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.