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Guidelines Updated for Cognitive Rehabilitation After TBI

Updates include management of posttraumatic amnesia, new section addressing use of telemedicine

By Elana Gotkine HealthDay Reporter

TUESDAY, Jan. 17, 2023 (HealthDay News) — In an article published in the January/February issue of the Journal of Head Trauma Rehabilitation, the authors present an update to the guidelines for cognitive rehabilitation following traumatic brain injury (TBI).

After reviewing the changes in the evidence from 2014, Mark Theodore Bayley, M.D., from the KITE Research Institute at the University of Toronto, and colleagues provide an overview of the updated guidelines: INCOG 2.0 Cognitive Rehabilitation Following TBI.

The authors outline the general principles of cognitive rehabilitation, including an updated section on telerehabilitation. Guidance relating to management of posttraumatic amnesia has been updated to reflect new and emerging evidence for assessment and therapy, including a structured error-controlled and procedural learning approach. Limited changes were seen in relation to rehabilitation of attention and processing speed; stronger evidence underlying pharmacological interventions for attention are addressed. The evolving and strengthening evidence for metacognitive strategy instruction and use of telerehabilitation are documented in relation to executive functions. Revised and updated recommendations resulting from strengthening of the evidence are presented for treatment of cognitive-communication disorders, including recommendations of telerehabilitation. Inclusion of rehabilitation for impairments of social cognition represents a further enhancement of the guidelines. A continuing focus on teaching of strategies for memory rehabilitation, which are the most widely used cognitive rehabilitation interventions, is included.

“We recognize that much work remains and hope that INCOG 2.0 is a positive step toward promoting better outcomes for those living with the effects of TBI and their families,” the authors write.

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