Article

The aim of this study was to perform a systematic review of the
effectiveness of comprehensive rehabilitation programmes for adults in the
chronic phase after severe acquired brain injury. METHODS: PubMed, PsychINFO and
PsychLit were searched for articles published between 1990 and 2008 and a quality
assessment was performed.
The comprehensive programmes were subdivided into
neurobehavioral interventions, residential community reintegration and
day-treatment programmes. The extracted data included study characteristics,
patient characteristics and intervention characteristics. RESULTS: Thirteen
studies met pre-established criteria. Two studies were randomized controlled
trials, 5 were controlled comparative studies and 6 were uncontrolled
longitudinal cohort studies. Overall, their methodological quality was limited.
The investigated programmes led to substantial improvement in daily life
functioning and community integration of severe chronic brain injury patients,
with lasting effects at follow-up. Day-treatment programmes had the highest level
of evidence. CONCLUSION: Comprehensive rehabilitation programmes appear to be
effective in terms of a reduction in psychosocial problems, a higher level of
community integration and an increase in employment. Although this is the first
review to differentiate between specific programmes, clear-cut clinical
recommendations cannot yet be set out due to limited methodological quality and
poor description of patient and intervention characteristics. Specific recommendations for future studies are given.

Langue : ANGLAIS