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Updated: Apr 27, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
INCOG guidelines for cognitive rehabilitation following traumatic brain injury: methods and overview
Mark Theodore Bayley1, Robyn Tate, Jacinta Mary Douglas
1Brain and Spinal Cord Rehabilitation Program (Dr Bayley), Toronto Rehabilitation Institute/University Health Network (Dr Kua), Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Dr Bayley); Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School-Northern, University of Sydney, Royal Rehabilitation Centre, Sydney, New South Wales, Australia (Dr Tate); Department of Human Communication Sciences, La Trobe University, Melbourne, Victoria, Australia (Dr Douglas); Department of Communication Sciences and Disorders, University of Wisconsin-Madison (Dr Turkstra); School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia (Dr Ponsford); Toronto Rehabilitation Institute, Toronto, Ontario, Canada (Dr Stergiou-Kita); Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada (Dr Stergiou-Kita); and National Trauma Research Institute & Monash University, Melbourne, Victoria, Australia (Dr Bragge).
Introduction:
Traumatic brain injury results in complex cognitive sequelae. However, clinicians have difficulty implementing the available evidence. An international group of researchers and clinicians (known as INCOG) convened to develop clinical practice guidelines for cognitive rehabilitation posttraumatic brain injury.
Methods:
The Guidelines Adaptation and Development cycle was used to derive the recommendations. Previously published cognitive rehabilitation recommendations were identified and tabulated. An expert panel met to select appropriate recommendations. Afterward, the team enhanced the recommendations by reviewing available literature. To address shortfalls of previous guidelines, the team developed decision algorithms incorporating the recommendations based on inclusion and exclusion criteria of published trials and expert opinion. The team then prioritized the recommendations for implementation and developed audit criteria to evaluate adherence to best practice.
Results:
The team recommends that individuals have detailed assessments of cognition after resolution of posttraumatic amnesia. Cognitive assessment and rehabilitation should be tailored to the patient's neuropsychological profile, premorbid cognitive characteristics, and goals for life activities and participation. Clinical algorithms and audit tools to evaluate current practice are provided.
Conclusion:
Cognitive rehabilitation should be offered to select individuals with traumatic brain injury. These guidelines provide assistance to clinicians who want to provide evidence-based care.
