Velikonja Diana, Tate Robyn, Ponsford Jennie, McIntyre Amanda, Janzen Shannon, Bayley Mark
Neuropsychology, Acquired Brain Injury Program, Hamilton Health Sciences, Hamilton, Ontario, Canada (Dr Velikonja); Department of Psychiatry and Behavioural Neurosciences, DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada (Dr Velikonja); NHMRC Centre of Research Excellence in Traumatic Brain Injury Psychosocial Rehabilitation, Sydney, New South Wales, Australia (Drs Tate and Ponsford); Royal Rehabilitation Centre, Sydney, New South Wales, Australia (Dr Tate); Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School-Northern, University of Sydney, Sydney, New South Wales, Australia (Dr Tate); School of Psychology and Psychiatry, Monash University and Epworth Hospital, Melbourne, Victoria, Australia (Dr Ponsford); National Trauma Research Institute, Monash University and the Alfred Hospital, Melbourne, Victoria, Australia (Dr Ponsford); Lawson Health Research Institute, St. Joseph's Parkwood Hospital, London, Ontario, Canada (Mss McIntyre and Janzen); and Neuro Rehabilitation Program, Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada (Dr Bayley).
J Head Trauma Rehabil. 2014 Jul-Aug;29(4):369-86. doi: 10.1097/HTR.0000000000000069.
Traumatic brain injury results in complex cognitive sequelae. Impairments in memory are among the most common sequelae resulting in significant functional problems. An international team of researchers and clinicians (known as INCOG) was formed to develop recommendations for the management of impairments in memory.
The experts met to select appropriate recommendations and then reviewed available literature to ensure recommendations were current. Decision algorithms incorporating the recommendations based on inclusion and exclusion criteria of published trials were developed. The team then prioritized recommendations for implementation and developed audit criteria to evaluate adherence to the best practice recommendations.
The recommendations for rehabilitation of memory impairments support the integration of internal and external compensatory strategies implemented using appropriate instructional techniques that consider functional relevance and important patient characteristics. Restorative strategies have regained significant popularity, given broader access to computer technology; however, evidence for efficacy of these techniques remains weak and the choice in using these should be guided by special considerations.
There is good evidence for the integration of internal and external compensatory memory strategies that are implemented using instructional procedures for rehabilitation for memory impairments. The evidence for the efficacy of restorative strategies currently remains weak.
创伤性脑损伤会导致复杂的认知后遗症。记忆障碍是最常见的后遗症之一,会导致严重的功能问题。一个由研究人员和临床医生组成的国际团队(称为INCOG)成立,旨在制定记忆障碍管理的建议。
专家们会面以选择合适的建议,然后查阅现有文献以确保建议是最新的。基于已发表试验的纳入和排除标准,制定了包含这些建议的决策算法。然后,该团队对实施建议进行了优先级排序,并制定了审核标准以评估对最佳实践建议的遵守情况。
记忆障碍康复的建议支持采用适当的教学技术整合内部和外部补偿策略,这些技术要考虑功能相关性和重要的患者特征。鉴于计算机技术的更广泛应用,恢复性策略重新受到广泛关注;然而,这些技术的疗效证据仍然薄弱,使用这些技术的选择应基于特殊考虑。
有充分证据支持使用教学程序来整合内部和外部补偿性记忆策略,以用于记忆障碍的康复。目前,恢复性策略疗效的证据仍然薄弱。