Article

I describe the findings of one of the largest randomized controlled trials (RCTs)
of rehabilitation after traumatic brain injury (TBI) ever conducted, examine the
theoretical relationship between cognitive and functional rehabilitation after
TBI, and describe the historical preference for cognitive (top-down) rather than
functional (bottom-up) interventions. I also contrast the goals and principles of
cognitive rehabilitation and of the neurofunctional approach of Giles and Clark-Wilson (1993; Giles, 2005)--a bottom-up approach. Findings of the RCT
provide empirical support for both functional and cognitive interventions
following acute TBI. In addition, they provide evidence that each type of
intervention offers significant advantages for a specific subpopulation. The
clinical implications of these findings for occupational therapy practitioners
are discussed.

Langue : ANGLAIS