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Contents
1 Introduction ............................................................................................................................................................1
1.1 The need for a guideline ............................................................................................................................................................1
1.2 Remit of the guideline ................................................................................................................................................................1
1.3 Definitions .......................................................................................................................................................................................2
1.4 Methodological limitations inherent in rehabilitation literature ................................................................................4
1.5 Statement of intent ......................................................................................................................................................................6
2 Key recommendations ..........................................................................................................................................8
2.1 Assessment and treatment of mild brain injury ................................................................................................................8
2.2 Cognitive rehabilitation .............................................................................................................................................................8
2.3 Service delivery .............................................................................................................................................................................8
3 Assessment and treatment of mild brain injury ...............................................................................................9
3.1 Epidemiology and definitions ................................................................................................................................9
3.2 Non-specific symptoms ..............................................................................................................................................................10
3.3 Prognostic factors in adults ......................................................................................................................................................10
3.4 Treatment of mild traumatic brain injury ............................................................................................................................12
4 Physical rehabilitation and management..........................................................................................................14
4.1 Gait, balance and mobility ........................................................................................................................................................14
4.2 Spasticity and muscle tone .......................................................................................................................................................16
4.3 Physical therapeutic interventions .........................................................................................................................................18
4.4 Continence problems..................................................................................................................................................................19
5 Cognitive rehabilitation ........................................................................................................................................20
5.1 Introduction....................................................................................................................................................................................20
5.2 Self awareness and insight ........................................................................................................................................................20
5.3 Memory ............................................................................................................................................................................................21
5.4 Attention ..........................................................................................................................................................................................21
5.5 Executive functioning .................................................................................................................................................................22
5.6 Visuospatial functioning ............................................................................................................................................................22
5.7 Emotional processing .................................................................................................................................................................22
5.8 Comprehensive/holistic treatment programmes .............................................................................................................22
6 Rehabilitation of behavioural and emotional disorders ................................................................................. 23
6.1 Challenging or aggressive behaviour ...................................................................................................................................23
6.2 Depression and anxiety ..............................................................................................................................................................24
7 Communication and swallowing .........................................................................................................................27
7.1 Managing communication problems ...................................................................................................................................27
7.2 Assessing and managing dysphagia .....................................................................................................................................30
7.3 Oral hygiene ...................................................................................................................................................................................31
8 Vocational rehabilitation ......................................................................................................................................32
8.1 Benefits of returning to work ...................................................................................................................................................32
Contents