Summary

  1. There is Level 4 evidence for the effectiveness of constraint induced movement therapy in improving upper extremity use post ABI.
     
  2. Based on a single RCT, there is Level 1b evidence that nocturnal hand splinting does not improve range of motion, function or pain control post ABI.
     
  3. Based on a single RCT, there is Level 2 evidence that soft hand splinting improves spasticity and hand opening post ABI.
     
  4. Based on a single RCT, there is Level 1b evidence that both functional and tabletop fine motor control retraining activities result in improved fine motor coordination; however functional retraining activities were more effective in improving fine motor tasks in the dominant hand.
     
  5. There is Level 2 evidence that visual feedback grip force training improved tracking and transfer performane.
     
  6. Based on a small RCT, there is Level 1b evidence that serial casting does induce increases in range of motion; however, these effects began to diminish one day post treatment.
     
  7. There is Level 2 evidence that serial casting does reduce ankle plantar flexion contractures due to spasticity of cerebral origin.
     
  8. There is Level 3 evidence that short duration (one to four days) serial casting has a significantly lower complication rate than longer duration (five to seven days) serial casting; however, there was no difference in range of motion outcome .
     
  9. There is Level 2 evidence that casting alone is as effective as the combination of casting and Botulinum toxin injections for treating plantar flexion contractures due to spasticity of cerebral origin.
     
  10. There is Level 2 evidence that botulinum toxin type A injections are effective in the management of localized spasticity following ABI.
     
  11. There is Level 1b evidence to suggest that patients receiving botulinum toxin type A through a single motor point or through multisite distributed injecions both show a reduction in spasticity regardless of the drug administration method.
     
  12. There is Level 4 evidence that phenol nerve blocks reduce contractures and spasticity at the elbow, wrist and finger flexors for up to five months post injection.
     
  13. There is Level 4 evidence that electrical stimulation is effective for decreasing lower extremity spasticity for six or more hours, lasting as long as 24 hours.
     
  14. There is Level 4 evidence that oral baclofen improves lower extremity spasticity but not upper extremity spasticity.
     
  15. There is Level 1b evidence that bolus intrathecal baclofen injections produce short-term (up to six hours) reductions in upper and lower extremity spasticity following ABI.
     
  16. There is Level 4 evidence to suggest that prolonged intrathecal baclofen results in longer-term (three months, and one year) reductions in spasticity in both the upper and lower extremities following an ABI.
     
  17. There is Level 4 evidence, from two studies, to suggest that intrathecal baclofen results in short-term improvements of walking performance in ambulatory patients, particularly gait velocity, stride length, and step width.
     
  18. There is Level 1b evidence that partial body weight supported gait training does not provide any added benefit over conventional gait training in ambulation, mobility or dance. 
     
  19. There is Level 1b evidence based on a single RCT that specific sit-to-stand training results in improved abilities.
     
  20. There is level 2 evidence that reach training with an embedded intervention is more effective than a traditional reaching exercise program.
     
  21. There is Level 2 evidence that a specific balance and coordination training program is significantly more effective for improving balance and coordination compared to a traditional muscular training program. 
     
  22. There is Level 2 evidence that a virtual reality based balance retraining program is as effective at improving balance through a conventional balance retraining program.
     
  23. There is Level 1a evidence that exercise programs improve cardiorespiratory output post ABI.
     
  24. There is Level 2 evidence indicating that engaging in exercise prior to sustaining an ABI has a positive impact on exercise compliance post ABI.
     
  25. There is Level 4 evidence that exercise improves gait, mobility and individual's perception of their social, physical and mental health post ABI. 
     
  26. There is Level 1b evidence that participation in an exercise program improves health promotion and self-esteem post ABI.
     
  27. There is Level 2 evidence to suggest that exercise does help improve mood and overall general mental health (i.e., depressive symptoms, quality of life and stress).
     
  28. There is Level 1b evidence to suggest that computerbased restitution training is effective in improving the vision of those who sustain a TBI.
     
  29. There is Level 4 evidence showing that base-in prisms and bi-nasal occluders are effective in treating ambient vision disturbances resulting from an ABI.
     
  30. There is Level 4 evidence that prismatic spectacle lenses are effective in reducing symptom burden in patients with vertical heterophoria and post-concussive symptoms post injury.
     
  31. There is Level 4 evidence for the rehabilitation programs directed at improving visual function improves functional outcomes such as reading in patients post ABI.
     
  32. There is Level 2 evidence that vestibular rehabilitation programs, alone or in combination with betahistine dihydrochloride, improve recovery time for balance disorders compared to betahistine dihydrochloride alone.
     
  33. There is Level 2 evidence, from a single study, that gripping an unfixed object in the dominant hand can be beneficial in stabilizing an upright posture.
     
  34. There is Level 2 evidence to support using a combined aerobic dancing, slide and step training program to reduce balance and coordination deficits post TBI.
     
  35. There is Level 4 evidence that vestibular rehabilitation programs, such as behavioural exposure program, improve symptoms of vertigo in patients after TBI.
     
  36. There is Level 2 evidence from a single, small sampled cohort study suggesting that biofeedback is effective in the treatment of post-traumatic headaches; although, the severity of the participants was not clearly stated.
     
  37. There is Level 4 evidence supporting the use of CBT to reduce post traumatic headaches in those who have sustained a mild to severe TBI.
     
  38. There is Level 2 evidence suggesting the use of cold packs is not as effective as manual therapy in reducing post traumatic headaches.