The Evidence-Based Review of Rehabilitation of Moderate to Severe Acquired Brain Injuries (ERABI) was designed to comprehensively review current practices in acquired brain injury (ABI) rehabilitation with the eventual aim of:

1. identifying effective treatment interventions;
2. identifying gaps in the literature deserving further research and;
3. to serve as an accessible tool for clinicians in an effort to encourage improved
  evidence-based practice.

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Tags: Introduction, Methodology

Acquired Brain injury (ABI), particularly of the traumatic brain injury (TBI) type, is one of the leading causes death and lifelong disability in North America, particularly in children and adolescents [Greenwald et al. 2003;Thurman et al. 1999]. In Western developed countries incidence figures for TBI are estimated to be at around 250-300 per 100,000 population [Campbell 2000]. It is estimated that the annual incidence of TBI in the United States is 1.5 million [Thurman et al. 1999]. In Ontario, the Ontario Brain Injury Association [2004] estimates that the total annual number of brain injuries is over 18,000 with nearly 4,000 annual injuries occurring in the pediatric population alone (0-14 years).

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Tags: Epidemiology, Long-Term, Outcomes

The rehabilitation of acquired brain injury (ABI) patients involves a comprehensive effort by several members of an interdisciplinary team including physicians, nurses, and occupational therapists. Considering the incidence and consequences of ABI, it is important to understand the effectiveness of rehabilitation. Efficacy, as measured by functional outcome, will be assessed in this chapter across the continuum, from inpatient rehabilitation to community interventions. The question, ‘does rehab work?’ will be addressed in this chapter.

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Tags: Efficacy, ABI, Rehabilitation

The primary cause of motor impairment and movement dysfunction post acquired brain injury is upper motor neuron syndrome (UMNS). UMNS results in both positive symptoms of enhanced stretch reflexes (spasticity), released flexor reflexes in the lower limbs, such as the Babinski sign and mass synergy patterns as well as negative symptoms including loss of dexterity and weakness [Mayer 1997]. These symptoms of upper motor neuron syndrome have physiologic implications for muscles which often subsequently develop stiffness and contracture thereby further negatively affecting effective movement [Mayer 1997].

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Tags: Motor and Sensory, Impairment, Post ABI, Remediation