Milieu-based neurorehabilitation in patients with traumatic brain injury: outcome at up to 11 years postdischarge.

OBJECTIVE To examine the rate of productivity and competitive activity in participants with traumatic brain injury (TBI) at a milieu-based day treatment neurorehabilitation program. DESIGN Follow-up data in a cross-sectional design sought from all admissions from May 1986 to May 1998 at 3 months and at year 1, 3, 5, 7, 9, and 11. SETTING Outpatient milieu-based interdisciplinary day treatment program. PATIENTS One hundred twelve participants with TBI, representing 78.9% of TBI patients successfully discharged from the program. INTERVENTIONS Milieu-based interdisciplinary neurorehabilitation (mean length of treatment, 6.2 mo). MAIN OUTCOME MEASURES Productivity, defined as gainful employment, school, and/or volunteer work, and competitive activity, defined as work for pay or enrollment in school. RESULTS 88.4% of patients were productive up to 11 years after discharge, with 76.8% engaged in competitive activity and with no decline in productivity seen over time from discharge. CONCLUSIONS A large majority of patients suffering from TBI are able to return to work or a productive life situation after milieu-based neurorehabilitation. Level of outcome did not significantly decline over an 11-year follow-up interval.

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