Critical analysis of studies evaluating the effectiveness of rehabilitation after traumatic brain injury

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Critique of studies that have examined whether comprehensive acute inpatient and postacute outpatient rehabilitation interventions result in improved long term outcome after traumatic brain injury (TBI). The first part discusses three threats to the internal validity of research designs for measuring the effectiveness of rehabilitation interventions: spontaneous recovery, preinjury characteristics of the subjects, and the nature and severity of the initial brain injury. The second part critically reviews selected studies with respect to how well they have controlled for the three potentially confounding variables. The review includes both studies of acute inpatient rehabilitation and studies examining return to work after postacute outpatient rehabilitation. A final section discusses future research needs and offers suggestions to improve the scientific quality of TBI rehabilitation efficacy studies.

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