Traumatic brain injury (TBI) is a principal cause of death and disability in young adults with consequences ranging from physical disabilities to long-term cognitive, behavioral, and social disorders (Salazar, Warden, Schwab, Spector, Braverman,
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 that there is limited class I evidence documenting the efficacy of cognitive rehabilitation after a TBI. This is due, in part, to the fact that conducting randomized controlled double-blind trials to determine the efficacy of cognitive rehabilitation after a TBI is arduous. Jordan (2000) further maintains that inherent difficulties in conducting such research include the heterogeneity of TBI, the very type and consequent efficacy of cognitive rehabilitation interventions, and th...