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Brain Injury Volume 21, 2007 - Issue 2
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A systematic review of the rehabilitation of moderate to severe acquired brain injuries

Robert Teasell St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, CanadaCorrespondence[email protected]
, MD, FRCPC,
Nestor Bayona St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Shawn Marshall St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Nora Cullen St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Mark Bayley St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Josie Chundamala St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Jimmy Villamere St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
David Mackie St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Laura Rees St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Cheryl Hartridge St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Corbin Lippert St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Maureen Hilditch St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Penny Welch-West St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Margaret Weiser St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Connie Ferri St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Pat Mccabe St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Anna Mccormick St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Jo-Anne Aubut St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Paul Comper St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Katherine Salter St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Robert Van Reekum St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
David Collins St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Norine Foley St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Jozef Nowak St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Jeff Jutai St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Mark Speechley St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
,
Chelsea Hellings St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
&
Linh Tu St. Joseph's Health Care London, Ottawa Rehabilitation Centre, and the Toronto Rehabilitation Institute, and affiliated with Physical Medicine and Rehabilitation at the Schulich School of Medicine and Dentistry, University of Western Ontario, Faculty of Medicine, University of Ottawa, and Faculty of Medicine, University of Toronto, Ontario, Canada
 show all
Pages 107-112 | Received 16 Jun 2006, Accepted 04 Dec 2006, Published online: 03 Jul 2009
 
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Abstract

Objective: To conduct a systematic review of the rehabilitation literature of moderate to severe acquired brain injuries (ABI) from traumatic and non-traumatic causes.

Methods: A review of the literature was conducted for studies looking at interventions in ABI rehabilitation. The methodological quality of each study was determined using the Downs and Black scale for randomized controlled trials (RCTs) and non-RCTs as well as the Physiotherapy Evidence Database (PEDro) scale for RCTs only.

Results: Almost 14 000 references were screened from which 1312 abstracts were selected. A total of 303 articles were chosen for careful review of which 275 were found to be interventional studies but only 76 of these interventional studies were RCTs. From this, 5 levels of evidence were determined with 177 conclusions drawn; however of the 177 conclusions only 7 were supported by two or more RCTs and 41 were supported by one RCT.

Conclusion: Only 28% of the interventional studies were RCTs. Over half of the 275 interventional studies were single group interventions, pointing to the need for studies of improved methodological quality into ABI rehabilitation.

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