OBJECTIVE: Evaluation of multidisciplinary community based outreach rehabilitation after severe @entity131 ( @entity131 ). METHODS: A randomised controlled trial compared outreach treatment (mean of two sessions a week for 27.3 (SD 19.1) weeks) in community settings such as @entity1 ' homes, day centres, or workplaces, with provision of written information detailing alternative resources. Follow up for an average of 24.8 months after initial allocation was by a blinded independent assessor. @entity1 were aged 16-65, had sustained severe @entity131 between 3 months and 20 years previously, and had no other @entity16 . Of 110 initially allocated, 48 outreach and 46 information @entity1 were successfully followed up. Primary outcome measures (Barthel index (BI) and the @entity1545 community rehabilitation outcome-39 (BICRO-39)) focused on levels of activity and participation. Secondary measures were the functional independence measure and the functional assessment measure (FIM+FAM) and, in a subgroup of 46 @entity1 , the hospital @entity148 and @entity308 scale. Analyses were non-parametric. RESULTS: outreach @entity1 were significantly more likely to show gains on the BI and the BICRO-39 total score and self organisation and psychological wellbeing subscales. There were likewise strong trends (p<0.10) for BICRO personal care and mobility, and on the FIM+FAM for personal care and cognitive functions. Differential improvements were not seen for indices of socializing, productive employment, @entity148 , or @entity308 . Median changes on individual subscales were small, reflecting the diversity of the clinical population; however, 40% of outreach but only 20% of information @entity1 made a clinically significant improvement of 2+ points on at least one BICRO-39 scale. Time since injury was unrelated to the magnitude of gains. CONCLUSIONS: This is the first RCT of multidisciplinary community rehabilitation after severe @entity131 , and suggests that even years after injury it can yield benefits which outlive the active treatment period.

Community based rehabilitation after severe XXXX : a randomised controlled trial.

@entity1 :: ('9606', 'Species') :: ['participants', 'Participants'] @entity1545 :: ('MESH:D020214', 'Disease') :: ['brain injury'] @entity131 :: ('MESH:D001930', 'Disease') :: ['TBI', 'traumatic brain injury'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological conditions'] @entity148 :: ('MESH:D001008', 'Disease') :: ['anxiety']
@entity131 :: (MESH:D001930,Disease) :: ['traumatic brain injury']
