Why Do We Need a New Clinical Practice Guideline for Moderate to Severe Traumatic Brain Injury?

Stroke rehabilitation in low-income and middle-income countries: a call to action

The WHO Rehabilitation 2030 agenda recognises the importance of rehabilitation in the value chain of quality health care. Developing and delivering cost-effective, equitable-access rehabilitation services to the right people at the right time is a challenge for health services globally. These challenges are amplified in low-income and middle-income countries (LMICs), in which the unmet need for rehabilitation and recovery treatments is high. In this Series paper, we outline what is happening more broadly as part of the WHO Rehabilitation 2030 agenda, then focus on the specific challenges to development and implementation of effective stroke rehabilitation services in LMICs. We use stroke rehabilitation clinical practice guidelines from both high-income countries and LMICs to highlight opportunities for rapid uptake of evidence-based practice. Finally, we call on educators and the stroke rehabilitation clinical, research, and not-for-profit communities to work in partnership for greater effect and to accelerate progress.

Current practice of cognitive rehabilitation following traumatic brain injury: An international survey

Traumatic brain injury (TBI) is a global public health issue, frequently resulting in impairments in the cognitive domains of attention, information processing speed, memory, executive function, and communication. Despite the importance of rehabilitating cognitive difficulties, and the release of clinical practice guidelines (CPGs) for cognitive rehabilitation, little is known about current clinician practice. This study aimed to explore current international clinician practice of cognitive rehabilitation. One hundred and fifteen English-speaking allied health professionals, including neuropsychologists and occupational therapists, from 29 countries outside Australia, were surveyed online about their current practice and reflections on cognitive rehabilitation. Both cognitive retraining and functional compensation approaches to cognitive rehabilitation were commonly utilized. Clinicians mostly targeted deficits in attention and executive functioning with retraining interventions, whilst memory deficits were mostly targeted with compensatory interventions. Clinicians were aware of and utilized various resources for cognitive rehabilitation, including CPGs. Clinicians considered the client's social support network, client engagement and motivation in rehabilitation, multidisciplinary team collaboration, and goal setting and implementation as highly impactful factors on the success of cognitive rehabilitation interventions. Whilst practice is broadly consistent with current CPG recommendations, addressing facilitating factors can further optimize client outcomes and quality of life following TBI.