Article

OBJECTIVE: To update our clinical recommendations for cognitive rehabilitation of
people with traumatic brain injury (TBI) and stroke, based on a systematic review
of the literature from 2003 through 2008. DATA SOURCES: PubMed and Infotrieve
literature searches were conducted using the terms attention, awareness,
cognitive, communication, executive, language, memory, perception, problem
solving, and/or reasoning combined with each of the following terms:
rehabilitation, remediation, and training for articles published between 2003 and
2008. The task force initially identified citations for 198 published articles.
STUDY SELECTION: One hundred forty-one articles were selected for inclusion after
our initial screening. Twenty-nine studies were excluded after further detailed
review. Excluded articles included 4 descriptive studies without data, 6
nontreatment studies, 7 experimental manipulations, 6 reviews, 1 single case
study not related to TBI or stroke, 2 articles where the intervention was
provided to caretakers, 1 article redacted by the journal, and 2 reanalyses of
prior publications. We fully reviewed and evaluated 112 studies. DATA EXTRACTION:
Articles were assigned to 1 of 6 categories reflecting the primary area of
intervention: attention; vision and visuospatial functioning; language and
communication skills; memory; executive functioning, problem solving and
awareness; and comprehensive-holistic cognitive rehabilitation. Articles were
abstracted and levels of evidence determined using specific criteria. DATA
SYNTHESIS: Of the 112 studies, 14 were rated as class I, 5 as class Ia, 11 as
class II, and 82 as class III. Evidence within each area of intervention was
synthesized and recommendations for Practice Standards, Practice Guidelines, and
Practice Options were made. CONCLUSIONS: There is substantial evidence to support
interventions for attention, memory, social communication skills, executive
function, and for comprehensive-holistic neuropsychologic rehabilitation after
TBI. Evidence supports visuospatial rehabilitation after right hemisphere stroke,
and interventions for aphasia and apraxia after left hemisphere stroke. Together
with our prior reviews, we have evaluated a total of 370 interventions, including
65 class I or Ia studies. There is now sufficient information to support
evidence-based protocols and implement empirically-supported treatments for
cognitive disability after TBI and stroke.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS