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Evidence-based cognitive rehabilitation: recommendations for clinical practice.

K D Cicerone1, C Dahlberg, K Kalmar

  • 1JFK-Johnson Rehabilitation Institute, Edison, NJ 08820, USA. kcicerone@jfk.hbocvan.com

Archives of Physical Medicine and Rehabilitation
|December 29, 2000
PubMed
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This review provides evidence-based recommendations for cognitive rehabilitation in traumatic brain injury (TBI) and stroke patients. Effective treatments exist for attention, memory, and executive functions in TBI, and for language and perception in stroke survivors.

Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Psychology

Background:

  • Cognitive deficits are common after traumatic brain injury (TBI) and stroke.
  • Effective cognitive rehabilitation strategies are crucial for patient recovery and functional outcomes.
  • Establishing evidence-based practice parameters is essential for guiding clinicians.

Purpose of the Study:

  • To systematically review the scientific literature on the effectiveness of cognitive rehabilitation for individuals with TBI or stroke.
  • To develop evidence-based recommendations for clinical practice in cognitive rehabilitation.

Main Methods:

  • A comprehensive MEDLINE search was conducted using keywords related to cognition and rehabilitation.
  • Studies were screened and selected based on predefined inclusion/exclusion criteria, focusing on intervention studies for TBI and stroke.

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  • Eligible articles were categorized by intervention type and assessed for methodological quality (Class I, II, III).

    • Main Results:

    • 171 articles were evaluated, with 29 classified as Class I, 35 as Class II, and 107 as Class III studies.
    • Evidence supports the effectiveness of various cognitive rehabilitation approaches for stroke and TBI.
    • Specific recommendations were formulated based on the strength of evidence for different cognitive domains.

    Conclusions:

    • Cognitive rehabilitation is an effective intervention for individuals with TBI and stroke.
    • Evidence supports specific recommendations for remediating language and perception after stroke.
    • Recommendations are provided for improving attention, memory, communication, and executive functions in TBI patients.