背景:我们介绍了西班牙神经康复学会的成人获得性脑损伤(ABI)康复指南。这些建议是基于对2013年至2020年间发布的国际临床实践指南的回顾。
方法:我们根据所审查研究的证据水平和对人口特征的专家共识以及所研究的干预或程序的具体方面来制定建议。
结论:所有ABI患者一旦临床稳定性达到最低水平,就应接受神经康复治疗。神经康复应在频率方面提供尽可能多的治疗,持续时间,和强度(需要的每种特定治疗形式至少45-60分钟)。神经康复需要协调,具有知识的多学科团队,经验,以及与患者及其家人合作所需的技能。住院康复干预措施建议患者有更严重的缺陷和那些在急性期,一旦患者的临床情况允许,将提供门诊治疗,只要强度标准可以保持。治疗的持续时间应基于治疗反应和进一步改善的可能性,根据现有的最佳证据。出院时,应该为患者提供健康促进,身体活动,支持,和后续服务,以确保保持所取得的效益,为了检测可能的并发症,并评估可能导致患者需要其他治疗方案的功能状态的可能变化。
BACKGROUND: 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.
METHODS: 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.