Content and outcome of non-pharmacological rehabilitation for women with traumatic brain injury – a scoping review
DOI:
https://doi.org/10.2340/jrm.v58.45767Keywords:
brain injuries, female, gender, interventionAbstract
Objective: To identify and map evidence on the content and outcomes of non-pharmacological rehabilitation for women with traumatic brain injury.
Design: Scoping review.
Subjects/patients: Women aged 18–65 years with traumatic brain injury of any severity.
Methods: The PubMed, CINAHL and PsycINFO databases were searched. Studies including individuals with nontraumatic brain injuries, text and opinion papers, conference abstracts, study protocols, and grey literature were excluded. Inclusion criteria were: either ≥ 50% of the sample were women, or outcome data distinguished women’s results from the rest of the sample. A data-extraction form was used. Extracted data included specific details concerning the participants, context, study methods, and key findings.
Results: 41 studies with varying designs were included. None of the interventions described had a specific focus on women or women’s needs. Community or outpatient settings dominated. The interventions were grouped into 3 main categories with underlying sub-categories – Alternative and complementary interventions, Training to restore functions, and Skills training to enhance cognitive functioning – with the latter category containing the most studies.
Conclusion: The interventions described targeted a wide range of consequences from traumatic brain injury but without a clear gender perspective. Current rehabilitation models need to be developed to also include such a perspective.
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References
Dewan MC, Rattani A, Gupta S, Baticulon RE, Hung Y-C, Punchak M, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg 2018; 130: 1080–1097.
Baker A, Barker S, Sampson A. Caregiver outcomes and interventions: a systematic scoping review of the traumatic brain injury and spinal cord injury literature. Clin Rehabil 2017; 31: 45–60.
Evans J. Goal setting during rehabilitation early and late after acquired brain injury. Curr Opin Neurol 2012; 25: 651–655.
Scholten AC, Haagsma JA, Cnossen MC, Olf M, van Beeck EF, Polinder S, et al. Prevalence of and risk factors for anxiety and depressive disorders after traumatic brain injury: a systematic review. J Neurotraum 2016; 33: 1969–1994.
Sergeyenko Y, Andreae ME, Segal M. Diagnosis and management of mild traumatic brain injury (mTBI): a comprehensive, patient-centered approach. Curr Pain Headache Rep 2025; 29: 19: 2–10.
Toglia J, Foster E. The multicontext approach to cognitive rehabilitation: a metacognitive strategy intervention to optimize functional cognition. Tampa, FL: Gatekeeper Press; 2021.
Bray EA, Hogan C, Mitchell J. Impact of early personal resources on long-term psychosocial outcomes after moderate-to-severe traumatic brain injury: a systematic review. J Head Trauma Rehab 2024; 39: E481–E97.
Mollayeva T, Mollayeva S, Colantonio A. Traumatic brain injury: sex, gender and intersecting vulnerabilities. Nat Rev Neurol 2018; 14: 711–722.
Colantonio A. Sex, gender, and traumatic brain injury: a commentary. Archi Phys Med Rehabil 2016; 97: S1–S4.
Eapen BC, Bowles AO, Sall J, Lang AE, Hoppes CW, Stout KC, et al. The management and rehabilitation of post-acute mild traumatic brain injury. Brain Injury 2022; 36: 693–702.
Carcel C, Sandset EC, Ali M, Allende Echanez MI, Mosconi MG, de Souza AC, et al. Addressing sex and gender differences in stroke risk and management: a scientific statement from the World Stroke Organization. Int J Stroke 2026: 21: 303–323.
Maas AI, Menon DK, Manley GT, Abrams M, Åkerlund C, Andelic N et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol 2022; 21(11): 1004–1060.
Valera EM, Joseph ALC, Snedaker K, Breiding MJ, Robertson CL, Colantonio A, et al. Understanding traumatic brain injury in females: a state-of-the-art summary and future directions. J Head Trauma Rehabil 2021; 1: 36(1): E1–E17.
O’Reilly K, Wilson N, Peters K. Narrative literature review: health, activity and participation issues for women following traumatic brain injury. Disabil Rehabil 2018; 40: 2331–2342.
