The efficacy of community-based rehabilitation programmes for adults with TBI

Aims: The aim of this systematic review was to investigate the factors that infl uence the efficacy of community-based rehabilitation programmes in improving the quality of life and daily functioning of adults with severe traumatic brain injury. Methods: A systematic review of the literature was conducted. In keeping with the principles of best evidence synthesis, the findings from the studies were analysed according to their methodological quality. Findings: Eleven studies were included in the review; synthesis of these studies revealed that the outcomes of community rehabilitation programmes are mediated by a complex interaction between programme characteristics, participant characteristics and the methods used to assess outcomes. Variations in study methodology and quality further impact the extent to which treatment effectiveness can be demonstrated. There was evidence to support the use of telephone counselling and interdisciplinary team rehabilitation. There was moderate strength evidence indicating the psychosocial benefits of engaging in group rehabilitation programmes. Conclusions: Outcome measures designed specifically for use with traumatic brain injury clients in community settings need to be validated. The clinical and cost benefits of telephone counselling, peer support groups and interdisciplinary team rehabilitation programmes warrant further research.