Community integration following moderate to severe traumatic brain injury: a longitudinal investigation.
OBJECTIVE
To evaluate the course and identify determinants of community integration for up to 3 years following moderate to severe traumatic brain injury.


METHODS
Prospective cohort study.


METHODS
A total of 119 moderate to severe traumatic brain injury patients aged 16-67 years.


METHODS
The Community Integration Questionnaire was completed at 3, 6, 12, 18, 24 and 36 months post-injury. Repeated measures analysis of variance was performed to determine changes over time in the Community Integration Questionnaire and its subscales. Bivariate and multivariate regression analyses were used to identify determinants of community integration 36 months post-injury.


RESULTS
Compared with pre-injury, mean home integration, social integration, productivity, and total questionnaire scores decreased 3 months post-injury. Patient scores showed maximal improvement during the first year post--injury. Mean home integration, productivity, and total scores increased to a lesser extent during years 1-3 post-injury. Age, Barthel Index scores, hospital discharge destination, and pre-injury community integration scores were the major determinants of community integration 36 months post-injury (R2 = 60%).


CONCLUSIONS
After an initial decline, mean community integration scores gradually improve following moderate to severe traumatic brain injury. Understanding the course and determinants of community integration is necessary in order to determine functional prognosis following traumatic brain injury.
Willemse-van Son
Agnes H P
AH
Department of Rehabilitation Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands. a.vanson-willemse@erasmusmc.nl
Ribbers
Gerard M
GM
Hop
Wim C J
WC
Stam
Henk J
HJ
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult