Potential Roles for Cognitive Rehabilitation Therapy in Treating Traumatic Brain Injury

by Kathy Jones on  October 13, 2011 at 8:26 PM Research News
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A new report from the Institute of Medicine acknowledges that there is some evidence about the potential value of cognitive rehabilitation therapy (CRT) for treating traumatic brain injury (TBI). However it adds that overall it is not sufficient to develop definitive guidelines on how to apply these therapies and to determine which type of CRT will work best for a particular patient.

Research has yielded promising data on the effectiveness of some forms of CRT for helping patients with TBI, but the majority of the evidence is limited due to methodological shortcomings in the studies and challenges in studying the use of CRT in this patient population, said the committee that wrote the report. Obtaining the necessary evidence requires improvements to the way those data are collected and standardization of the terms used to describe these personalized therapies and their outcomes.

Given that methodological shortcomings in the evidence do not rule out potential meaningful benefits for patients, the committee supported the ongoing use of CRT for people suffering from TBI while improvements are made in the standardization, design, and conduct of studies.

CRT is an umbrella term for a range of systematic, goal-oriented approaches to overcoming or compensating for cognitive impairments such as those caused by TBI. There are several forms of the therapy that vary by technique as well as the symptoms they target. Roughly 10 million people worldwide have TBI, which can cause significant physical, emotional, and cognitive disabilities and may have spillover effects on family members and caregivers. TBI has become known as the "signature wound" of the wars in Iraq and Afghanistan. From 2000 to 2010, the number of military service members diagnosed with TBI nearly tripled from just under 11,000 to more than 30,700, the report notes. The majority of injuries are mild and only a small percentage are severe, but recovery is often lengthy and incomplete, especially in more severe cases. The report responds to a request from the U.S. Department of Defense for an objective evaluation of CRT's effectiveness to guide decisions about the use and coverage of these interventions in the military health system.

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