Colantonio A, Mar W, Escobar M, Yoshida K, Velikonja D, Risoli S, et al. Women’s health outcomes after traumatic brain injury. J Womens Health 2010; 19: 1109–1116.
Blaya MO, Raval AP, Bramlett HM. Traumatic brain injury in women across lifespan. Neurobiol Dis 2022; 164: 1–15.
Frost RB, Farrer TJ, Primosch M. Prevalence of traumatic brain injury in the general adult population: a meta-analysis. J Neuroepidem 2013; 40: 154–159.
Haag H, Jones D, Joseph T. Battered and brain injured: traumatic brain injury among women survivors of intimate partner violence – a scoping review. Trauma Violence Abus 2022; 23: 1270–1287.
Wills E, Fitts M. Listening to the voices of aboriginal and Torres Strait islander women in regional and remote Australia about traumatic brain injury from family violence: a qualitative study. Health Expect 2024; 27: e14125.
Mikolić A, Van Klaveren D, Groeniger JO, Wiegers EJ, Lingsma HF, Zeldovich M, et al. Differences between men and women in treatment and outcome after traumatic brain injury. J Neurotrauma 2021; 15; 38(2): 235–251.
Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares C, et al. Guidance for conducting systematic scoping reviews. JBI Evid Implement 2015; 13: 141–146.
Peters MD, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth 2021; 18: 2119–2126.
Tricco AC, Lillie E, Zarin W, O’Brien K, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018; 169: 467–473.
Holmqvist KL, Strandberg T, Simpson G, Massey J, Matérne M. Content and outcome of non-pharmacological rehabilitation in hospital, or community-based care, for women with traumatic brain injury: a scoping review protocol. BMJ Open 2025; 15: e092767.
Covidence. The world’s #1 systematic review tool [web page]. Melbourne: Covidence [cited 2024 March 8]. Available from: https://www.covidence.org/
Banerjee M, Hegde S, Thippeswamy H. In search of the ‘self’: holistic rehabilitation in restoring cognition and recovering the ‘self’ following traumatic brain injury: a case report. NeuroRehabilitation 2021; 48: 231–242.
Bieman-Copland S, Dywan J. Achieving rehabilitative gains in anosognosia after TBI. Brain Cogn 2000; 44: 1–5.
Connolly K, Lyon DW. In-office vision therapy for the treatment of post-concussion syndrome: is it beneficial? A case report. Optom Vis Perform 2017; 5: 221.
Fritz NE, Basso DM. Dual-task training for balance and mobility in a person with severe traumatic brain injury: a case study. J Neurol Phys Ther 2013; 37: 37–43.
Imhoff S, Lavallière M, Germain-Robitaille M. Training driving ability in a traumatic brain-injured individual using a driving simulator: a case report. Int Med Case Reports J 2017; 10: 41–45.
Mahajan SN, Jain A, Chattopadhyay S. Integrating rational emotive behavior therapy, compassion-focused therapy with cognitive retraining in traumatic brain injury: a case report. Consort Psychiatricum 2024; 5: 91–102.
Özata Değerli MN, Değerli Yİ, Aydöner S. The effect of occupational therapy intervention based on a multicontext approach in a patient with traumatic brain injury: a case study. Internet J Allied Health Sci Practice 2025; 23: 23.
Schmid AA, Miller KK, Van Puymbroeck M. Feasibility and results of a case study of yoga to improve physical functioning in people with chronic traumatic brain injury. Disabil Rehabil 2016; 38: 914–920.
Rath JF, Simon D, Langenbahn DM. Group treatment of problem- solving deficits in outpatients with traumatic brain injury: a randomised outcome study. Neuropsychol Rehabil 2003; 13: 461–488.
Palmese CA, Raskin SA. The rehabilitation of attention in individuals with mild traumatic brain injury, using the APT-II programme. Brain Injury 2000; 14: 535–548.
Grimm L, Van Puymbroeck M, Miller K. Yoga after traumatic brain injury: changes in emotional regulation and health-related quality of life in a case-study. Int J Complement Altern Med 2017; 8: 00247.
Tsaousides T, Spielman L, Kajankova M. Improving emotion regulation following web-based group intervention for individuals with traumatic brain injury. J Head Trauma Rehab 2017; 32: 354–365.
