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中度至重度创伤性脑损伤后认知康复疗效的更新:范围综述。

Update on the Efficacy of Cognitive Rehabilitation After Moderate to Severe Traumatic Brain Injury: A Scoping Review.

机构信息

Department of Neurology, Toulouse University Hospital, Toulouse, France; Toulouse Neuroimaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.

Department of Neurology, Toulouse University Hospital, Toulouse, France; Toulouse Neuroimaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.

出版信息

Arch Phys Med Rehabil. 2023 Feb;104(2):315-330. doi: 10.1016/j.apmr.2022.07.007. Epub 2022 Jul 31.

DOI:10.1016/j.apmr.2022.07.007
PMID:35921874
Abstract

OBJECTIVES

To identify, categorize, and analyze the methodological issues of cognitive rehabilitation of patients with moderate to severe traumatic brain injury and its efficacy.

DATA SOURCES

Pubmed and PsycINFO were searched for studies published between 2015 and 2021 using keywords for cognitive intervention and traumatic brain injury.

STUDY SELECTION

Two independent reviewers selected articles concerning cognitive rehabilitation for adults with traumatic brain injury. Of 458 studies, 97 full-text articles were assessed and 46 met the inclusion criteria.

DATA EXTRACTION

Data were analyzed by 1 reviewer according to criteria concerning the methodological quality of studies.

DATA SYNTHESIS

Results showed a large scope of 7 cognitive domains targeted by interventions, delivered mostly in individual sessions (83%) with an integrative cognitive approach (48%). Neuroimaging tools as a measure of outcome remained scarce, featuring in only 20% of studies. Forty-three studies reported significant effects of cognitive rehabilitation, among which 7 fulfilled a high methodological level of evidence.

CONCLUSIONS

Advances and shortcomings in cognitive rehabilitation have both been highlighted and led us to develop methodological key points for future studies. The choice of outcome measures, the selection of control interventions, and the use of combined rehabilitation should be investigated in further studies.

摘要

目的

识别、分类和分析中度至重度创伤性脑损伤患者认知康复及其疗效的方法学问题。

资料来源

使用认知干预和创伤性脑损伤的关键词,在 Pubmed 和 PsycINFO 上搜索了 2015 年至 2021 年期间发表的研究。

研究选择

两名独立的审查员选择了关于创伤性脑损伤成人认知康复的文章。在 458 项研究中,评估了 97 篇全文文章,其中 46 篇符合纳入标准。

数据提取

根据研究方法学质量的标准,由 1 名审查员对数据进行分析。

数据综合

结果显示,干预措施针对 7 个认知领域,大多数采用个体治疗(83%)和综合认知方法(48%)。作为评估结果的神经影像学工具仍然很少,只有 20%的研究使用了这种工具。43 项研究报告了认知康复的显著效果,其中 7 项具有较高的证据水平。

结论

本文强调了认知康复的进展和不足,并为未来的研究提出了方法学要点。应在进一步的研究中调查结果测量的选择、对照干预的选择以及联合康复的使用。

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