Shen Ye, Jiang Linzhi, Lai Junmei, Hu Jiahui, Liang Feng, Zhang Xingru, Ma Fangfang
Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.
Geriatric Medicine Center, Department of Geriatric Medicine, Department of Nursing, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Front Neurol. 2025 Jun 13;16:1608645. doi: 10.3389/fneur.2025.1608645. eCollection 2025.
Traumatic Brain Injury (TBI), particularly in moderate-to-severe cases, remains a leading cause of long-term disability worldwide, affecting over 64 million individuals annually. Its complex and multifactorial nature demands an integrated, multidisciplinary rehabilitation approach to address the diverse physical, cognitive, behavioral, and psychosocial impairments that follow injury. We conducted a structured literature search using PubMed, Scopus, and Web of Science databases for suitable studies. This comprehensive review critically examines key rehabilitation strategies for TBI, including neuropsychological assessments, cognitive and neuroplasticity-based interventions, psychosocial support, and community reintegration through occupational therapy. The review emphasizes emerging technological innovations such as virtual reality, robotics, brain-computer interfaces, and tele-rehabilitation, which are expanding access to care and enhancing recovery outcomes. Furthermore, it also explores regenerative approaches, such as stem cell therapies and nanotechnology, highlighting their future potential in neurorehabilitation. Special attention is given to the importance of rigorous outcome evaluation, including standardized functional measures, neuropsychological testing, and advanced statistical methodologies to assess treatment efficacy and clinical significance. Patient-centered care is emphasized as a core element-rehabilitation plans are tailored to each individual's cognitive profile, functional needs, and life goals. Studies show this approach leads to better outcomes in executive functioning, emotional wellbeing, and community reintegration. It identifies gaps in current research, such as the lack of longitudinal studies, predictors of individualized treatment success, cost-benefit evaluations, and strategies to manage comorbidities like PTSD. Thus, combining conventional and technology-assisted rehabilitation-guided by patient-centered strategies-can enhance recovery in moderate-to-severe TBI. Future research should focus on long-term effectiveness, cost-efficiency, and scalable personalized care models.
创伤性脑损伤(TBI),尤其是中重度病例,仍然是全球长期残疾的主要原因,每年影响超过6400万人。其复杂的多因素性质需要一种综合的、多学科的康复方法,以解决受伤后出现的各种身体、认知、行为和心理社会障碍。我们使用PubMed、Scopus和Web of Science数据库进行了结构化文献检索,以寻找合适的研究。这篇综述批判性地审视了TBI的关键康复策略,包括神经心理学评估、基于认知和神经可塑性的干预措施、心理社会支持以及通过职业治疗实现社区重新融入。该综述强调了虚拟现实、机器人技术、脑机接口和远程康复等新兴技术创新,这些技术正在扩大医疗服务的可及性并改善康复效果。此外,它还探讨了再生方法,如干细胞疗法和纳米技术,突出了它们在神经康复方面的未来潜力。特别关注严格的结果评估的重要性,包括标准化功能测量、神经心理学测试以及评估治疗效果和临床意义的先进统计方法。以患者为中心的护理被强调为核心要素——康复计划根据每个人的认知状况、功能需求和生活目标量身定制。研究表明,这种方法在执行功能、情绪健康和社区重新融入方面能带来更好的结果。它指出了当前研究中的空白,如缺乏纵向研究、个体化治疗成功的预测因素、成本效益评估以及管理创伤后应激障碍等合并症的策略。因此,结合传统康复和技术辅助康复——以患者为中心的策略为指导——可以提高中重度TBI的康复效果。未来的研究应关注长期有效性、成本效益和可扩展的个性化护理模式。