Traumatic Brain Injury Review: A Systematic Review of the Evidence for Paediatric Traumatic Brain Injury, and for Adults With Mild Traumatic Brain Injury
International Centre for Allied Health Evidence. (2013).
Adelaide (Australia): International Centre for Allied Health Evidence, (Prepared for New Zealand's ACC Traumatic Brain Injury Strategy), 1-298.
This systematic review investigates the management of pediatric traumatic brain injury (TBI) and mild traumatic brain injury (mTBI) in adults. Of particular interest to clinicians are section 1.4 on the cognitive educational training for pediatric TBI and section 2.3 on outpatient rehabilitation for adults with mTBI.
International Centre for Allied Health Evidence, University of South Australia
This umbrella review contains 16 other systematic reviews and guidelines. Some of these are in the Evidence Maps and included in the Associated Article section below.
January 2006-March 2013
Systematic reviews; meta-analyses; guidelines
114
<div>Six high quality guidelines and one good quality systematic review found consistent evidence supporting the need for outpatient rehabilitation and compensatory treatments targeting memory, attention, executive functioning, communication and balance disorders in adults with mTBI. The findings have a potentially substantial impact for this population (p. 154; Level A Evidence, Level A Consistency, Level B Clinical Impact).</div>
<div>Eight systematic reviews examined various cognitive and education/training interventions for children and adolescents with TBI. While the reviews targeting cognition, planning, and social skills were inconclusive, observational data provided clinically important considerations and highlighted the need for further research investigating specific interventions (p. 65; Level A Evidence, Level C Consistency, Level C Clinical Impact).</div>
<div>Three guidelines and two systematic review examined various aspects of inpatient and outpatient rehabilitation for children and adolescents with TBI (e.g., early management, cognitive, behavioral and communication interventions). However, the lack of findings from the included studies and the paucity of literature pertaining to specific interventions did not allow for comparison of findings across studies. Despite the potentially high clinical impact, the authors conclude that there is a lack of evidence for inpatient and outpatient rehabilitation for this population (p. 46; Level A Evidence, Level C Consistency, Level D Clinical Impact).</div>
<div>Three guidelines found that cognitive treatments (e.g., social skills training, compensatory strategies, environmental modifications) had positive effects on the management of challenging behaviors in adults with mTBI. While the findings have a potentially substantial impact for improving the outcomes of individuals with mTBI, there is a lack of evidence for the best treatment approach (e.g., cognitive, pharmacological) for this population (190; Level A Evidence, Level B Consistency, Level C Clinical Impact).</div>
<div>Four guidelines reported consistent recommendations for coordinated, interdisciplinary rehabilitation for adults with mTBI. The findings suggest that coordinated, interdisciplinary outpatient rehabilitation services have a substantial impact on the outcomes of adults with mTBI (p. 149; Level A Evidence, Level B Consistency, Level B Clinical Impact).</div>
