The Mayo-Portland Adaptability Inventory (MPAI-4) is the industry standard in measuring functional outcomes for post-acute brain injury rehabilitation programs. The tool measures outcomes based upon 29 functional measures in three areas: ability, adjustment and participation.
“With the gains being held for most individuals at 12 months post discharge from a residential rehabilitation program, the return on investment is evident even if the person does not receive additional therapy following residential care. The return is also evident as costs reduce with each subsequent level of care yet gains are maintained, or continue with improvement of functional skills (Lewis & Horn, 2023).
Key Findings
- On average, our participants demonstrated an increase in functional independence across all 29 items of the MPAI-4.
- On average, our participants improved one severity level on each of the three MPAI-4 subscales.
*This page was updated in January of 2023.
Improvement in MPAI-4 Participation, Adjustment and Abilities T-scores
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AbilitiesAbilities Index: measures physical sensory and motor skills, communication, and cognitive skills.
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AdjustmentAdjustment Index: measures the functional impact of mood, neurobehavioral control, and interpersonal interactions.
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ParticipationParticipation Index: measures instrumental activities of daily living including initiation, social contact, self-care, home skills, productivity, and money skills.
- National Reference Sample
Average Age = 44.7, Average Length of Stay = 5.4 months. Outcomes for all persons treated in active rehabilitation. The mean reduction in disability was 8.67 points, a clinically and statistically significant improvement (p<.001).
On average, our participants demonstrated an increase in functional independence across all 29 items of the MPAI-4.
Improvement from Admission to Discharge on Key MPAI-4 Functional Measures: Active Rehabilitation All Diagnoses
Continued Below
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MobilityMobility: Problems walking or moving; balance problems that interfere with moving about.
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FatigueFatigue: Feeling tired; lack of energy; tiring easily; not due to mood.
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Verbal CommunicationVerbal Communication: Problems expressing or understanding language.
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AttentionAttention: Problems ignoring distractions, shifting attention, keeping more than one thing in mind at a time.
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MemoryMemory: Problems learning and recalling new information.
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Problem SolvingProblem Solving: Problems thinking up solutions or picking the best solution to new problems.
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InitiationInitiation: Problems getting started on activities without prompting. May also include over initiation (impulsivity).
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AnxietyAnxiety: Tense, nervous, fearful, phobias, nightmares, flashbacks of stressful events.
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DepressionDepression: Sad, blue, hopeless, poor appetite, poor sleep, worry, self-criticism.
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IrritabilityIrritability: Physical expressions of anger.
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Inappropriate SocialInappropriate Social: Acting childish, silly, rude, behavior not fitting for time and place.
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Self-AwarenessSelf-Awareness: Lack of recognition of personal limitations and disabilities and interference with activities, work, and/or school.
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Social ContactSocial Contact: Social contact with friends, work associates, and other people who are not family, significant others, or professionals.
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LeisureLeisure: Activities and interest development for skills application.
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Self-CareSelf-Care: Activities of daily living such as bathing, grooming, dressing, hygiene.
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Home SkillsHome Skills: Responsibilities of independent living and homemaking (e.g., meal preparation, home repairs and maintenance, personal health maintenance including medical management).
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TransportationTransportation: bus trials, use of taxi, or learned use of public transportation; return to driving.
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Money ManagementMoney Management: Shopping, keeping a check book or other bank account, managing personal income and investments.
Improvement in each of the items above represent a clinically meaningful reduction and disability and a statistically significant difference from admission to discharge (p<.01).