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The impact of complementary and integrative medicine following traumatic brain injury: A scoping review

Journal: Brain Injury Date: 2023/11, 37(sup1):Pages: 9. doi: Subito , type of study: scoping review

Free full text   (https://www.tandfonline.com/doi/full/10.1080/02699052.2023.2247822)

Keywords:

brain [76]
conference abstract [108]
injury [85]
OMT [2951]
osteopathic manipulative treatment [2973]
scoping review [27]
trauma [100]

Abstract:

Introduction: Rehabilitation programs are progressively incorporating an increase in nonpharmacologic complementary integrative medicine (CIM) offerings to treat persons with traumatic brain injury (TBI). The aim of this scoping review was to examine the evidence levels, study characteristics, and outcomes of nonpharmacologic CIM interventions in rehabilitation for individuals with TBI. Methods: The following databases that were sourced included MEDLINE (OvidSP), PubMed (NLM), EMBASE (Embase. com), CINAHL (EBSCO), PsycINFO (OvidSP), Cochrane Library (Wiley), and National Guidelines Clearinghouse databases. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA- ScR) was followed to conduct this review, and the study protocol was registered in INPLASY (protocol registration: INPLASY202160071). The data extraction process involved the review of quantitative studies published between 1992 and 2020 that investigated the efficacy of CIM for individuals with TBI of any severity, age, and outcome. Exclusion criteria included animal studies, studies of special diets, herbal and dietary supplements, counseling/psychological interventions, and mixed samples if TBI data could not be extracted. A two-level review comprised of title and abstract screening, followed by full-text assessment by two independent reviewers, was completed. Data synthesis was completed through a compilation of data into a single spreadsheet using Microsoft Excel 2019 (Microsoft Corporation, Richmond, Washington) for validation, coding, and data analyses. Data were summarized using descriptive statistics. Results: Study characteristics: 90 studies were included, with a total of 57,001 patients. Of the 90 studies, 18 (20%) were randomized controlled trials (RCTs). The remainder included 20 quasi-experimental studies (2-group or 1-group pre/post-treatment comparison), 9 retrospective studies, 1 single-subject study design, 2 mixed-methods designs, and 40 case study/case reports. The American Academy of Neurology evidence levels were used to rate included studies. Class II criteria were met by 61% of the RCTs. CIM interventions included biofeedback/ neurofeedback (40%), acupuncture (22%), yoga/tai chi (11%), meditation/mindfulness/relaxation (11%), and chiropractic/ osteopathic manipulation (11%). Clinical outcomes included physical impairments (62%), mental health (49%), cognitive impairments (39%), pain (31%), and activities of daily living/ quality of life (28%). Additional descriptive statistics were summarized using narrative synthesis. Of the studies included for analyses, 97% reported overall positive benefits of CIM. Conclusion: Positive trends were noted in the majority of studies. There is a need for more rigorous and well-designed studies (including RCTs) to confirm the initial evidence supporting the use of CIM found in the existing literature.


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