Citation

Bayley MT, Lamontagne ME, Kua A, Marshall S, Marier-Deschênes P, Allaire AS, Kagan C, Truchon C, Janzen S, Teasell R, Swaine B. J. Head Trauma Rehabil. 2018; 33(5): 296-305.

Affiliation

Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada (Dr Bayley); Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Dr Bayley); Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada (Dr Lamontagne); Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada (Ms Kua); Ottawa Hospital Research Institute (OHRI) and University of Ottawa, Ontario, Canada (Dr Marshall); Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada (Ms Marier-Deschênes); Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Québec, Canada (Ms Allaire); Ontario Neurotrauma Foundation (ONF), Toronto, Ontario, Canada (Ms Kagan); Institut national d'excellence en santé et en services sociaux (INESSS), Québec, Canada (Dr Truchon); Lawson Health Research Institute, St Joseph's Health Care, London, Ontario, Canada (Ms Janzen); St Joseph's Health Care, University of Western Ontario, London, Ontario, Canada (Dr Teasell); and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) and Université de Montréal, Québec, Canada (Dr Swaine).

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000428

PMID

30188459

Abstract

OBJECTIVE: Traumatic brain injury (TBI) clinical practice guidelines are a potential solution to rapidly expanding literature. The project objective was to convene experts to develop a unique set of TBI rehabilitation recommendations incorporating users' priorities for format and implementation tools including indicators of adherence.

METHODS: The Guidelines Adaptation & Development Cycle informed recommendation development. Published TBI recommendations were identified and tabulated. Experts convened to adapt or, where appropriate, develop new evidence-based recommendations. These draft recommendations were validated by systematically reviewing relevant literature. Surveys of experts and target users were triangulated with strength of evidence to identify priority topics.

RESULTS: The final recommendation set included a rationale, implementation tools (algorithms/adherence indicators), key process indicators, and evidence summaries, and were divided in 2 sections: Section I: Components of the Optimal TBI Rehabilitation System (71 recommendations) and Section II: Assessment and Rehabilitation of Brain Injury Sequelae (195 recommendations). The recommendations address top priorities for the TBI rehabilitation system: (1) intensity/frequency of interventions; (2) rehabilitation models; (3) duration of interventions; and (4) continuity-of-care mechanisms. Key sequelae addressed (1) behavioral disorders; (2) cognitive dysfunction; (3) fatigue and sleep disturbances; and (4) mental health.

CONCLUSION: This TBI rehabilitation guideline used a robust development process to address users' priorities.

Language: en