Cope D N
Paradigm Health Corporation, Concord, CA 94520, USA.
Brain Inj. 1995 Oct;9(7):649-70. doi: 10.3109/02699059509008224.
The rehabilitation of traumatic brain injury (TBI) has undergone tremendous development over the past 20 years. A much more aggressive, extended and comprehensive approach is now common and clinically accepted. Multiple new forms and sites of treatment are utilized such as cognitive, behavioural, sub-acute and post-acute rehabilitation programmes. While there has been widespread clinical acceptance of these treatments the appearance of well-designed experimental or quasi-experimental studies actually evaluating the results of such treatment have been, until recently, generally lacking. This review article selects, analyses, and critiques the most salient of recent studies published regarding the overall clinical benefit, and to some extent the cost benefit, of TBI treatment programmes in their multiple forms. A conclusion which is reached following this survey is that while truly randomized controlled studies still have not been achieved, an impressive variety of studies of quasi-experimental design have been completed. The overall conclusion from these studies is that the efficacy (and cost-effectiveness) of TBI rehabilitation is strongly supported.
在过去20年里，创伤性脑损伤（TBI）的康复取得了巨大进展。如今，一种更积极、更全面且更具扩展性的康复方法已很常见并被临床所接受。人们采用了多种新的治疗形式和治疗地点，比如认知、行为、亚急性和急性后期康复项目。虽然这些治疗方法在临床上已被广泛接受，但直到最近，实际上评估此类治疗效果的精心设计的实验性或准实验性研究普遍还很缺乏。这篇综述文章挑选、分析并评论了近期发表的关于TBI多种治疗方案的总体临床益处以及在一定程度上成本效益的最突出研究。本次调查得出的结论是，虽然尚未真正实现随机对照研究，但已经完成了大量令人印象深刻的准实验设计研究。这些研究的总体结论是，TBI康复的疗效（和成本效益）得到了有力支持。
