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Brain injury rehabilitation in adults 14 Development of the guideline 14.1 INTRoDuCTIoN 52 | SIGN is a collaborative network of clinicians, other healthcare professionals and patient organisations and is part of Healthcare Improvement Scotland. SIGN guidelines are developed by multidisciplinary groups of practising clinicians using a standard methodology based on a systematic review of the evidence. Further details about SIGN and the guideline development methodology are contained in SIGN 50: A Guideline Developer’s Handbook, available at www.sign.ac.uk 14.2 THE GuIDElINE DEVEloPMENT GRouP Ms Ailsa McMillan Lecturer, Division of Nursing, Occupational Therapy and Arts Therapies, (Chair) School of Health Sciences, Queen Margaret University, Edinburgh Dr Gillian Baer Senior Lecturer, Division of Physiotherapy, School of Health Sciences, Queen Margaret University, Edinburgh Mrs Avril Beattie Clinical Coordinator, Centre for Brain Injury Rehabilitation, Royal Victoria Hospital, Dundee Dr Alan Carson Consultant Neuropsychiatrist, Astley Ainslie Hospital, Edinburgh Ms Mary Edwards Speech and Language Therapist, Royal Hospital for Sick Children, Glasgow Professor jonathan Evans Professor of Applied Neuropsychology, Glasgow University Dr Andrew Harrison Clinical Neuropsychologist, Astley Ainslie Hospital, Edinburgh Ms Shiona Hogg AHP Manager for Rehabilitation, Falkirk Community Hospital Dr Roger Holden Consultant in Rehabilitation Medicine, Dumfries and Galloway Royal Infirmary Dr Roisin jack Clinical Psychologist (Neuropsychology), Craig Court Neurorehabilitation Unit, Aberdeen Ms Vicky Mayer Speech and Language Therapist, Astley Ainslie Hospital, Edinburgh Ms Gaille McCann West Scotland Regional Coordinator, Headway, Edinburgh Dr Gordon McLaren Consultant in Public Health Medicine, NHS Fife, Leven Mr Donald McLean Coordinator/Superintendent Physiotherapist, Falkirk Community Hospital Miss jacqueline McPherson Paediatric Neurology Nurse Specialist, Royal Hospital for Sick Children, Edinburgh Dr Moray Nairn Programme Manager, SIGN Mrs Lynne Smith Evidence and Information Scientist, SIGN Miss Angela Sprott Acquired Brain Injury Service Coordinator, West Dunbartonshire Council Ms Dorothy Strachan Clinical Services Manager, Momentum Pathways, Aberdeen Dr Alastair Weir Consultant in Rehabilitation Medicine, Southern General Hospital, Glasgow Mrs jenny Williams Carer, Isle of Lewis The membership of the guideline development group was confirmed following consultation with the member organisations of SIGN. All members of the guideline development group made declarations of interest and further details of these are available on request from the SIGN Executive.
