A Prospective Study to Evaluate a Residential Community Reintegration Program for Patients With Chronic Acquired Brain Injury

• Published in: Archives of physical medicine and rehabilitation Vol. 92; no. 5; pp. 696 - 704
• Main Authors: Geurtsen, Gert J., MSc, van Heugten, Caroline M., MSc, PhD, Martina, Juan D., MD, Rietveld, Antonius C., MSc, PhD, Meijer, Ron, MD, PhD, Geurts, Alexander C., MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2011; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Brain injuries; Brain Injury, Chronic - complications; Brain Injury, Chronic - rehabilitation; Depression - complications; Diseases of the osteoarticular system; Employment; Humans; Male; Medical sciences; Middle Aged; Miscellaneous; Physical Medicine and Rehabilitation; Prospective Studies; Quality of Life; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation Centers; Rehabilitation Residential treatment; Residence Characteristics; Social Adjustment; Treatment outcome; Young Adult; Treatment outcome; EQ-5D; RCT; Center for Epidemiological Studies Depression Scale; EuroQOL quality of life scale; World Health Organization Quality of Life Scale Abbreviated; Brain injuries; Community Integration Questionnaire; analysis of variance; Employment; ANOVA; Glasgow Coma Scale; Rehabilitation Residential treatment; TBI; Global Assessment of Functioning scale; MANOVA; WHOQOL-BREF; traumatic brain injury; CIQ; GAF; multiple analysis of variance; Quality of life; QOL; randomized controlled trial; t; GCS; CES-D; time measurement moments; Human; Nervous system diseases; Prognosis; Cerebral disorder; Chronic; Reeducation; Treatment; Orthopedics; Central nervous system disease
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2010.12.022

Abstract Geurtsen GJ, van Heugten CM, Martina JD, Rietveld AC, Meijer R, Geurts AC. A prospective study to evaluate a residential community reintegration program for patients with chronic acquired brain injury. Objective To examine the effects of a residential community reintegration program on independent living, societal participation, emotional well-being, and quality of life in patients with chronic acquired brain injury and psychosocial problems hampering societal participation. Design A prospective cohort study with a 3-month waiting list control period and 1-year follow up. Setting A tertiary rehabilitation center for acquired brain injury. Participants Patients (N=70) with acquired brain injury (46 men; mean age, 25.1y; mean time postonset, 5.2y; at follow up n=67). Intervention A structured residential treatment program was offered directed at improving independence in domestic life, work, leisure time, and social interactions. Main Outcome Measures Community Integration Questionnaire (CIQ), Employability Rating Scale, living situation, school, work situation, work hours, Center for Epidemiological Studies Depression Scale, EuroQOL quality of life scale (2 scales), World Health Organization Quality of Life Scale Abbreviated (WHOQOL-BREF; 5 scales), and the Global Assessment of Functioning (GAF) scale. Results There was an overall significant time effect for all outcome measures (multiple analysis of variance T2 =26.16; F36,557 134.9; P =.000). There was no spontaneous recovery during the waiting-list period. The effect sizes for the CIQ, Employability Rating Scale, work hours, and GAF were large (partial η2 =0.25, 0.35, 0.22, and 0.72, respectively). The effect sizes were moderate for 7 of the 8 emotional well-being and quality of life (sub)scales (partial η2 =0.11–0.20). The WHOQOL-BREF environment subscale showed a small effect size (partial η2 =0.05). Living independently rose from 25.4% before treatment to 72.4% after treatment and was still 65.7% at follow up. Conclusions This study shows that a residential community reintegration program leads to significant and relevant improvements of independent living, societal participation, emotional well-being, and quality of life in patients with chronic acquired brain injury and psychosocial problems hampering societal participation.