Current practice of cognitive rehabilitation following traumatic brain injury: An international survey

Nowell, Clare; Downing, Marina; Bragge, Peter; Ponsford, Jennie

doi:10.1080/09602011.2019.1623823

Cited by 21 publications

(29 citation statements)

References 36 publications

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“… 22 TBI can cause many cognitive impairments, including attention, information processing speed, memory, executive function, and communication. 23 The results in this study showed significant improvement in the GOAT, MNA, RLAS, and CCAT scores after the patients with TBI completed the PAC program, suggesting the patients had significant improvements in cognitive and language functions. Depression is the most common psychiatric illness in patients with TBI, with an incidence of 10%-70%.…”

Section: Discussionmentioning

confidence: 52%

Post-Acute Care for Traumatic Brain Injury Patients in Taiwan

Huang¹,

Bih²,

Tsai³

et al. 2023

IJGM

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Background Traumatic brain injury (TBI) can result in functional impairments. Many patients with TBI require post-acute care to improve their functional skills and allow for greater self-independence and a better quality of life. Taiwan’s National Health Insurance proposed a nationwide post-acute care program in 2017 for patients with traumatic brain injury. The program’s goal was to maximize patients’ functional recovery and make it possible for them to return to their homes and communities. This study aimed to explore the effectiveness of such programs in Taiwan. Methods This pilot study retrospectively evaluated a de-identified database that contained the scores of various assessments evaluated at admission and discharge. It used the data to determine the functional improvement of patients with traumatic brain injury after participating in post-acute care programs. Results This study collected complete data from 27 patients. After an average of 45.11 days in the program, the patients showed significant improvement in the Barthel Activity Daily Living Index, the Lawton–Brody Instrumental Activity Daily Living Scale, the Mini Nutrition Assessment, the EuroQol Five Dimensions Questionnaire, the Berg Balance Scale, the Galveston Orientation and Amnesia Test, the Rancho Los Amigos Scale, the Concise Chinese Aphasia Test, and the Mini Mental State Examination. After discharge, 96% of the patients could return to their community. Conclusion This pilot study concluded that the program significantly promoted functional recovery for patients and could help patients with traumatic brain injury return to their communities and reduce the risk of institutionalization. Thus, patients with the potential for functional recovery could receive post-acute care in regional or community hospitals immediately after being discharged from acute wards. In the future randomized controlled trials are needed to further confirm the clinical impact of this program.

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Section: Discussionmentioning

confidence: 52%

Post-Acute Care for Traumatic Brain Injury Patients in Taiwan

Huang¹,

Bih²,

Tsai³

et al. 2023

IJGM

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“…In developing and designing these new INCOG recommendations, we have given consideration to CPG implementation. This reflects our belief that better assessment, treatment, and outcomes for individuals with TBI are only possible if CPG teams keep implementation at the forefront of their thinking and is further underlined by our efforts to measure the extent to which clinical practice reflects awareness and use of INCOG guideline recommendations 2,30. As we found in reviewing previous cognitive rehabilitation guidelines, this focus on auditability (evaluating whether recommendations have been translated into clinical practice) is an area traditionally neglected in CPGs 31…”

mentioning

confidence: 96%

“…Insights into its utility; the feasibility, acceptability, and affordability of the recommended therapies; and new questions and research needs would be gathered from clinicians, patients, and families and used to iterate and improve the ViaTherapy resource. Our own work on how INCOG 2014 has translated into practice indicates that this type of continuous learning is presently lacking 2,30…”

mentioning

confidence: 99%

The Future of INCOG (Is Now)

Bragge

Bayley²,

Velikonja³

et al. 2023

Journal of Head Trauma Rehabilitation

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“…Therefore, improving or maximizing attention represents an important rehabilitation goal. A recent survey of 115 allied health professionals worldwide identified that addressing attentional impairments was the second most commonly reported focus of cognitive rehabilitation 27. However, increased awareness of up-to-date evidence is needed to facilitate informed clinical practice.…”

mentioning

confidence: 99%

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part II: Attention and Information Processing Speed

Ponsford

Velikonja²,

Janzen³

et al. 2023

Journal of Head Trauma Rehabilitation

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Introduction: Moderate to severe traumatic brain injury (MS-TBI) commonly causes disruption in aspects of attention due to its diffuse nature and injury to frontotemporal and midbrain reticular activating systems. Attentional impairments are a common focus of cognitive rehabilitation, and increased awareness of evidence is needed to facilitate informed clinical practice. Methods: An expert panel of clinicians/researchers (known as INCOG) reviewed evidence published from 2014 and developed updated guidelines for the management of attention in adults, as well as a decision-making algorithm, and an audit tool for review of clinical practice. Results: This update incorporated 27 studies and made 11 recommendations. Two new recommendations regarding transcranial stimulation and an herbal supplement were made. Five were updated from INCOG 2014 and 4 were unchanged. The team recommends screening for and addressing factors contributing to attentional problems, including hearing, vision, fatigue, sleepwake disturbance, anxiety, depression, pain, substance use, and medication. Metacognitive strategy training focused on everyday activities is recommended for individuals with mild-moderate attentional impairments. Practice on decontextualized computer-based attentional tasks is not recommended because of lack of evidence of generalization, but direct training on everyday tasks, including dual tasks or dealing with background noise, may lead to gains for performance of those tasks. Potential usefulness of environmental modifications is also discussed. There is insufficient evidence to support mindfulness-based meditation, periodic alerting, or noninvasive brain stimulation

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Current practice of cognitive rehabilitation following traumatic brain injury: An international survey

Cited by 21 publications

References 36 publications

Post-Acute Care for Traumatic Brain Injury Patients in Taiwan

Post-Acute Care for Traumatic Brain Injury Patients in Taiwan

The Future of INCOG (Is Now)

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part II: Attention and Information Processing Speed

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