COGNITIVE REHABILITATION
Cognitive Rehabilitation Treatment Process1) Neuropsychological Evaluation: The first step is to obtain a comprehensive neuropsychological evaluation to identify the individual patient's cognitive deficits to be addressed in therapy. If the patient has not already been evaluated, we are able to schedule their evaluation through our practice. This evaluation will also identify psychological issues related to pain, depression, and anxiety that might negatively impact a patient's recovery. |
|
2) Treatment Plan: A treatment plan is based on the patient's neuropsychological profile and report of functional difficulties. Because not all cognitive deficits are proven to benefit from therapeutic intervention, we focus on interventions that are proven. Deficits most commonly treated by our staff are memory, attention, executive functioning, problem solving, and visuo-spatial deficits. Recommendations will also be made to address psychological issues through psychotherapy if contributing psychological factors are identified.
3) Implementation of Customized Treatment Plan: The patient and therapist typically meet one to two times per week for an average of 8-12 weeks. Patients are expected to complete activities and exercises in between sessions at home and work as part of the therapy process.
Literature Review: Evidence Based Cognitive Rehabilitation
The purpose of this study was to update the evidence-based recommendations of the Brain Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine regarding cognitive rehabilitation for traumatic brain injury (TBI) and stroke patients. A total of 312 articles were reviewed, with 87 studies evaluated in depth.
"Cognitive rehabilitation is defined as a systematic, functionally-oriented service of therapeutic activities that is based on assessment and understanding of the patient's brain-behavior deficits. It can be distinguished from traditional rehabilitation and psychotherapy by its primary focus: alleviation of acquired neurocognitive impairment and disability."
This meta-analysis concluded that cognitive rehabilitation treatment should be considered the practice standard for patients with: attention deficits, memory deficits, memory deficits, visuospatial deficits, language deficits, and problem-solving deficits. Statistically, cognitive rehabilitation was found to be 92% more effective than conventional rehabilitation. The researchers concluded that, "These findings are consistent with our prior recommendation that the integration of individualized cognitive therapies be considered a practice standard."
The intensive development and study of cognitive rehabilitation treatment in the past 10 years has resulted in a well-researched course of treatment for TBI and stroke patients, with a proven track record of success. In summary, "Cognitive rehabilitation services should be directed at achieving changes that improve each person's function in areas that are relevant to their everyday lives."
Cicerone, K., et al., Archives of Physical medicine Rehabilitation Vol 86, August 2005.