Hwan Kim, Angela Colantonio; Effectiveness of Rehabilitation in Enhancing Community Integration After Acute Traumatic Brain Injury: A Systematic Review. Am J Occup Ther 2010;64(5):709-719. doi: 10.5014/ajot.2010.09188.
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© 2019 American Occupational Therapy Association
OBJECTIVE. We assessed evidence for post–acute traumatic brain injury (TBI) rehabilitation interventions used to enhance community integration (CI) relevant to occupational therapy.
METHOD. We conducted a systematic review of intervention studies on TBI rehabilitation from 1990 to 2007.
RESULTS. We analyzed and summarized 10 studies that met the inclusion criteria. Of 10 studies, 7 found that post–acute TBI rehabilitation benefits CI; all effective studies involved occupational therapy or involved interventions occupational therapists can do.
CONCLUSION. Many CI programs show positive results and should be studied more rigorously. Such promising programs should also be considered when decisions about post–acute TBI rehabilitation services for clients are being made. To further establish that post–acute TBI rehabilitation interventions improve CI, future studies should include intervention strategies based on injury severity, a control group, and longer term follow-up. The role of occupational therapy in these effective programs should be further explored.
Strong evidence: The findings are supported by the results of two or more RCTs of at least fair quality (fair quality is defined as a PEDro score ≥4).
Moderate evidence: The findings are supported by a single RCT of at least fair quality.
Limited evidence: The findings are supported by at least one nonexperimental trial or intervention.
Consensus: In the absence of evidence, agreement was obtained from a group of experts on the appropriate treatment course. Consensus opinion is regarded as the lowest form of evidence.
Conflicting: Disagreement between findings of at least two RCTs or disagreement between two non-RCTs where RCTs are not available. Where there were more than four RCTs and the results of only one conflicted, the conclusion was based on the majority of the studies, unless the study with conflicting results was of higher quality.
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