The Impact of Early Pre-Hospital Cognitive Rehabilitation on Quality of Life After Traumatic Brain Injury

Abstract

Background: Traumatic brain injury (TBI) is a major global health concern and one of the leading causes of long-term disability and reduced quality of life. Although advances in emergency medicine have improved survival rates, many patients continue to experience persistent cognitive, physical, psychological, and social impairments. Early cognitive rehabilitation has emerged as a promising strategy for enhancing neurological recovery; however, its application during the pre-hospital phase remains insufficiently investigated.

Aim: The aim of this systematic review is to evaluate and synthesize the available evidence regarding the impact of early pre-hospital cognitive rehabilitation on health-related quality of life among patients with traumatic brain injury (TBI). The review also aims to examine its influence on cognitive recovery, functional independence, neurological outcomes, and social reintegration.

Methods: This systematic review was conducted to evaluate the available evidence regarding the impact of early pre-hospital cognitive rehabilitation on health-related quality of life following traumatic brain injury. Electronic databases including PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar were searched for studies published between 2020 and 2025. Study selection was performed according to the PRISMA 2020 guidelines. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools, and the findings were synthesized narratively because of the heterogeneity among the included studies.

Importance of the Study: This study is important because it addresses a significant gap in the current literature regarding the role of early pre-hospital cognitive rehabilitation in patients with traumatic brain injury. The findings may contribute to a better understanding of the potential value of integrating cognitive rehabilitation into the early stages of emergency care. In addition, the study may support the development of integrated trauma care pathways, provide evidence to guide clinical practice and rehabilitation strategies, and inform healthcare policies aimed at improving long-term patient outcomes, functional recovery, and health-related quality of life.