Division of Rehabilitation Psychology, Department of Physical Medicine and Rehabilitation, The Ohio State University College of Medicine, Columbus (Drs Beaulieu, Corrigan, and Bogner); Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus (Dr Hade and Ms Peng); Department of Rehabilitation Services, The Ohio State University Medical Center, Columbus (Ms Montgomery); Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City (Dr Horn); and Speech Pathology Department, Intermountain Medical Center, Murray, Utah (Ms Gilchrist).
J Head Trauma Rehabil. 2021;36(5):E312-E321. doi: 10.1097/HTR.0000000000000649.
To evaluate the effect of providing quasi-contextualized speech therapy, defined as metacognitive, compensatory, or strategy training applied to cognitive and language impairments to facilitate the performance of future real-life activities, on functional outcomes up to 1 year following traumatic brain injury (TBI).
Acute inpatient rehabilitation.
Patients enrolled during the TBI-Practice-Based Evidence (TBI-PBE) study (n = 1760), aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, received speech therapy in acute inpatient rehabilitation at one of 9 US sites, and consented to follow-up 3 and 9 months postdischarge from inpatient rehabilitation.
Propensity score methods applied to a database consisting of multisite, prospective, longitudinal observational data.
Participation Assessment with Recombined Tools-Objective-17, FIM Motor and Cognitive scores, Satisfaction With Life Scale, and Patient Health Questionnaire-9.
When at least 5% of therapy time employed quasi-contextualized treatment, participants reported better community participation during the year following discharge. Quasi-contextualized treatment was also associated with better motor and cognitive function at discharge and during the year after discharge. The benefit, however, may be dependent upon a balance of rehabilitation time that relied on contextualized treatment.
The use of quasi-contextualized treatment may improve outcomes. Care should be taken, however, to not provide quasi-contextualized treatment at the expense of contextualized treatment.
评估提供准语境化言语治疗的效果，这种治疗方法将元认知、补偿或策略训练应用于认知和语言障碍，以促进未来真实生活活动的表现，直至创伤性脑损伤（TBI）后 1 年的功能结果。
急性住院康复。
在 TBI 实践证据（TBI-PBE）研究中纳入的患者（n=1760），年龄在 14 岁或以上，患有严重、中度或复杂轻度 TBI，在 9 个美国地点之一的急性住院康复中接受言语治疗，并同意在出院后 3 个月和 9 个月进行随访。
应用于多站点、前瞻性、纵向观察数据数据库的倾向评分方法。
使用 Recombined Tools-Objective-17 进行参与评估、FIM 运动和认知评分、生活满意度量表和患者健康问卷-9。
当至少 5%的治疗时间采用准语境化治疗时，参与者在出院后的一年内报告了更好的社区参与度。准语境化治疗也与出院时和出院后一年的运动和认知功能更好相关。然而，这种益处可能取决于依赖于语境化治疗的康复时间的平衡。
使用准语境化治疗可能会改善结果。然而，应注意不要以牺牲语境化治疗为代价提供准语境化治疗。
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