Community neurorehabilitation: A synthesis of current evidence and future research directions

Abstract

Over the past decade, community neurorehabilitation has emerged as a promising extension of neurological rehabilitation. The goal of community neurorehabilitation is to maximize functional ability and quality of life through multidimensional rehabilitation that occurs while the individual is living in a home versus acute or transitory care setting. Because of its multidisciplinary focus, many variations of community neurorehabilitation teams have been implemented. Critical gaps exist, however, in understanding of the influence of structural and procedural differences among programs, as well as patient level variables such as social support, on recovery. This paper examines the current evidence of the effectiveness of community neurorehabilitation through a review of the findings of systematic reviews and meta-analyses of four neurological conditions: stroke, multiple sclerosis, traumatic brain injury, and Parkinson's disease. It focuses in particular on the data regarding physical therapy and occupational therapy, which are two of the primary components of community neurorehabilitation programs.

Quality of life in multiple sclerosis: a Kuwaiti MSQOL-54 experience

“…Our results indicate that patients who are older, less educated and unemployed are particularly vulnerable and need specific attention. The findings support the call for programs that address depression, disability, the impact of treatment side effects, caregiver attitudes and education, both in the clinical setting and in the community, with a view to enhancing the quality of care (3,35).…”

“…The findings support the call for programs that address depression, disability, the impact of treatment side effects, caregiver attitudes and education, both in the clinical setting and in the community, with a view to enhancing the quality of care (3,35). The findings support the call for programs that address depression, disability, the impact of treatment side effects, caregiver attitudes and education, both in the clinical setting and in the community, with a view to enhancing the quality of care (3,35).…”

Does attendance at a multidisciplinary outpatient rehabilitation program for people with Parkinson's disease produce quantitative short term or long term improvements? A systematic review

“…They reported on medical management [1,2]. -2 studies were systematic reviews but no new data was presented [3,5]. -2 studies were descriptive and provided no outcome measurements [4,16].…”

“…Of this number, 43 studies were single discipline and only 1 was multidisciplinary. In 2006, Chard reviewed Community neurorehabilitation for Stroke, Traumatic brain injuries, Multiple Sclerosis and PD and he also identified only one random controlled trial (RCT) for people with PD on multidisciplinary program outcomes, therefore, little is known about multidisciplinary programs for people with PD [3].…”

Residential design and outdoor area accessibility

“…The goal of neurorehabilitation is to reduce the consequences of neurological health conditions and maximize functional ability and quality of life in a person's immediate environment [8,15,27]. The ICF provides a new paradigm for viewing health and applicable health components of well-being in terms of health and health-related domains [31].…”