Guideline development and literature review expertise, support and facilitation were provided by the SIGN Executive. All members of the SIGN Executive make yearly declarations of interest and further details of these are available on request. Mrs Lesley Forsyth Events Coordinator Mrs karen Graham Patient Involvement Officer Mr Campbell Reynolds Distribution and Office Coordinator Mr Stuart Neville Publications Designer Ms Gaynor Rattray Guideline Coordinator 14.3 ACKNoWlEDGEMENTS SIGN is grateful to the following former members of the guideline development group and others who have contributed to the development of the guideline. Ms Shona Forsyth Neuropaediatric Outreach Nurse, Southern General Hospital, Glasgow Dr Nitin Gambhir General Practitioner, Glasgow Ms Sheena Glen Neurorehabilitation Services Occupational Therapy Lead Clinician, Scottish Brain Injury Service, Astley Ainslie Hospital, Edinburgh Professor Tom McMillan Professor of Clinical Neuropsychology, University of Glasgow Dr Sharon Mulhern Consultant Clinical Psychologist, Ayrshire Central Hospital Ms Claire O’Brien Specialist Nurse, Community Treatment Centre of Brain Injury, Glasgow Mr kevin Williams Lay representative, Isle of Lewis 14.4 CoNSulTATIoN AND PEER REVIEW 14.4.1 NATIONAL OPEN MEETING A national open meeting is the main consultative phase of SIGN guideline development, at which the guideline development group presents its draft recommendations for the first time. The national open meeting for this guideline was held on 5 December 2011 and was attended by 137 representatives of all the key specialties relevant to the guideline. The draft guideline was also available on the SIGN website for a limited period at this stage to allow those unable to attend the meeting to contribute to the development of the guideline. 14.4.2 SPECIALIST REVIEW This guideline was also reviewed in draft form by the following independent expert referees, who were asked to comment primarily on the comprehensiveness and accuracy of interpretation of the evidence base supporting the recommendations in the guideline. The guideline group addresses every comment made by an external reviewer, and must justify any disagreement with the reviewers’ comments. All expert referees made declarations of interest and further details of these are available on request from the SIGN Executive. SIGN is very grateful to all of these experts for their contribution to the guideline. 14 • Development of the guideline Ms Sharon Beck Occupational Therapist, Raigmore Hospital, Inverness Dr Nicola Brain Consultant in Rehabilitation Medicine, Royal Derby Hospital Dr john Burn Consultant in Rehabilitation and Brain Injury, Poole Hospital, Poole Dr Sheena Caldwell Consultant in Rehabilitation Medicine, Musgrave Park Hospital, Belfast Ms Michelle Coulson Patient Representative, Aberdeen Dr Breda Cullen Clinical Neuropsychologist, Physically Disabled Rehabilitation Unit, Southern General Hospital, Glasgow | 53
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SIGN 130 • Brain injury rehabilit
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Scottish Intercollegiate Guidelines
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Contents 1 Introduction ...........
Page 7 and 8: 1 Introduction 1.1 THE NEED foR A G
Page 9 and 10: 1.3.3 BRAIN INjURy SEVERITy Long te
Page 11 and 12: Functional therapies tend to be saf
Page 13 and 14: Prior to any prescribing, the licen
Page 15 and 16: 3 Assessment and treatment of mild
Page 17 and 18: False positives on cognitive testin
Page 19 and 20: 3 • Assessment and treatment of m
Page 21 and 22: 4.1.3 TASk-SPECIFIC AND REPETITIVE
Page 23 and 24: One further RCT (n=35) compared two
Page 25 and 26: 4.4 CoNTINENCE PRoBlEMS 4 • Physi
Page 27 and 28: It has been argued that there are v
Page 29 and 30: 6 Rehabilitation of behavioural and
Page 31 and 32: elationship between specific compon
Page 33 and 34: 7 Communication and swallowing 7.1
Page 35 and 36: 7.1.6 TRAINING COMMUNICATION PARTNE
Page 37 and 38: No evidence was identified relating
Page 39 and 40: 8 • Vocational rehabilitation The
Page 41 and 42: 9.1.2 MINIMALLy CONSCIOUS STATE A p
Page 43 and 44: A Cochrane review of evidence for m
Page 45 and 46: 10.2 CoMMuNITy REHABIlITATIoN 10.2.
Page 47 and 48: of improvement. There were no signi
Page 49 and 50: Evidence has also suggested the pot
Page 51 and 52: 11 Provision of information This se
Page 53 and 54: or has mental health or addiction p
Page 55 and 56: 12 • Implementing the guideline y
Page 57: y therapies to improve disordered s
Page 61 and 62: Dr killian Welch Consultant Neurops
Page 63 and 64: NMES neuromuscular electrical stimu
Page 65 and 66: 5. What is the evidence for the eff
Page 67 and 68: 15. Is there any evidence of improv
Page 69 and 70: 31. Bryant RA, Harvey AG. Relations
Page 71 and 72: 94. Goverover Y, Johnston MV, Togli
Page 73 and 74: 157. Practice parameters: assessmen
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