Building the crossroad between inpatient/outpatient rehabilitation and lifelong community-based fitness for people with neurologic disability.

The length of stay in inpatient and outpatient rehabilitation after an injury or illness has declined in recent years, exposing those with newly acquired neurologic disability to a risk of significant postrehabilitation health decline. Following a short stay in outpatient rehabilitation, individuals with neurologic disability have few, if any, options to continue their physical recovery after discharge, thus further increasing their risk for functional decline and secondary conditions. Professionals who work in community-based fitness facilities have the potential to assist therapists in extending the recovery process and preventing this decline. The focus of this article was to address a conceptual framework for better understanding how rehabilitation and health/fitness professionals can work together to help with this growing need. To that end, the antecedents to and effects of postrehabilitation health decline are discussed, followed by the introduction of a theoretical model illustrating a therapist-to-trainer system that facilitates the use of community-based fitness facilities by individuals with neurologic disabilities to continue their recovery postrehabilitation. Finally, a thorough description of an exemplary existing community-based inclusive fitness program is presented, followed by examples of select disability groups using these programs for continued recovery.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A45) for more insights from the authors.