patients were rated at 2-, 4-, 6-, 12-, and 24-month intervals after reported date of injury in the following areas: Basic ADLs (feeding, grooming, bed mobility), Wheelchair Mobility, Dressing, Functional Transfers, Basic Hand Skills, Community Skills, Kitchen Skills, and Jebsen Hand Function.

Results illustrated improvement over time in mean scores for all areas evaluated up to 2 years post-injury for both coma groups. The shorter coma group appeared initially less disabled, improved more rapidly, and exhibited significantly less disability on these measures at 1-year post-injury than the longer coma group. Frequency distributions of all patients at the 2-month and 1-year time frame supported the recovery trends and also indicated that the majority of clients improved in functional areas over time despite extensive coma lengths. Chi-square analysis of all patients indicated that the amount of change in mean scores between 2 months and 12 months post-injury was statistically significant for all variables and that the amount of change in mean scores between 6 months and 12 months post-injury was also significant for seven variables. The implications for potential use of these findings for occupational therapy intervention are discussed.

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