Abstract:In this particular MTBI sample, early active rehabilitation did not change the outcome to a statistically-significant degree. Further studies should focus on patients with several complaints during the first 1-3 months and test various types of interventions.
“…Many either failed to use a randomized clinical trial (RCT) or controlled trial without randomizing (Goranson, Graves, Allison, & La Freniers, 2003;Gronwall, 1986;Minderhoud, Boelens, Huizenga, & Saan, 1980), or failed to state the process of randomization when used (Ghaffar, McCullagh, Ouchterlony, & Feinstein, 2006;Rath, Simon, Langenbahn, Sherr, & Diller, 2003). Only two studies (Tiersky et al, 2005;Elgmark Andersson, Emanuelson, Bjorklund, & Stalhammer, 2007) explained a process for concealing group allocation, and only three studies reported blind outcomes measurement (Elgmark Andersson et al, 2007;Leonard, 2004;Tiersky et al, 2005).…”
Mild traumatic brain injury (MTBI) is common and results in persisting disability for a minority of cases. Evidence guiding clinical management of this more complex group is lacking. This study systematically reviews psychological/neuropsychological treatments for adults with MTBI, with an emphasis on external validity. A total of 8 further studies were found adding to 10 from previous reviews. Although the methodological quality remains poor, mild supportive evidence was found for educational interventions provided early following injury. However, the routine provision of interventions for all MTBI cases may not be effective. Continuing and novel research efforts are needed to identify factors associated with poor outcomes to enable efficient targeting of healthcare resources.
“…Many either failed to use a randomized clinical trial (RCT) or controlled trial without randomizing (Goranson, Graves, Allison, & La Freniers, 2003;Gronwall, 1986;Minderhoud, Boelens, Huizenga, & Saan, 1980), or failed to state the process of randomization when used (Ghaffar, McCullagh, Ouchterlony, & Feinstein, 2006;Rath, Simon, Langenbahn, Sherr, & Diller, 2003). Only two studies (Tiersky et al, 2005;Elgmark Andersson, Emanuelson, Bjorklund, & Stalhammer, 2007) explained a process for concealing group allocation, and only three studies reported blind outcomes measurement (Elgmark Andersson et al, 2007;Leonard, 2004;Tiersky et al, 2005).…”
Mild traumatic brain injury (MTBI) is common and results in persisting disability for a minority of cases. Evidence guiding clinical management of this more complex group is lacking. This study systematically reviews psychological/neuropsychological treatments for adults with MTBI, with an emphasis on external validity. A total of 8 further studies were found adding to 10 from previous reviews. Although the methodological quality remains poor, mild supportive evidence was found for educational interventions provided early following injury. However, the routine provision of interventions for all MTBI cases may not be effective. Continuing and novel research efforts are needed to identify factors associated with poor outcomes to enable efficient targeting of healthcare resources.
“…However, a program started from two to eight weeks by a qualified rehabilitation team, for TBI patients, did not prove the difference between an early start and a rehabilitation start after one year from injury, because the patients analyzed in this study did not report improvement of sequelae, thus generating controversy in the investigations [10][11][12] (B).…”
“…Given the frequency with which OEF/OIF veterans meet screening criteria for probable brain injury, a substantial number of individuals are likely to suffer from the unrecognized and untreated consequences of TBI. At present, little empirical evidence exists to document the effectiveness of interventions for mild brain injury (Elgmark Andersson et al, 2007;Ghaffar et al, 2006;Paniak et al, 2000). The challenge of developing and conducting rigorous evaluation of treatments for mild brain injury presents an important opportunity to help OEF/OIF veterans.…”
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