Cognitive Rehabilitation Therapy for Traumatic Brain Injury : Evaluating the Evidence

Traumatic brain injury (TBI) may affect 10 million people worldwide. It is considered the "signature wound" of the conflicts in Iraq and Afghanistan. These injuries result from a bump or blow to the head, or from external forces that cause the brain to move within the head, such as whiplash or exposure to blasts. TBI can cause an array of physical and mental health concerns and is a growing problem, particularly among soldiers and veterans because of repeated exposure to violent environments. One form of treatment for TBI is cognitive rehabilitation therapy (CRT), a patient-specific, goal-oriented approach to help patients increase their ability to process and interpret information. The Department of Defense asked the IOM to conduct a study to determine the effectiveness of CRT for treatment of TBI. Table of ContentsFront MatterSummaryPART I: BACKGROUND1 Introduction2 Traumatic Brain Injury3 Factors Affecting Recovery4 Defining Cognitive Rehabilitation Therapy5 State of Practice and Providersof Cognitive Rehabilitation TherapyPART II: REVIEW OF THE EVIDENCE6 Methods7 Attention8 Executive Function9 Language and Social Communication10 Memory11 Multi-Modal or Comprehensive Cognitive Rehabilitation Therapy12 Telehealth Technology13 Adverse Events or HarmPART III: RECOMMENDATIONS14 DirectionsAppendixesAppendix A: Comparative Effectiveness and Implementation Research for Neurocognitive Disorders: Concepts Relevant to Cognitive Rehabilitation Therapy for Traumatic Brain InjuryAppendix B: Workshop AgendasAppendix C: Recent and Ongoing Clinical Trials: CRT for TBIAppendix D: Biosketches of Committee Members and Staff

Traumatic brain injury (TBI) may affect 10 million people worldwide. It is considered the "signature wound" of the conflicts in Iraq and Afghanistan. These injuries result from a bump or blow to the head, or from external forces that cause the brain to move within the head, such as whiplash or exposure to blasts. TBI can cause an array of physical and mental health concerns and is a growing problem, particularly among soldiers and veterans because of repeated exposure to violent environments. One form of treatment for TBI is cognitive rehabilitation therapy (CRT), a patient-specific, goal-oriented approach to help patients increase their ability to process and interpret information. The Department of Defense asked the IOM to conduct a study to determine the effectiveness of CRT for treatment of TBI.