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How do you recover from traumatic brain injury? The updated INCOG 2.0

How do you recover from traumatic brain injury? The updated INCOG 2.0

Traumatic Brain Injury is a leading cause of disability in all regions of the globe. In Australia alone more than 20,000 patients are hospitalised each year with brain injury. The INCOG guideline summarises the gold standard recommendations for health professionals involved in the rehabilitation of patients. The latest update to these groundbreaking guidelines includes a range of interventions during the early recovery phase, as well as telehealth-assisted rehabilitation to assist people in rural and remote locations. Evidence is also mounting to support the use of technology, such as smartphones. The development of these guidelines were supported by the evidence review services at BehaviourWorks Australia.

What is INCOG 2.0?

Traumatic Brain Injury – TBI – happens when a sudden, external, physical assault damages the brain and can range from mild, temporary symptoms through to much more serious, long-term complications.  The guidelines for cognitive rehabilitation for TBI, known as INCOG, have just been updated by an international team of leading traumatic brain injury researchers, led by University of Toronto in collaboration with Monash University.  

The newly published ‘INCOG 2.0’ guidelines reflect the most up-to-date evidence for rehabilitation of cognitive function following TBI.  These guidelines represent the gold standard for health professionals working to optimise patients ability to function and enjoy life.

Everyday, early structured therapy - and smartphones

With patients often agitated and confused (especially in the early stages of TBI) researchers identified that strategies to improve memory and attention processes through structured therapies (including physical therapies) during early recovery resulted in increased independence, shorter length of hospital stay and significant cost savings.  

Telerehabilitation is also an important new addition to the guidelines, with the COVID pandemic seeing massive growth in this health practice. With the most effective interventions being those embedded in the injured person's everyday life and involving family and significant others, technology such as smartphones have been shown to support independence.  

Many researchers across the globe

“A major contribution from the Monash researchers involved in the guidelines has been identifying the most effective therapies and strategies during early recovery from TBI” says guideline co-lead, Professor Jennie Ponsford of Monash’s Turner Institute for Brain and Mental Health and Director of the Monash-Epworth Rehabilitation Research Centre.

Professor Peter Bragge from Monash’s BehaviourWorks Australia and Director of the Monash Sustainable Development Institute Evidence Review Service reflected on how the underlying review methods that support the guidelines have advanced since the original INCOG guidelines were published in 2014. “COVID-19 and the ongoing acceleration of technology have led to exponential increases in demand for up-to-date knowledge to support decision-making.”  He believes “guideline developers should ensure that key principles of guideline production are followed”, including responding to real-world patient needs; allocating professional development time to health professionals and measuring practice to ensure it is consistent with best-available knowledge.

The full guidelines, entitled INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: What's Changed From 2014 to Now? can be found here.

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