Occupational Reintegration in Patients with Traumatic Brain Injury

Abstract

. Incidence of TBI varies greatly between studies. As compared to 98/100,000 in USA or to 160/100,000 in India, it has been reported that the annual incidence of TBI was 235/100,000 in Europe with large disparities among countries: 91/100,000 in Italy, 435/100,000 in England or 546/100,000 in Sweden [3][4][5].In Western countries, one person is victim of a TBI every three minutes, which represents 200,000 victims/year from which 50,000 will be hospitalized, 2,800 will die and 5,000 will keep permanent disabilities [6][7][8]. Th ese fi gures do not include the 15,000 accidents of sport per year which are responsible for various behavioral disorders [9,10].In neuro-rehabilitation practice, diff use cerebral lesions, either of hemorrhagic or of traumatic origin, are generally associated with a coma whose initial severity and duration will determine (a) the chances of survival and (b) the degree of the subsequent recovery [11][12][13]. In survivors, the impacts on the cerebral functioning are numerous and complex, aff ecting motor control, sensory modalities, psychointellectual function, language and writing, recognition of the familiar faces, perception of the environment, … Unfortunately, patients will remain in a state of complete functional dependence for the Activities of Daily Life (ADL) in many cases.Neurological rehabilitation aims primarily to promote the return to independence at home, in the society and at work. One of the fundamental missions of our Department of neuro-rehabilitation is to provide adequate neurological and/or cognitive rehabilitation treatments in order to to ensure an optimal integration with a priority for returning to work [14].Our Department has 100 beds specifi cally intended for the neurological treatments of cerebral injuries. Th e daily care starts from the acute phase of the injury until the functional recovery and the return to autonomy. Continuation of the multidisciplinary treatments as ambulatory cares is provided when necessary. In addition, a AbstractThere is little information on the effi ciencies and limits of the professional reintegration models among patients having suffered from a traumatic brain injury (TBI). In order to identify which factors should be taken into account to establish an accurate individual professional reintegration program, we have studied retrospectively the data from 56 consecutive patients having suffered a TBI with initial loss of consciousness. Our results indicate that many patients evidenced cognitive and executive functions disorders with negative impacts upon employment outcomes. In the patients who returned to work after the TBI, professional reintegration was achieved along with social integration process. Socioeconomic status also appears to affect the possibilities of work recovery as patients with lower levels of education and employment showed a poor outcome in returning to work. Among other positive features, young age at the time of the onset and facilities of arrangement of the work conditions tended to be useful for occupational...