http://ecuanst.weebly.com/uploads/6/0/6/0/60601319/cognitive_rehabilitation-_meta-analysis_and_review.pdf

Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008.

PRIMARY OBJECTIVE: To investigate the relation between psychosocial functioning (community integration, life satisfaction and social support) and symptoms (post-concussion, post-traumatic stress and depression) in persons with mild traumatic brain injury (MTBI) 3 years after the trauma. METHODS: Population-based follow-up study of 163 patients. At follow-up, an assessment of community integration, social support, life satisfaction and symptoms was made. RESULTS: Total score of Community Integration Questionnaire (CIQ) was negatively correlated to total score of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ, r = -0.270, p < 0.001) and to total score of the Beck Depression Inventory (BDI, r = -0.332, p < 0.001). Life satisfaction (LiSat-11) was negatively correlated to the RPQ (r = -0.459, p < 0.001), to total score of the Impact of Event Scale (IES, r = -0.365, p < 0.001) and to the BDI (r = -0.642, p < 0.001). Low levels of life satisfaction were common at follow-up. CONCLUSIONS: A large proportion of the individuals with MTBI experienced both psychosocial difficulties, with low levels of life satisfaction in particular and symptoms (post-concussion, post-traumatic stress and depression) 3 years after trauma. Since the possibility of pre-injury factors contributing to the condition at follow-up cannot be ruled out, the study indicates that all these factors should be taken into consideration in the management of persons with MTBI.

Community integration, social support and life satisfaction in relation to symptoms 3 years after mild traumatic brain injury

Objectives Participation in meaningful life situations is an important aspect of functioning after traumatic brain injury (TBI). However, to date, few studies have included measures of social participation or community integration as outcome measures after TBI rehabilitation. This paper is a selective review of the literature that examines the effects of TBI rehabilitation on measures of participation or community integration. It also addresses the related questions of clinically significant improvements in community integration, variability in patterns of community functioning, and the relationship of participation and quality of life after TBI. Design Literature review. Conclusions A small number of studies suggest that postacute TBI rehabilitation can produce improvements in participation and community integration. However, a considerable amount of variability in rehabilitation outcomes may be apparent. Analysis of clinically significant changes in individual's functioning suggests that rehabilitation may exert its benefits not only by facilitating improvements, but also by preventing declines in community functioning. Subjective well-being and quality of life have generally been ignored as TBI rehabilitation outcomes. There is considerable evidence that participation and subjective well-being represent distinct and dissociable outcomes after TBI, which may reflect the importance of patients' preferences and values in evaluating the effectiveness of rehabilitation.

Participation as an outcome of traumatic brain injury rehabilitation.

Background: Returning to work (RTW) in the UK is problematic following TBI. Vocational rehabilitation (VR) is limited and efficacy or costs seldom reported. This study aimed to determine whether a ...

Return to work after traumatic brain injury: Cohort comparison and economic evaluation

A systematic review of the community integration (CI) literature for persons with traumatic brain injury was undertaken to evaluate: (1) How do we best measure CI? (2) Can we predict CI following rehabilitation? (3) Does social and activity participation have an effect on CI? (4) Does CI have an effect on quality of life/life satisfaction? Seventy-two articles were analysed. The results demonstrated: (1) strong evidence supporting the use of the Community Integration Questionnaire (CIQ), (2) mixed evidence supporting the ability to predict CI, with the prominent predictive variables being severity of injury, age, gender, education, prior work, living environment, cognition, emotional status, functional performance and disability. The literature search was restricted to articles published in English and the heterogeneity in the outcomes, methods, participants and other characteristics not reported. Further research is needed to examine the complex relationship of person, environment and CI. Copyright © 2005 John Wiley & Sons, Ltd.

Appraising evidence on community integration following brain injury: a systematic review.

Primary objective : To determine the extent to which participation in a multidisciplinary rehabilitation programme and patient characteristics predict improvement in community integration following mild-to-moderate traumatic brain injury (TBI). Research design : A non-randomized case-control study was conducted employing a pre-test-post-test multiple regression design. Methods and procedures : Archival data for 42 patients with mild-to-moderate TBI who completed the Community Integration Questionnaire (CIQ) at intake and again 6-18 months later were analysed. Half the sample participated in an intensive outpatient rehabilitation programme that provided multi-modal interventions, while the other half received no rehabilitation. The two groups were matched on age, education and time since injury. Results : On the CIQ Home Integration scale, participation in rehabilitation and female gender predicted better outcome. On the Productivity scale, patients with a lower age at injury had better outcome. Outcome on...

Community integration following multidisciplinary rehabilitation for traumatic brain injury

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Community integration following multidisciplinary rehabilitation for traumatic brain injury