Improving cognitive deficits after a brain injury

80% of persons who sustained a traumatic brain injury believe that their need to improve their cognition had not been met at 1 year post injury.  This is according to research (see article below)

So what’s been missing? Is it a problem of perception or is it that rehabilitation is simply not as effective as we would like?  

Cognitive issues following a traumatic brain injury (TBI) are often a major cause of long-lasting disability.  These issues are difficult to recognise and characterise compared with the more obvious physical aspects of an injury.  Even with so called mild TBI, the consequences of the trauma for cognition can appear long after the initial trauma.

If early and accurate assessment is challenging, then so too is effective rehabilitation it seems.  We don't advocate that RehaCom is the answer to cognitive rehabilitation - it's role is to make the therapist's interventions more effective. 

Cognitive rehabilitation interventions typically involve two basic approaches, that is, direct restoration and compensation strategy training.  Both approaches are used simultaneously in “best-practice” rehabilitation.  Direct restoration is believed to be associated with the restitution/restoration of function via reconnection of pathways.  This approach is based on the assumption that damaged neural circuits can be retrained if they have been partially or substantially spared after injury.  In direct restoration, the effect of the deficit following injury is reduced through systematic exposure to specific cognitive activities targeting specific neural processes.  In short - this means specifically targeted training and this is where RehaCom has a role in the hands of an experienced therapist.

Compensation strategy training, in contrast, is thought to be associated with the reorganisation, redistribution, and use of adjacent and remote neural circuits following injury This approach has perhaps been the most popular in the UK - largely because the research in support of restitution was stronger once upon a time.  

The rehabilitation team’s role of course is to deploy these various approaches to maximise the outcome for patients. The therapist is the "conductor" and the various strategies are the "instruments" that have to be blended in the right way for a harmonious result. 

Corrigan JD, Whiteneck G, Mellick MA. Perceived needs following traumatic brain injury. J Head Trauma Rehabil. 2004;19:205–216.