Department of Clinical Science, Karolinska Institutet, 18288 Stockholm, Sweden. E-mail:
J Rehabil Med. 2021 Feb 5;53(2):jrm00149. doi: 10.2340/16501977-2791.
To determine the effectiveness of specialized rehabilitation in adults with prolonged symptoms, or risk of prolonged symptoms, following mild traumatic brain injury.
Randomized controlled trials or non-randomized controlled studies published between 1 Jan 2000 and 10 Mar 2019 in Cochrane Controlled Register of Trials, PubMed, EMBASE, CINAHL or PsycINFO. Meta-analyses were performed for studies of similar interventions when identical or comparable outcomes were reported.
Screening, data extraction, and risk of bias assessment were carried out by 2 independent researchers. Quality of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation.
A total of 9 studies were identified, which were divided into 3 subgroups. Results from meta-analyses implied that problem-solving therapy and cognitive behavioural therapy reduce residual symptoms, improve psychological functioning, decrease depression, increase activity and participation, and improve quality of life, compared with usual care. The meta-analyses also suggested that specialized interdisciplinary rehabilitation reduces residual symptoms.
Persons with mild traumatic brain injury who are at risk of, or who experience, prolonged symptoms should be considered for specialist treatment, as they may experience positive effects from cognitive behavioural therapy, problem-solving therapy, or interdisciplinary team rehabilitation. Further research is required to strengthen the evidence.
确定针对轻度创伤性脑损伤后症状持续时间延长或有延长风险的成年人进行专门康复的效果。
2000 年 1 月 1 日至 2019 年 3 月 10 日期间在 Cochrane 对照试验注册库、PubMed、EMBASE、CINAHL 或 PsycINFO 中发表的随机对照试验或非随机对照研究。当报告了相同或可比的结局时，对相似干预措施的研究进行了荟萃分析。
两名独立研究人员进行了筛选、数据提取和偏倚风险评估。使用推荐评估、制定与评价（Grading of Recommendations Assessment, Development, and Evaluation）对证据质量进行了评估。
共确定了 9 项研究，这些研究分为 3 个亚组。荟萃分析的结果表明，与常规护理相比，问题解决疗法和认知行为疗法可减少残留症状、改善心理功能、减轻抑郁、增加活动和参与度，并提高生活质量。荟萃分析还表明，专门的跨学科康复可减少残留症状。
有持续时间延长或有延长风险的轻度创伤性脑损伤患者应考虑接受专家治疗，因为他们可能会从认知行为疗法、问题解决疗法或跨学科团队康复中获益。需要进一步的研究来加强证据。
