TY  - JOUR
PY  - 2014//
TI  - Nonsurgical Interventions After Mild Traumatic Brain Injury: A Systematic Review. Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis
JO  - Archives of physical medicine and rehabilitation
A1  - Nygren-de Boussard, Catharina
A1  - Holm, Lena W.
A1  - Cancelliere, Carol
A1  - Godbolt, Alison K.
A1  - Boyle, Eleanor
A1  - Stålnacke, Britt-Marie
A1  - Hincapié, Cesar A.
A1  - Cassidy, J. David
A1  - Borg, Jörgen
SP  - S257
EP  - S264
VL  - 95
IS  - 3S
N2  - OBJECTIVE: To synthesize the best available evidence regarding the impact of nonsurgical interventions on persistent symptoms after mild traumatic brain injury (MTBI). DATA SOURCES: MEDLINE and other databases were searched (2001-2012) with terms including "rehabilitation." Inclusion criteria were original, peer-reviewed research published in English and other languages. References were also identified from the bibliographies of eligible articles. STUDY SELECTION: Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 MTBI cases and assess nonsurgical interventions using clinically relevant outcomes such as self-rated recovery. DATA EXTRACTION: Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed each study and extracted data from the admissible studies into evidence tables. DATA SYNTHESIS: The evidence was synthesized qualitatively according to the modified SIGN criteria. Recommendations were linked to the evidence tables using a best-evidence synthesis. After 77,914 records were screened, only 2 of 7 studies related to nonsurgical interventions were found to have a low risk of bias. One studied the effect of a scheduled telephone intervention offering counseling and education on outcome and found a significantly better outcome for symptoms (6.6 difference in adjusted mean symptom score; 95% confidence interval, 1.2-12.0), but no difference in general health outcome at 6 months after MTBI. The other was a randomized controlled trial of the effectiveness of 6 days of bed rest on posttraumatic complaints 6 months postinjury, compared with no bed rest, and found no effect. CONCLUSIONS: Some evidence suggests that early, reassuring educational information is beneficial after MTBI. Well-designed intervention studies are required to develop effective treatments and improve outcomes for adults and children at risk for persistent symptoms after MTBI.<p /> <p>Language: en</p>
LA  - en
SN  - 0003-9993
UR  - http://dx.doi.org/10.1016/j.apmr.2013.10.009
ID  - ref1
ER  -