American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

The Cochrane Collaboration; King’s College London UK; Luff Foundation UK; Department of Health Research and Development Programme UK
Multi-Disciplinary Rehabilitation for Acquired Brain Injury in Adults of Working Age

Turner-Stokes, L., Disler, P. B., et al. (2005).
Cochrane Database of Systematic Reviews(3).

Indicators of Review Quality:

The review addresses a clearly focused question Yes
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes

Description: This is a meta-analysis of randomized controlled trials investigating the effects of multi-disciplinary rehabilitation on individuals with acquired brain injury.

Question(s) Addressed:

  1. Does organized multi-disciplinary rehabilitation achieve better outcomes than the absence of such services for this group of patients?
  2. Does a greater intensity (time and/or expertise) of rehabilitation lead to greater gains?
  3. Which type of programs are effective in which setting?
  4. Which specific outcomes are influenced (dependency, social integration, mood, return to work, etc.)?
  5. Are there demonstrable cost-benefits for multi-disciplinary rehabilitation?

Population: Between 16 and 65 years of age with acquired brain injury of any cause.

Intervention/Assessment: Any intervention designed to reduce disability and handicap resulting from disease or injury. Multi-disciplinary rehabilitation was defined for this review as any intervention delivered by two or more disciplines.

Number of Studies Included: 14

Years Included: Through March 2004

Findings:

Conclusions:

  • "While every patient presenting to hospital with acquired brain injury should be given information about the nature of brain injury and who to contact in case of problems, it appears that routine follow-up may be reserved for patients identified as having at least significant brain injury on the basis of their presentation or residual deficits, most easily defined as those admitted to hospital or, if not, with any documented period of coma or with post-traumatic amnesia extending for more than 30 minutes (p. 20)
  • "For those patients engaged in rehabilitation, intervention should be offered as intensively as possible, although the balance between intensity and cost-effectiveness has yet to be determined (p. 20)
  • "Patients discharged from inpatient rehabilitation settings, who have continued rehabilitation needs and goals, should have access to follow-up outpatient or community-based services as appropriate to their needs." (p. 20)

Keywords: Brain Injury, Stroke, Cognitive Rehabilitation

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Note:

Conclusion is relevant but not specific to speech-language pathology.

Added to Compendium: September 2009

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