Community integration after severe traumatic brain injury in adults.
OBJECTIVE
Despite being the main cause of death and disability in young adults, traumatic brain injury (TBI) is a rather neglected epidemic. Community integration of persons with TBI was, until recently, insufficiently informed by clinical research.


RESULTS
To bridge the gap between rehabilitation and community re-entry, the first task is to assess the person, using TBI-specific outcome measures. The second task is to provide re-entry programs, the effectiveness of which is assessed by those measures, using well designed studies. There are very few such studies. However, there are some effective comprehensive programs and others which are specifically targeted dealing mainly with return to work, behavior, and family issues. The complex psychological and environmental components of the disability require individualized and often long-term care.


CONCLUSIONS
For persons with severe TBI trying to achieve the best possible community integration a new semiology is required, not just limited to medical care, but also involving social and psychological care that is tailored to the needs of each individual and family, living within his/her environment. Currently, only a minority benefit from well validated programs.
Truelle
Jean-Luc
JL
Department of Neurological Rehabilitation, Raymond Poincaré University Hospital, Garches, France. jean-luc.truelle@wanadoo.fr
Fayol
Patrick
P
Montreuil
Michèle
M
Chevignard
Mathilde
M
D000203:Activities of Daily Living / Q000523:psychology; D001930:Brain Injuries / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008134:Long-Term Care / Q000379:methods* / Q000639:trends*; D019964:Mood Disorders / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards; D015397:Program Evaluation / Q000592:standards; D012111:Residence Characteristics; D012720:Severity of Illness Index; D012917:Social Adjustment; D012944:Social Support