A New report from the Institute of Medicine outlines progress in the treatment of Traumatic Brain Injury (TBI) using Cognitive Rehabilitation Therapy (CRT).

Approximately 10 million people worldwide have TBI and it has become a more common problem with low level wars running in Afghanistan and Iraq that cause non fatal but damaging head injuries from roadside bombing and insurgent attacks. From 2000 to 2010 the number of US military personnel suffering from TBA has almost tripled from 11,000 to 30,700.

While many of the injuries are minor and only a small percentage are severe, recovery can take months and years and is often incomplete, especially in the worst cases. As there are increasing numbers of TBI cases caused from military action, The U.S. Department of Defense called for an objective evaluation of CRT’s effectiveness in order to assist their decisions about the availability and implementation of these treatments in the military health system.

Committee Chair Ira Shoulson, professor of neurology, pharmacology, and human science, and director of the program for regulatory science and medicine, Georgetown University Medical Center, Washington, D.C. says :

“Survivors of traumatic brain injury may face long-term challenges in rehabilitation and reintegration to everyday life. They need an effective health care infrastructure and evidence-based treatment and rehabilitation policies to care for and cope with their impairments …. This report lays out a research agenda to surmount the shortcomings and challenges that have thus far limited our understanding of the full effectiveness of various forms of cognitive rehabilitation therapy in helping patients with different severity and stages of TBI.”

Different pupil sizes – a sign of a possible traumatic brain injury

CRT is basically a broad term that covers a wide range of systematic, goal-oriented approaches to overcoming or compensating for cognitive impairments such as those caused by TBI. There are a variety of forms of the therapy that differ according to technique and the problems the patient is suffering from.

Thus the problem of assessing the effectiveness of the treatments is clouded by a variety of non standard terms, lack of patient data and a general lack of clear methodology. Researchers are frustrated to some extent because although they have clear indications of CRT being successful, they cannot empirically classify the results to their satisfaction. Their first goal then is to improve the way data is collected and to produce a standard set of terms that practitioners can use to describe the therapies and outcomes.

The study was sponsored by the U.S. Department of Defense. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.

Written By Rupert Shepherd