Advocacy for Early, Multidisciplinary Rehabilitation in Acute Moderate-to-Severe TBI Patients

Authors

• Lorenzo A. Santos, University of LynchburgFollow

Specialty

Trauma Surgery

Advisor

Debra Munsell, DHSc, PA-C, DFAAPA

Abstract

This manuscript evaluates the current evidence for rehabilitative modalities that mitigate the early effects of acute moderate-to-severe traumatic brain injuries (TBIs). A literature search using PubMed, Cochrane Library, Google Scholar, and the Physical Medicine and Rehabilitation (PMR) journal identified several therapies targeting mobility, cognition, and psycho-behavioral rehabilitation. The search yielded nine articles, including comprehensive reviews, randomized controlled trials (RCTs), and meta-analyses. The current literature demonstrates that early mobility-based therapies are safe and effective in improving functional mobility scores, hospital stays, and participation tolerance, regardless of injury severity. While cognitive therapies target memory and attention deficits, existing research focuses on post-hospitalized patients. Environmental and pharmacologic therapies mitigate common psycho-behavioral symptoms, such as aggression, which has shown to improve long-term participation and tolerance for future therapies, as the effects of TBIs can extend beyond the hospitalization phase. Although these modalities align with current American College of Surgeons (ACS) Best Practice Guidelines, the evidence remains relatively outdated. Limitations in sample size, follow-up duration, hospitalization status, isolated therapy examinations, and outdated studies were identified in this search. Despite these gaps, the dynamic clinical manifestation of acute TBIs necessitates a comprehensive approach to management. This manuscript highlights a critical need for earlier multidisciplinary integration by identifying opportunities for additional research to update current practice guidelines and bridge the gap between acute stabilization and successful long-term rehabilitation in TBI patients.

Recommended Citation

Santos LA. Advocacy for Early, Multidisciplinary Rehabilitation in Acute Moderate-to-Severe TBI Patients. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).