Traumatic Brain Injury

Rosner, Martin, & Ecklund, 2000). For these reasons, the total cost of TBI in the United States is estimated at more than $37 billion per year. Postacute TBI management differs significantly from that of other neurological disabilities. Most TBI patients appear to benefit from some level of specialized, interdisciplinary rehabilitation. However, as Salazar, et al (2000) have noted, cognitive rehabilitation strategies for TBI have not been subjected to the degree of scientific scrutiny for effectiveness and cost efficiency that is expected of other medical therapies.

Despite the lack of a comprehensive database of empirical

support for the efficacy of cognitive rehabilitation and differing therapies used with patients affected by TBI, the literature on the topic, is extensive (Jordan, 2000). The efficacy of cognitive rehabilitation in the treatment of patients with TBI has been a controversial issue.

Jordan (2000) has stated that in the current era of evidence-based medicine and increased scientific scrutiny of common medical practices, the efficacy of therapeutic intervention needs to be supported by class I evidence or randomized controlled trials.

The primary deficit in the literature is t

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al relationships (Czubaj, 1996; Fabiano & Daugherty, 1998; Jordan, 2000; Ghajar, 2000; "Rehabilitation of persons," 1999; Robertson & Murre (1999); Salazar, et al, 2000). As this extensive listing of the various impairments that can result from TBI should demonstrate, caregivers working with this patient population face enormous challenges in developing effective as well as cost-efficient therapeutic interventions. Part of the problem, as identified by the NIH Consensus Panel, is that many of these impairments are secondary to TBI and do not appear symptomatically until an often quite substantial amount of time after the initial injury has elapsed (Rehabilitation of persons..., 1999). Ylvisaker and Feeney (1996), as well as Dombovy and Olek (1997), have commented that executive functioning in particular may not be observed as impaired until the TBI patients seems well on the road to recovery - or not until months have passed. A study by Cowen, Meythaler, DeVivo, Ivie, Ledow, and Novack (1995) addressed the relationship between early variables and outcome variables in TBI. The early variables considered included initial Glasgow Coma Scale (GCS) scores, CT findings, presence of skeletal trauma, age, and length of acut
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Approximate Word count = 9151
Approximate Pages = 37 (250 words per page)

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