Effectiveness of rehabilitation in enhancing community integration after acute traumatic brain injury: a systematic review.

OBJECTIVE: We assessed evidence for post-acute traumatic brain injury (TBI) rehabilitation interventions used to enhance community integration (CI) relevant to occupational therapy.

METHOD: We conducted a systematic review of intervention studies on TBI rehabilitation from 1990 to 2007.

RESULTS: We analyzed and summarized 10 studies that met the inclusion criteria. Of 10 studies, 7 found that post-acute TBI rehabilitation benefits CI; all effective studies involved occupational therapy or involved interventions occupational therapists can do.

CONCLUSION: Many CI programs show positive results and should be studied more rigorously. Such promising programs should also be considered when decisions about post-acute TBI rehabilitation services for clients are being made. To further establish that post-acute TBI rehabilitation interventions improve CI, future studies should include intervention strategies based on injury severity, a control group, and longer term follow-up. The role of occupational therapy in these effective programs should be further explored.