Toglia J, Johnston MV, Goverover Y. A multicontext approach to promoting transfer of strategy use and self regulation after brain injury: an exploratory study. Brain Injury 2010; 24: 664–677.
Campbell KR, Wilhelm JL, Pettigrew NC. Implementation and adoption of telerehabilitation for treating mild traumatic brain injury. J Neurol Phys Ther 2022; 46: E1–E10.
Bay E, Ribbens-Grimm C, Chan RR. Development and testing of two lifestyle interventions for persons with chronic mild-to-moderate traumatic brain injury: acceptability and feasibility. Appl Nurs Res 2016; 30: 90–93.
Brown AW, Moessner AM, Bergquist TF. A randomized practical behavioural trial of curriculum-based advocacy training for individuals with traumatic brain injury and their families. Brain Injury 2015; 29: 1530–1538.
Callahan CE, Beisecker L, Zeller S. LoveYourBrain mindset: feasibility, acceptability, usability, and effectiveness of an online yoga, mindfulness, and psychoeducation intervention for people with traumatic brain injury. Brain Injury 2023; 37: 373–382.
Cantor J, Ashman T, Dams-O’Connor K, Dijkers MP, Gordon W, Spielman L, et al. Evaluation of the short-term executive plus intervention for executive dysfunction after traumatic brain injury: a randomized controlled trial with minimization. Arch Physical Med Rehabil 2014; 95: 1–9. e3.
Donnelly KZ, Baker K, Pierce R. A retrospective study on the acceptability, feasibility, and effectiveness of LoveYourBrain Yoga for people with traumatic brain injury and caregivers. Disabil Rehabil 2021; 43: 1764–1775.
Esquenazi A, Lee S, Packel AT. A randomized comparative study of manually assisted versus robotic-assisted body weight supported treadmill training in persons with a traumatic brain injury. PM&R 2013; 5: 280–290.
Kreutzer JS, Marwitz JH, Sima AP. Efficacy of the resilience and adjustment intervention after traumatic brain injury: a randomized controlled trial. Brain Injury 2018; 32: 963–971.
Raina KD, Morse JQ, Chisholm D. Feasibility of a cognitive behavioral intervention to manage fatigue in individuals with traumatic brain injury: a pilot study. J Head Trauma Rehabil 2016; 31: E41–E49.
Sartor-Glittenberg C, Brickner L. A multidimensional physical therapy program for individuals with cerebellar ataxia secondary to traumatic brain injury: a case series. Physiother Theor Pract 2014; 30: 138–148.
Toglia J, Goverover Y, Johnston MV. Application of the multicontextual approach in promoting learning and transfer of strategy use in an individual with TBI and executive dysfunction. OTJR-Occup Part Heal 2011; 31: S53–S60.
Bedard M, Felteau M, Mazmanian D, Fedyk K, Klein R, Richardson J, et al. Pilot evaluation of a mindfulness-based intervention to improve quality of life among individuals who sustained traumatic brain injuries. Disabil Rehabil 2003; 25: 722–731.
Bonn MM, Dickey JP, Moran B. Completing an interdisciplinary outpatient intervention improves patient rehabilitation goals following a mild traumatic brain injury. Physiother Theor Pr. 2023; 39: 310–316.
Dawson DR, Gaya A, Hunt A. Using the cognitive orientation to occupational performance (CO-OP) with adults with executive dysfunction following traumatic brain injury. Can J Occup Ther 2009; 76: 115–127.
Bonn MM, Dickey JP, Moran B. The relationship between prognostic factors and patient satisfaction with performance of self-identified goals following interdisciplinary mild traumatic brain injury rehabilitation. Physiother Theor Pract 2025; 41: 1172–1180.
Alarie C, Gagnon I, de Guise E, McKerral M, Kersalé M, van het Hoog B, et al. A remotely delivered progressive walking intervention for adults with persistent symptoms of a mild traumatic brain injury: feasibility and exploration of its impact. Front Rehab Sci 2022; 3: 898804.
Finch E, Cornwell P, Copley A. Remediation of social communication impairments following traumatic brain injury using metacognitive strategy intervention: a pilot study. Brain Injury 2017; 31: 1830–1839.
