Andrei Diana, Mederle Alexandra Laura, Ghenciu Laura Andreea, Borza Claudia, Faur Alexandra Corina
Department XVI, Discipline of Medical Rehabilitation, University of Medicine and Pharmacy "Victor Babes", 300041 Timisoara, Romania.
Department XIV, Discipline of Dermatology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Life (Basel). 2025 Mar 20;15(3):503. doi: 10.3390/life15030503.
Traumatic brain injury (TBI) represents a significant public health issue, causing long-term disabilities and imposing considerable socioeconomic and healthcare challenges. While advancements in acute care have improved survival rates, the demand for effective neurorehabilitation is increasing. This narrative review explores the evidence on neurorehabilitation strategies for TBI, focusing on interventions targeting cognitive, motor, and psychological recovery. A total of 32 studies were included and categorized into six approaches: non-invasive brain stimulation, virtual reality (VR), computer-based training, telerehabilitation, robot-assisted therapy (RAT), and mixed approaches. Non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), showed variable effectiveness in improving cognitive outcomes. VR-based therapies enhanced attention and executive functions, while RAT, such as Lokomat and exoskeletons, improved gait symmetry and functional mobility. Computer-assisted programs demonstrated benefits in rehabilitating social cognition and executive functions. Telerehabilitation and telephone-based treatments provided short-term gains but lacked sustained effects. Overall, cognitive improvements were better described and represented, while several motor improvements lacked consistency. Despite the promising results, significant gaps remain, including heterogeneity in methodologies, small sample sizes, and limited long-term outcome data.
创伤性脑损伤（TBI）是一个重大的公共卫生问题，会导致长期残疾，并带来巨大的社会经济和医疗挑战。尽管急性护理方面的进展提高了生存率，但对有效神经康复的需求仍在增加。本叙述性综述探讨了TBI神经康复策略的证据，重点关注针对认知、运动和心理恢复的干预措施。共纳入32项研究，并分为六种方法：无创脑刺激、虚拟现实（VR）、基于计算机的训练、远程康复、机器人辅助治疗（RAT）和混合方法。无创脑刺激技术，如经颅直流电刺激（tDCS）和重复经颅磁刺激（rTMS），在改善认知结果方面显示出不同的效果。基于VR的疗法增强了注意力和执行功能，而RAT，如Lokomat和外骨骼，改善了步态对称性和功能移动性。计算机辅助程序在恢复社会认知和执行功能方面显示出益处。远程康复和基于电话的治疗提供了短期收益，但缺乏持续效果。总体而言，认知改善得到了更好的描述和体现，而一些运动改善缺乏一致性。尽管结果令人鼓舞，但仍存在重大差距，包括方法的异质性、样本量小以及长期结果数据有限。
