Post-acute polytrauma rehabilitation and integrated care of returning veterans: toward a holistic approach.
Throughout the history of war, exposure to combat has been associated with clusters of physical and psychological symptoms labeled in various ways, from "hysteria" to "shell shock" in World War I to "polytrauma" in Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF).


OBJECTIVE
To describe the historical conceptualizations of combat injury and the ways they are relevant to developing current rehabilitation strategies, discuss the symptom complex presented by OEF/OIF veterans, and describe key elements and principles of holistic, integrated care for post-acute OEF/OIF veterans.


CONCLUSIONS
A conceptualization of rehabilitation recognizing a final common pathway of functional disability and suffering is proposed, and both systematic and treatment-specific aspects at the core of a veteran-centered holistic approach are discussed.
Uomoto
Jay M
JM
VA Puget Sound Health Care System, Seattle, WA, USA. jay.uomoto@va.gov
Williams
Rhonda M
RM
D000208:Acute Disease; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation*; D019033:Delivery of Health Care, Integrated / Q000379:methods*; D006694:Holistic Health; D006801:Humans; D054542:Iraq War, 2003-2011; D009104:Multiple Trauma / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D014481:United States; D014728:Veterans / Q000523:psychology*