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Evidence Lacking That Cognitive Rehab Therapy Helps Brain-Injured Vets
Date:10/11/2011

TUESDAY, Oct. 11 (HealthDay News) -- Studies on the effectiveness of cognitive rehabilitation therapy for traumatic brain injury are plagued by design problems, a new report issued by the U.S. Institute of Medicine (IOM) finds.

The upshot: While evidence exists that this kind of therapy helps such patients regain lost mental and physical skills, it's not strong enough to develop definitive guidelines for its use.

With traumatic brain injury (TBI) now a "signature wound" among veterans of the Iraq and Afghanistan wars, the U.S. Department of Defense initiated a review of studies on cognitive rehabilitation therapy (CRT) to determine how it should be used and covered in the military health system.

The Society for Cognitive Rehabilitation website describes the therapy as "the process of relearning cognitive skills that have been lost or altered as a result of damage to brain cells/chemistry."

"Survivors of traumatic brain injury may face long-term challenges in rehabilitation and reintegration to everyday life," report chair Ira Shoulson, director of Georgetown University Medical Center's program for regulatory science and medicine, said in an IOM news release.

"They need an effective health care infrastructure and evidence-based treatment and rehabilitation policies to care for and cope with their impairments," he added.

CRT can be given one-on-one or in a group, and for long or short periods of time. A typical program can involve a speech-language pathologist, a neuropsychologist, a physical therapist, and/or an occupational therapist depending on the issue at hand. All therapies are designed to help TBI patients recover their ability to communicate, think clearly, and/or perform basic daily functions such as cooking and dressing.

Dr. Summer Ott, a neuropsychologist and co-director of the Methodist Concussion Center in Houston, said measuring success of CRT is understandably difficult.

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