IMPACT OF STRUCTURED REHABILITATION ON QUALITY OF LIFE IN TRAUMATIC BRAIN INJURY PATIENTS AT TERTIARY CARE HOSPITALS IN PESHAWAR

Abstract

Background: Traumatic brain injury (TBI) remains a major public health burden worldwide, contributing significantly to long-term disability and mortality. In low- and middle-income countries such as Pakistan, the impact of TBI is further aggravated by frequent road traffic accidents, limited emergency care, and underdeveloped rehabilitation systems. Conventional assessments like the Glasgow Coma Scale often fail to capture the broader functional and psychosocial consequences faced by survivors. Addressing these gaps through structured rehabilitation may improve recovery outcomes.

Objective: To evaluate the effect of a structured rehabilitation program on cognitive, emotional, functional, and social domains of quality of life (QoL) in post-TBI patients attending tertiary care outpatient departments in Pakistan.

Methods: A descriptive cross-sectional study was conducted from June to December 2024 across three tertiary care hospitals in Peshawar. A total of 169 TBI patients aged 18–60 years were enrolled via convenience sampling. Participants underwent a standardized rehabilitation protocol comprising daily physical therapy (30 minutes, 5 days/week) and weekly psychological counseling (1 hour/session) over two months. QoL was assessed pre- and post-intervention using the QOLIBRI scale. A score <54 indicated poor QoL, while >84 indicated good QoL. Statistical analysis was performed using the Wilcoxon signed-rank test.

Results: Among the 169 patients, 78 (46.15%) were aged 18–30 years, and 105 (62.13%) were male. Post-rehabilitation, Mini-Mental Scale stupor ratings dropped from 59.1% to 14.2%, and cognitive impairments reduced from 47.93% to 11.83% (p < 0.001). Emotional difficulties declined from 33.73% to 15.38%, and impaired social relationships from 42.6% to 14.79% (p < 0.001). Total QOLIBRI scores showed significant improvement across all age and gender groups (p < 0.001).

Conclusion: Structured rehabilitation significantly improves cognitive, emotional, and functional outcomes in TBI patients. These findings advocate for the routine inclusion of multidisciplinary rehabilitation programs in outpatient care, particularly within resource-limited healthcare systems.