Fleming JM, Shum D, Strong J. Prospective memory rehabilitation for adults with traumatic brain injury: a compensatory training programme. Brain Injury 2005; 19: 1–10.
Nguyen JV, Willmott C, Ponsford J. Moving forward on the road to recovery after concussion: participant experiences of interdisciplinary intervention for persisting post-concussion symptoms. Disabil Rehabil 2024; 46: 3961–3969.
Ownsworth T, Quinn H, Fleming J. Error self-regulation following traumatic brain injury: a single case study evaluation of metacognitive skills training and behavioural practice interventions. Neuropsychol Rehabil 2010; 20: 59–80.
Tate RL, Wakim D, Sigmundsdottir L. Evaluating an intervention to increase meaningful activity after severe traumatic brain injury: a single-case experimental design with direct inter-subject and systematic replications. Neuropsychol Rehabil 2020; 30: 641–672.
Faulkner J, Prouty D, Devlin L, Appleton D, Rocje M, Below K, et al. Acceptance and commitment therapy for mild traumatic brain injury (ACTion-mTBI): a quasiexperimental feasibility study. BMJ Open 2025; 15: e089727.
Faulkner JW, Chua J, Voice-Powell A, Snell DL, Rocke M, Moffat J, et al. Experience of Acceptance and Commitment Therapy for those with mild traumatic brain injury (ACTion mTBI): a qualitative descriptive study. PLoS One 2025; 20: e0312940.
Tzeng HY, Chang CC, Chen SC, Chen SJ, Hueng DY, Chu CM, et al. Effect of a digitally monitored walking program on functional and psychological outcomes in individuals with mild traumatic brain injury: a randomized controlled trial. Arch Phys Med Rehabil 2025; 107: 1–10.
Briggs S, Scheiman M, Asakura Y. Occupational therapist-led remedial vision program after mild traumatic brain injury: pre/post pilot study. Open J Occup Ther 2024; 12: 1–13.
Kersey J, Alimi E, McArthur AR. ENGAGE-TBI: adaptation of a community-based intervention to improve social participation after brain injury. Brain Injury 2025; 39: 518–525.
Hecker L, King S, Stapert S, Geusgens C, den Hollander M, Fleischeuer B, et al. Can exposure therapy be effective for persistent post-concussion symptoms? A nonconcurrent multiple baseline design across 4 cases. J Head Trauma Rehabil 2025; 40: 269–278.
King S, Stapert SZ, Winkens I. Efficacy of an intensive exposure intervention for individuals with persistent concussion symptoms following concussion: a concurrent multiple baseline single-case experimental design (SCED) study. J Head Trauma Rehabil. 2024; 39: E419–429.
Lian L, Coupland R, Tylinski Sant’Ana T. Community integration challenges of men and women after traumatic brain injury: a reflexive thematic analysis of lived experiences through a gender lens. J Head Trauma Rehabil 2025; 40: E163–E74.
Law MC, Baptiste S, Carswell A, McColl MA, Polatajko HJ, Pollock N. Canadian occupational performance measure. Toronto: Canadian Association of Occupational Therapists; 1994.
Yun D, Choi J. Person-centered rehabilitation care and outcomes: a systematic literature review. Int J Nurs Stud 2019; 93: 74–83.
Plant SE, Tyson SF, Kirk S, Parsons J. What are the barriers and facilitators to goal-setting during rehabilitation for stroke and other acquired brain injuries? A systematic review and meta-synthesis. Clin Rehabil 2016; 30(9): 921–930.
Liljehult MM, von Euler-Chelpin MC, Christensen T. Sex differences in independence in activities of daily living early in stroke rehabilitation. Brain Behav 2021; 11: e2223.
Alston M, Jones J, Curtin M. Women and traumatic brain injury: “It’s not visible damage”. Australian Social Work 2012; 65: 39–53.
Domensino AF, Verberne D, Prince L. Client experiences with holistic neuropsychological rehabilitation: ‘It is an ongoing process’. Neuropsychol Rehabil 2022; 32: 2147–2169.
Richards DA, Hallberg IR, Estabrooks C, Köpke S, Meyer G, Wallin L, et al. Complex interventions in health: an overview of research methods. New York: Routledge; 2026
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