We evaluated evidence for the effectiveness of cognitive rehabilitation methods to improve outcomes for persons with traumatic brain injury (TBI). A search of MEDLINE, HealthSTAR, CINAHL, PsycINFO, and the Cochrane Library produced 600 potential references. Thirty-two studies met predetermined inclusion criteria and were abstracted; data from 24 were placed into evidence tables. Two randomized controlled trials and one observational study provided evidence that specific forms of cognitive rehabilitation reduce memory failures and anxiety, and improve self-concept and interpersonal relationships for persons with TBI. The durability and clinical relevance of these findings is not established. Future research utilizing control groups and multivariate analysis must incorporate subject variability and must include standard definitions of the intervention and relevant outcome measures that reflect health and function.
Assistant Professor, Department of Emergency Medicine (Carney)
Director, Neurotrauma and Neurosurgical Critical Care, Departments of Neurological Surgery and Emergency Medicine (Chesnut)
Professor, Department of Emergency Medicine, Division of Medical Informatics and Outcomes Research (Maynard)
Assistant Professor, Department of Emergency Medicine (Mann)
Assistant Professor of Nursing (Patterson)
Associate Professor, Division of Medical Informatics and Outcomes Research, Oregon Health Sciences University, Portland, Oregon (Helfand)
This study was supported by Contract no. 290–97–0018, awarded by the Agency for Health Care Policy and Research (AHCPR). The authors are solely responsible for the content of this article, and the opinions do not necessarily represent the views of the AHCPR.
The authors acknowledge Oregon Health Sciences University Neurotrauma Research Group, the Fourth Annual Aspen Neurobehavioral Conference, the Brain Injury Support Group of Portland, and Mark Ylvisaker, PhD.
Address correspondence to N. Carney, Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098.