The American Psychological Association (APA) has announced new findings that cognitive rehabilitation after a serious brain injury or stroke can assist mental functions in much the same way that physical therapy helps the body. The release says "because the data suggest that treatment may work best when tailored to age, injury, symptoms, and time since injury, the findings may help establish evidence-based treatment guidelines." The report on this data is in the January issue of Neuropsychology, which is published by the APA. The article is entitled, "Effectiveness of Cognitive Rehabilitation Following Acquired Brain Injury: A Meta-Analytic Re-examination of Cicerone et al.'s (2000, 2005) Systematic Reviews."

An APA press release describes how researchers at the University of South Alabama and the University of North Carolina at Charlotte analyzed and updated the data found in systematic reviews, published in 2000 and 2005 of several hundred studies of cognitive rehabilitation. The meta-analysis examined 97 articles, comprising 115 studied treatment samples and 45 control samples. From studying the patterns the article's authors offered initial treatment guidelines:

--Generally, it is better to start treating patients as early as possible, rather than waiting for a more complete neurological recovery.
--Even older patients (age 55 and up) may benefit from cognitive rehabilitation, particularly if the brain injury is due to stroke.
--Clinicians should focus their efforts on direct cognitive skills training in specific cognitive domains (such as attention or visuospatial processing). More holistic, non-targeted interventions appear to be less effective.

Several specific findings were discerned from the study. As example, patients treated less than a year after injury did better than those treated more than a year later. In another finding, older patients tended to improve more after stroke than younger patients improved after traumatic brain injury (TBI). However, the researchers caution, because strokes are more common in old age and TBI is more common in youth, further research is needed to disentangle the roles of age and injury type.

The full text of the article is available from the APA Public Affairs Office and at http://www.apa.org/journals/releases/neu23120.pdf.

Adapted from a press release by the APA.

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