Spinal Cord Injury (SCI) can result in long-term physical impairments, subsequent disability (inability to perform functional activities) and difficulties participating in social activities. For individuals with this condition, successful rehabilitation involves maximizing community integration areas, including: the ability to participate in community life activities, remain active in family and recreational events, and access local activities and resources, including health care followup and employment opportunities. Community integration emphasizes the ability of individuals to overcome disability barriers and has been shown to have a positive influence on their quality of life. With recent health care trends emphasizing earlier discharges from acute rehabilitation centers, it becomes increasingly important to adequately prepare individuals (and their support networks) for return to home and community. This special issue of NeuroRehabilitation presents nine articles that address this continuum of community integration. Prominent researchers associated with the National Institute on Disability and Rehabilitation Research (NIDRR) and the National Spinal Cord Injury Model Systems have submitted articles that provide state-of-the art research and review of the current literature related to this topic. Three key “layers” of the community integration continuum will be highlighted in this issue: the relationship of participation to personal characteristics, the effects of the environment and the benefits of activity-based community opportunities. At the first layer, the impact of personal characteristics is considered. Personal characteristics range from race and gender to personality variables and motivation. In this issue, Krause and his colleagues examine how gender and race impact on psychosocial and quality of life outcomes. Their outcomes highlight the importance of personal characteristics in determining reported priorities and areas of need associated with life satisfaction and participation. In a related article, Charlifue and Gerhart examine how aging is associated with community integration for persons with SCI. The findings indicate a general decline in community reintegration over time in terms of physical independence, mobility, occupation and social integration with an associated decline in life satisfaction. The next layer affecting participation is environmental characteristics that can serve as barriers to, or supports for, activities and independence. This layer includes factors such as the physical and social environment, community resources, and public policy. Centers for Independent Living (CILs) are community-based programs that help to provide necessary resources and minimize barriers to enable this process to be more effective. The article by Forchheimer and Tate discusses the need for a variety of independent living skills and the association of those skills with outcomes while highlighting the importance of communication between medical centers and CILs. Personal assistant services, another support that allow persons with SCI to achieve greater independence and community integration, are reviewed by Hagglund and his colleagues. After discussing the benefits and importance of these services, evidence-based recommendations are made with regard
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