Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada (Dr Bayley); Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Dr Bayley); Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada (Dr Lamontagne); Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada (Ms Kua); Ottawa Hospital Research Institute (OHRI) and University of Ottawa, Ontario, Canada (Dr Marshall); Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada (Ms Marier-Deschênes); Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Québec, Canada (Ms Allaire); Ontario Neurotrauma Foundation (ONF), Toronto, Ontario, Canada (Ms Kagan); Institut national d'excellence en santé et en services sociaux (INESSS), Québec, Canada (Dr Truchon); Lawson Health Research Institute, St Joseph's Health Care, London, Ontario, Canada (Ms Janzen); St Joseph's Health Care, University of Western Ontario, London, Ontario, Canada (Dr Teasell); and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) and Université de Montréal, Québec, Canada (Dr Swaine).
J Head Trauma Rehabil. 2018 Sep/Oct;33(5):296-305. doi: 10.1097/HTR.0000000000000428.
Traumatic brain injury (TBI) clinical practice guidelines are a potential solution to rapidly expanding literature. The project objective was to convene experts to develop a unique set of TBI rehabilitation recommendations incorporating users' priorities for format and implementation tools including indicators of adherence.
The Guidelines Adaptation & Development Cycle informed recommendation development. Published TBI recommendations were identified and tabulated. Experts convened to adapt or, where appropriate, develop new evidence-based recommendations. These draft recommendations were validated by systematically reviewing relevant literature. Surveys of experts and target users were triangulated with strength of evidence to identify priority topics.
The final recommendation set included a rationale, implementation tools (algorithms/adherence indicators), key process indicators, and evidence summaries, and were divided in 2 sections: Section I: Components of the Optimal TBI Rehabilitation System (71 recommendations) and Section II: Assessment and Rehabilitation of Brain Injury Sequelae (195 recommendations). The recommendations address top priorities for the TBI rehabilitation system: (1) intensity/frequency of interventions; (2) rehabilitation models; (3) duration of interventions; and (4) continuity-of-care mechanisms. Key sequelae addressed (1) behavioral disorders; (2) cognitive dysfunction; (3) fatigue and sleep disturbances; and (4) mental health.
This TBI rehabilitation guideline used a robust development process to address users' priorities.
创伤性脑损伤 (TBI) 临床实践指南是解决文献快速扩张的潜在方法。项目目标是召集专家制定一套独特的 TBI 康复建议，纳入用户对格式和实施工具的优先级，包括依从性指标。
指南适应和发展周期为建议的制定提供了信息。确定并列出了已发表的 TBI 建议。召集专家对现有建议进行改编，或在适当情况下制定新的基于证据的建议。这些草案建议通过系统审查相关文献进行验证。对专家和目标用户的调查与证据强度相结合，以确定优先主题。
最终的建议集包括一个基本原理、实施工具（算法/依从性指标）、关键流程指标和证据摘要，并分为两部分：第一部分：最佳 TBI 康复系统的组成部分（71 条建议）和第二部分：脑损伤后遗症的评估和康复（195 条建议）。这些建议针对 TBI 康复系统的优先事项：（1）干预的强度/频率；（2）康复模式；（3）干预的持续时间；（4）连续性护理机制。解决的主要后遗症包括：（1）行为障碍；（2）认知功能障碍；（3）疲劳和睡眠障碍；（4）心理健康。
本 TBI 康复指南采用了强大的开发过程来满足用户的优先级。
