Date Presented 04/20/2023

This systematic review found moderate evidence for the effects of cognitive rehabilitation, including contextualized, educational, and hybrid cognitive rehabilitation, on improving quality of life for people with a traumatic brain injury.

Primary Author and Speaker: Jennifer N. King

Additional Authors and Speakers: Valerie Ballinger, Garrett Bahney, Arianna Koppen

PURPOSE: The purpose of this poster is to evaluate the literature on the effectiveness of cognitive rehabilitation on improving quality of life for patients with a traumatic brain injury (TBI). Comprehensive consolidation of the literature on cognitive rehabilitation is needed due to the variety of intervention types currently used in practice in order to inform best evidence-based practice for improving quality of life for individuals with a TBI.

DESIGN: A systematic review of available literature was performed as a part of the Evidence-Based Literature Review Project of AOTA.

METHOD: Articles included for review were retrieved from PubMed and CINAHL databases. Out of 248 articles, twenty were found to have met the inclusion and exclusion criteria. The levels of evidence are as follows: ten Level Is, seven Level IIs, two level IIIs, and one Level IV.

RESULTS: There is overall moderate evidence to support the use of cognitive rehabilitation on improving quality of life for individuals with a TBI. Additionally, there was moderate evidence to support contextualized cognitive rehabilitation (Twamley et al., 2015; Pąchalska et al., 2012), moderate evidence for educational cognitive rehabilitation interventions (TornÅs et al., 2016), and low to moderate evidence for a hybrid form of cognitive rehabilitation (Brands et al., 2017).

CONCLUSION: Based on the findings, the literature supports various forms of cognitive rehabilitation to improve quality of life in individuals with a TBI. However, there is a need for further research with Level I designs to provide stronger evidence on the effects of cognitive rehabilitation on quality of life.

IMPACT STATEMENT: TBIs can significantly impact an individual’s occupations, roles, and quality of life. This systematic review supports occupational therapists in making evidence-based decisions when working with these individuals to address overall quality of life and provide holistic care.


Twamley, E. W., Thomas, K. R., Gregory, A. M., Jak, A. J., Bondi, M. W., Delis, D. C., & Lohr, J. B. (2015). CogSMART Compensatory Cognitive Training for Traumatic Brain Injury: Effects Over 1 Year. The Journal of head trauma rehabilitation, 30(6), 391–401.

Tornas, S., Løvstad, M., Solbakk, A.-K., Schanke, A.-K., & Stubberud, J. (2016). Goal management training combined with external cuing as a means to improve emotional regulation, psychological functioning, and quality of life in patients with acquired brain injury: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 97(11).

Pąchalska, M., Mańko, G., Chantsoulis, M., Knapik, H., Mirski, A., & Mirska, N. (2012). The quality of life of persons with TBI in the process of a comprehensive rehabilitation program. Medical science monitor: international medical journal of experimental and clinical research, 18(7), CR432–CR442.

Brands, I., Custers, M., & van Heugten, C. (2017). Self-efficacy and quality of life after low-intensity neuropsychological rehabilitation: a pre-post intervention study. NeuroRehabilitation, 40(4), 587-594.