Development of key elements of clinical rehabilitation pathway for patient with memory impairment after traumatic brain injury in South Korea

Research Objectives: To establish rehabilitation guideline of memory impairment after TBI caused by traffic accident in South Korea.

Design: A descriptive survey study.

Setting: Outpatient and hospitalized care of rehabilitation.

Participants: We surveyed 104 professionals in rehabilitation medicine to obtain their opinions on key elements about memory rehabilitation and the development of clinical pathways; 94 experts responded.

Interventions: Since this study aimed to develop a clinical pathway for memory impairment rehabilitation through a literature review and a Delphi survey, no separate intervention was applied.

Main Outcome Measures: We conducted a survey on the tests, interventions, and medications used in the rehabilitation therapy of memory impairments. Additionally, through a literature review, rehabilitation therapy strategies that are widely used globally are investigated.

Results: The K-WMS-IV (n=62) and the forward digit span test (n=61) were the examinations that experts most frequently used to assess verbal and non-verbal memory, respectively. Both the Complaints Questionnaires Everyday Memory Questionnaire (n=12) and the Rivermead Behavioral Memory Test (n=12) were mostly used. A compensatory and a restorative techniques were used in rehabilitation for memory impairment. Visual imaging (n=53), errorless learning (n=52), and memory notebook (n=53) were the most often used compensatory technique. In restorative technique, Computer-Assisted Cognitive Rehabilitation Therapy—which was created to be appropriate for the circumstances in Korea—was mostly used. It combines rehab-com, com-cog, and cog-rehab for the purpose of rehabilitation of attention and memory.

Conclusions: This study developed a clinical pathway for rehabilitation experts to use in treating patients with memory impairment after TBI. There is no guideline in Korea for memory impairment after TBI. Therefore, it is expected that the clinical pathway developed in this study would improve the efficacy of memory impairment rehabilitation after traumatic brain injury caused by road traffic accident.

Author(s) Disclosures: This study was supported by a grant from the Ministry of Land, Infrastructure and Transport (MOLIT)Research Fund (07-2023-5030).