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Development and Preliminary Validation of the Acute Brain Injury Physiotherapy Assessment (ABIPA)

Background and aims: For patients with a severe brain injury there is no objective physiotherapy assessment tool that is responsive to the incremental changes in motor recovery in the acute stage. The aims of this study were to identify the items of neuro-motor recovery and scoring criteria for the Acute Brain Injury Physiotherapy Assessment (ABIPA) and determine responsiveness to change and concurrent validity against accepted standard measures of consciousness and physical function in the severe brain injury population. Method: The literature was searched and an expert consensus panel of experienced clinical physiotherapists informed item selection and developed practical assessment guidelines. The ABIPA was investigated for responsiveness to change and concurrent validity against the Glasgow Coma Scale (GCS), Clinical Outcome Variable Scale (COVS) and Motor Assessment Scale (MAS). Eleven patients (9 males; cohort 41 ± 18 years) with moderate/severe brain injury were recruited, and assessed on days 1, 3, 7 and then weekly until discharge. Results: The ABIPA demonstrated good to excellent correlations overall with the GCS (rho > .76, p ≤ .001), COVS (rho > .82, p ≤ .001) and MAS (rho > 0.66, p ≤ .001). On day 3, the ABIPA showed the greatest responsiveness to change (standardised response means (SRM) > .83) compared to other measures (SRMs < .77). At discharge all tools demonstrated change in neuro-motor recovery. Conclusions: The ABIPA is a promising tool for detecting incremental changes in neuro-motor recovery early after severe brain injury.