EFNS Guidelines on cognitive rehabilitation: report of an EFNS Task Force

Abstract

In 1999, a Task Force was set up under the auspices of the European Federation of Neurological Societies with the aim to evaluate the existing evidence for the clinical effectiveness of cognitive rehabilitation. This review led to the development of a set of guidelines to be used in the management of adult patients with cognitive disorders due to acquired focal neurological damage.

Effectiveness of cognitive rehabilitation following acquired brain injury: A meta-analytic re-examination of Cicerone et al.'s (2000, 2005) systematic reviews.

“…We focused on a specific set of potential moderator variables suggested by the Cicerone et al (2000Cicerone et al ( , 2005 and Cappa et al (2003Cappa et al ( , 2005 reviews, as well as by our reading of the literature. Table 1 presents the distribution of studies across levels of several qualitative candidate moderator variables, as well as descriptive statistics for quantitative candidate moderator variables.…”

“…In this approach, evidence from stronger research designs, referred to as Class I studies, has greater influence on the final recommendations of the reviewer(s). The European Federation of Neurological Societies Task Force on Cognitive Rehabilitation was created in 1999 to evaluate the existing evidence for the clinical effectiveness of, and treatment guidelines for, cognitive rehabilitation in stroke and TBI (Cappa et al, 2003). This systematic review and a subsequent update (Cappa et al, 2005) found limited high-quality evidence (i.e., Class I) supporting some forms of cognitive rehabilitation; specifically, treatments for visual neglect and apraxia after stroke, impairments of attention after TBI, and memory dysfunction after either TBI or stroke.…”

“…The European Federation of Neurological Societies Task Force on Cognitive Rehabilitation was created in 1999 to evaluate the existing evidence for the clinical effectiveness of, and treatment guidelines for, cognitive rehabilitation in stroke and TBI (Cappa et al, 2003). This systematic review and a subsequent update (Cappa et al, 2005) found limited high-quality evidence (i.e., Class I) supporting some forms of cognitive rehabilitation; specifically, treatments for visual neglect and apraxia after stroke, impairments of attention after TBI, and memory dysfunction after either TBI or stroke. However, the authors noted the low number of randomized controlled trials (RCTs) that used pre-and posttreatment assessments on experimental and control groups and expressed reservations about having to rely on a relatively large number of single-case studies.…”

“…The study groups of Cappa et al (2003Cappa et al ( , 2005 and Cicerone et al (2000Cicerone et al ( , 2005 used systematic review procedures to analyze the literature. These evidence-based reviews can make important contributions to an understanding of how particular treatments might or might not be efficacious across a diverse set of literatures.…”

“…Our approach will allow for an evaluation of the statistical support for the effectiveness of cognitive rehabilitation on overall cognitive function, as well as an evaluation of the effectiveness of classes of treatment for more focal impairments within cognitive domains, which may lead to domain-specific improvements in outcome variables. Because meta-analysis provides methods for synthesizing and quantifying results across designs that differ in methodological details, we hope to augment the systematic reviews of Cicerone et al (2000Cicerone et al ( , 2005 and Cappa et al (2003Cappa et al ( , 2005 that were used to develop practice guidelines for cognitive rehabilitation after TBI and stroke.…”