External cognitive compensatory strategies may be effective in improving functional independence (ADL’s and IADL’s) in young adults with acquired/traumatic brain injury

Abstract

CLINICAL QUESTION: Are external cognitive compensatory strategies effective in improving functional independence (ADL’s and IADL’s) in young adults with acquired/traumatic brain injury?

CLINICAL BOTTOM LINE: There is weak evidence to demonstrate the effectiveness of external cognitive compensatory strategies impact on functional independence (ADL’s/IADL’s) in young adults with traumatic brain injury. Although practitioners agree that the desired outcome of cognitive rehabilitation is improvement in daily function, many of the commonly used outcome indicators are intermediate measures (lab tests) rather than health outcomes. The question remains do improved scores on lab tests accurately predict whether the patients’ performance with function adequately in the context of real life, where other factors that are not present during lab tests (i.e. distractions etc.) are evident. Future high quality research designs that address functional outcome with this population is required. In the meantime, Carney et al (1999) state that until we have done the necessary work to be able to demonstrate what is operating to produce improvement, we are bound to practice the services and care at our disposal for this population.