A Systematic Review of Cognition and Communication Skills in Adults with Acquired Brain Injury (Coleman et al., 2014)

Purpose This is a systematic review of assessment and treatment of cognitive and communicative abilities of individuals with acquired brain injury via telepractice versus in person. The a priori clinical questions were informed by previous research that highlights the importance of considering any functional implications of outcomes, determining disorder- and setting-specific concerns, and measuring the potential impact of diagnostic accuracy and treatment efficacy data on interpretation of findings.

Method A literature search of multiple databases (e.g., PubMed) was conducted using key words and study inclusion criteria associated with the clinical questions.

Results Ten group studies were accepted that addressed assessment of motor speech, language, and cognitive impairments; assessment of motor speech and language activity limitations/participation restrictions; and treatment of cognitive impairments and activity limitations/participation restrictions. In most cases, equivalence of outcomes was noted across service delivery methods.

Conclusions Limited findings, lack of diagnostic accuracy and treatment efficacy data, and heterogeneity of assessments and interventions precluded robust evaluation of clinical implications for telepractice equivalence and the broader area of telepractice efficacy. Future research is needed that will build upon current knowledge through replication. In addition, further evaluation at the impairment and activity limitation/participation restriction levels is needed.

目的：本项研究为通过远程实践与面对面实践对脑损伤患者认知和沟通能力进行评估与治疗的一次系统综述。预先设定的临床问题受到了先前研究的影响，这些研究强调了考虑任何结果的功能影响、确定特定疾病和环境的关注点以及衡量诊断准确性和治疗有效数据对结果解释潜在影响的重要性。
方法：通过使用与临床问题相关的关键词和研究纳入标准，在多个数据库（例如 PubMed）中进行了文献检索。
结果：共接受十项分组研究，这些研究涉及运动性言语、语言和认知障碍的评估；运动性言语和语言活动限制/参与限制的评估；以及认知障碍和活动限制/参与限制的治疗。在大多数情况下，服务提供方式之间的结果等效性得到注意。
结论：由于发现有限、缺乏诊断准确性和治疗有效数据以及评估和干预措施的同质性，无法对远程实践等效性及其更广泛的远程实践有效性领域的临床影响进行稳健的评价。未来的研究需要通过复制现有知识来构建，同时还需要在障碍和活动限制/参与限制层面进行进一步的评估。