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EBP Compendium: Summary of Clinical Practice Guideline

Department of Veterans Affairs; Department of Defense; The Office of Quality and Performance, VA, Washington, DC; Quality Management Directorate, United States Army MEDCOM
Management of Concussion/Mild Traumatic Brain Injury

The Management of Concussion/mTBI Working Group. (2009).
VA/DoD Clinical Practice Guideline, Version 1.0, 1-109.

AGREE Rating: Recommended with Provisos


This guideline provides recommendations for the assessment, diagnosis, treatment, and symptom management of mild traumatic brain injury (MTBI) in adults. The target audience of this guideline is healthcare professionals, including speech-language pathologists and audiologists, involved in the management of MTBI. The recommendations are classified A, B, C or I, based on the strength and consistency of evidence. A Level A recommendation indicates that the intervention improves important health outcomes and the benefits substantially outweigh the harms. A Level B recommendation provides fair evidence that the intervention improves health outcomes and the benefits outweigh the harms. A Level C recommendation provides fair evidence that the intervention is ineffective or that the harms outweigh the benefits. A Level I recommendation indicates that evidence for an intervention is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined. Consensus recommendations are based on expert clinical knowledge and experience.


  • Assessment/Diagnosis
    • Assessment Areas
      • Hearing - Treatment of physical symptoms less common in individuals with concussive or mild traumatic brain injury symptoms may include referral to audiology for hearing assessment and otologic examination and review of ototoxic medications (Consensus Statement).
  • Treatment
    • Cognition
      • Compensatory Memory Treatments - Recommendations for consistent cognitive difficulties include “referral to cognitive rehabilitation therapist with expertise in TBI rehabilitation (e.g. speech and language pathology, neuropsychology, or occupational therapy) for compensatory training and/or instruction and practice on use of external memory aids such as a PDA" (Level C Evidence) (p. 56). 

Keywords: Brain Injury

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Added to Compendium: November 2011

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