Appraising evidence on community integration following brain injury: a systematic review

Abstract

A systematic review of the community integration (CI) literature for persons with traumatic brain injury was undertaken to evaluate: (1) How do we best measure CI? (2) Can we predict CI following rehabilitation? (3) Does social and activity participation have an effect on CI? (4) Does CI have an effect on quality of life/life satisfaction? Seventy-two articles were analysed. The results demonstrated: (1) strong evidence supporting the use of the Community Integration Questionnaire (CIQ), (2) mixed evidence supporting the ability to predict CI, with the prominent predictive variables being severity of injury, age, gender, education, prior work, living environment, cognition, emotional status, functional performance and disability. The literature search was restricted to articles published in English and the heterogeneity in the outcomes, methods, participants and other characteristics not reported. Further research is needed to examine the complex relationship of person, environment and CI.

Toward a Veteran-centric view on community (re)integration

“…It has also been used to describe repatriation from a foreign county [10]. Reistetter and Abreu described reintegration as an adaptation process that is multidimensional, dynamic, personal, and culturally bound [12].…”

“…In addition, several population-specific instruments have been developed to measure aspects of community reintegration for people with a history of stroke, spinal cord injury, or TBI. Examples of this are the Community Integration Measure, the Craig Handicap Assessment and Reporting Technique, and the Community Integration Questionnaire, which are further described elsewhere [10][11][12]. Until recently, no tools were designed specifically for use with OIF/OEF/OND Veterans.…”

“…A review by Reistetter and Abreu indicated that following a TBI, community integration does not begin to stabilize until at least 1 yr postinjury, and it is quite possible that stabilization postdeployment requires some time for servicemembers and Veterans as well [12]. They also suggested that researchers need to consider community integration outcomes of interest when deciding which measure to use [12]. Missing from either of the aforementioned, more Veteran-specific, measurement tools is the subjective voice of the servicemember and Veteran.…”

The efficacy of community-based rehabilitation programmes for adults with TBI

“…A previous systematic review on community integration following brain injury (Reisetter and Abreu, 2005) demonstrated that community integration was mediated by severity of injury, age, gender, education, prior work, living environment, cognition, emotional status, functional performance and disability. These factors make the process of interpreting the results of systematic reviews to decide on effective interventions diffi cult (Bennett and Bennett, 2000).…”

“…(Reisetter and Abreu, 2005). Following acute and inpatient rehabilitation, the need for communitybased rehabilitation to enhance re-engagement in socially valued occupations is recognized (Powell et al, 2002).…”