Guidelines: basic principles of neurorehabilitation for patients with acquired brain injury. Recommendations of the Spanish Society of Neurorehabilitation

Neurologia (Engl Ed). 2024 Apr;39(3):261-281. doi: 10.1016/j.nrleng.2023.04.002. Epub 2023 Apr 26.

Abstract

Introduction: We present the Spanish Society of Neurorehabilitation's guidelines for adult acquired brain injury (ABI) rehabilitation. These recommendations are based on a review of international clinical practice guidelines published between 2013 and 2020.

Development: We establish recommendations based on the levels of evidence of the studies reviewed and expert consensus on population characteristics and the specific aspects of the intervention or procedure under research.

Conclusions: All patients with ABI should receive neurorehabilitation therapy once they present a minimal level of clinical stability. Neurorehabilitation should offer as much treatment as possible in terms of frequency, duration, and intensity (at least 45-60minutes of each specific form of therapy that is needed). Neurorehabilitation requires a coordinated, multidisciplinary team with the knowledge, experience, and skills needed to work in collaboration both with patients and with their families. Inpatient rehabilitation interventions are recommended for patients with more severe deficits and those in the acute phase, with outpatient treatment to be offered as soon as the patient's clinical situation allows it, as long as intensity criteria can be maintained. The duration of treatment should be based on treatment response and the possibilities for further improvement, according to the best available evidence. At discharge, patients should be offered health promotion, physical activity, support, and follow-up services to ensure that the benefits achieved are maintained, to detect possible complications, and to assess possible changes in functional status that may lead the patient to need other treatment programmes.

Keywords: Acquired brain injury; Clinical guidelines; Daño cerebral adquirido; Guía clínica; Ictus; Neurorehabilitation; Neurorrehabilitación; Stroke; Traumatic brain injury; Traumatismo cráneo encefálico.

Publication types

  • Review

MeSH terms

  • Adult
  • Ambulatory Care
  • Brain Injuries*
  • Humans
  • Neurological Rehabilitation* / methods
  • Patient Discharge