Clinical Practice Guidelines for Rehabilitation in Traumatic Brain Injury: A Critical Appraisal
Brain Injury
Lee, S. Y., Amatya, B., et al. (2019).
Brain Injury, 33(10), 1263-1271.
This systematic review of guidelines investigates the available recommendations for best practice in the rehabilitation of individuals with traumatic brain injury (TBI). Recommendations for occupational, physical, audiological, behavioral, vocational, and speech-language therapy are included.
Department of Rehabilitation Medicine, Royal Melbourne Hospital (Australia)
This umbrella systematic review contains a number of guidelines, only some of which are included in the Evidence Maps (see the Associated Article(s) section below for more details). Of particular relevance to the article's conclusions are the following:<br />
<ul>
<li>Colorado Department of Labor and Employment. (2013). <em>Traumatic Brain Injury Medical Treatment Guidelines</em>. Denver (CO): Colorado Department of Labor and Employment, (Rule 17 Exhibit 10), 1-119.</li>
<li>Wheeler, S., & Acord-Vira, A. (2016). <em>Occupational Therapy Practice Guidelines for Adults With Traumatic Brain Injury</em>. AOTA Press.</li>
</ul>
Inception to September 2017
Clinical practice guidelines
4 guidelines
A goal-focused comprehensive interdisciplinary team approach is recommended for the assessment and management of TBI (Recommendation: 4/4 Guidelines).
Comprehensive interdisciplinary inpatient rehabilitation and ongoing community care is recommended for individuals with moderate to severe TBI (Recommendation: 3/4 Guidelines).
Individuals with mild TBI should receive a routine cognitive assessment (Recommendation: 2/4 Guidelines).
Memory rehabilitation is recommended using compensatory external/internal strategies and learning techniques (Recommendation: 4/4 Guidelines). Assistive technologies (e.g., smart phone, tablet) are also recommended for cognitive remediation for individuals with TBI (Recommendation: 4/4 Guidelines)
Functional skills training through repetition and practice in daily activities is recommended to improve attention status post TBI (Recommendation: 1/4 Guidelines).
Compensatory visuospatial treatments are recommended for the treatment of neglect status post TBI (Recommendation: 4/4 Guidelines).
Based on limited evidence, repetitive goal-oriented cognitive-linguistic treatments (i.e., augmentative/alternative communication, melodic intonation therapy) are recommended for individuals with language deficits post TBI (Recommendation: 2/4 Guidelines).
Based on limited evidence, several restorative and compensatory swallowing treatments are recommended for individuals with dysphagia secondary to TBI. Swallowing treatments included postural maneuvers, diet modification, varying swallow viscosity, neuromuscular electrical stimulation, swallowing exercises, and oral hygiene programs (Recommendation: 2/4 Guidelines).
