NeuroRehabilitation
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NeuroRehabilitation · Jan 2004
ReviewUsing telework to enhance return to work outcomes for individuals with spinal cord injuries.
Return-to-work is an area of critical concern for individuals with a spinal cord injury (SCI), because of the psychological, psychosocial and economic benefits of employment. Although the majority of individuals with SCI are employed pre-injury, they are impeded from maintaining those jobs due to personal, organizational and systems level barriers. ⋯ For telework to fulfill its potential as a return-to-work strategy, rehabilitation professionals and employers must assess and enhance the readiness of the individual, workgroup and organization within the context of a disability management program. Strategies for successfully implementing telework as a return-to-work strategy for individuals with SCI are discussed, along with implications for future research.
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NeuroRehabilitation · Jan 2004
Long-term survival after traumatic brain injury: a population-based analysis.
This population-based retrospective cohort study identified all Olmsted County, MN residents with any diagnosis indicative of potential traumatic brain injury (TBI) during the years 1985 to 2000. The complete community-based medical records of a random sample (n = 7,175) were reviewed to confirm and characterize the event, and to determine vital status through 2002. The review identified 1,448 confirmed incident cases; 164 (11%) were moderate to severe; 1,284 were mild. ⋯ Proportional hazards modeling showed the adjusted hazard of all-cause mortality for moderate to severe cases relative to mild cases was 5.18 (3.65-7.3) within six months of the event and 1.04 (0.57-1.88) for the remaining follow-up period. This analysis indicates that persons who experience mild TBI exhibit a small but statistically significant reduction in long-term survival compared to the general population. The case fatality rate for persons with moderate to severe TBI is very high, but among six-month survivors, long-term survival is similar to that for persons with mild TBI.
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NeuroRehabilitation · Jan 2004
Mortality following rehabilitation in the Traumatic Brain Injury Model Systems of Care.
While many outcomes after traumatic brain injury (TBI) have been systematically investigated, the most basic of all outcomes--survival--has been neglected. The purpose of this study was to investigate mortality in a cohort of 2,178 individuals with TBI completing inpatient rehabilitation in one of 15 National Institute on Disability and Rehabilitation Research-funded TBI Model Systems of care. ⋯ Within the TBI population, the strongest independent risk factors for death after one-year post-injury were older age and not being employed at injury, and greater disability at rehabilitation discharge. This information is important to guide decision-making for treatment, utilization of limited medical resources, and planning for ongoing health care needs and lifetime planning.