title: Milieu-based neurorehabilitation in patients with traumatic brain injury: outcome at up to 11 years postdischarge.
abstract: OBJECTIVE
  To examine the rate of productivity and competitive activity in participants with traumatic brain injury (TBI) at a milieu-based day treatment neurorehabilitation program.
  
  
  METHODS
  Follow-up data in a cross-sectional design sought from all admissions from May 1986 to May 1998 at 3 months and at year 1, 3, 5, 7, 9, and 11.
  
  
  METHODS
  Outpatient milieu-based interdisciplinary day treatment program.
  
  
  METHODS
  One hundred twelve participants with TBI, representing 78.9% of TBI patients successfully discharged from the program.
  
  
  METHODS
  Milieu-based interdisciplinary neurorehabilitation (mean length of treatment, 6.2 mo).
  
  
  METHODS
  Productivity, defined as gainful employment, school, and/or volunteer work, and competitive activity, defined as work for pay or enrollment in school.
  
  
  RESULTS
  88.4% of patients were productive up to 11 years after discharge, with 76.8% engaged in competitive activity and with no decline in productivity seen over time from discharge.
  
  
  CONCLUSIONS
  A large majority of patients suffering from TBI are able to return to work or a productive life situation after milieu-based neurorehabilitation. Level of outcome did not significantly decline over an 11-year follow-up interval.
authors.affiliation: Catholic Healthcare West, Barrow Neurological Institute, Phoenix, AZ, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Klonoff
authors.forename: D G
authors.initials: DG
authors.lastname: Lamb
authors.forename: S W
authors.initials: SW
authors.lastname: Henderson
mesh_terms: D000293:Adolescent; D000328:Adult; D001130:Arizona; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation*; D003163:Competitive Behavior; D003430:Cross-Sectional Studies; D003631:Day Care, Medical; D004526:Efficiency; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012931:Social Environment; D013995:Time; D016896:Treatment Outcome