Summarized By Dr. Ashley Choi, OTD, OTR/L
January 2026

Introduction

Recovering from a traumatic brain injury (TBI) often feels like trying to find your way through a maze without a map. Tasks that were once a breeze like planning your day, keeping appointments, and cooking a meal, can suddenly feel impossible. For older adults, the challenge can be even greater, as aging and injury intersections compound the difficulties after TBI.

Background

A recent study in the Annals of Physical and Rehabilitation Medicine explored how a 12-week multimodal cognitive rehabilitation program, known as the Cognitive Enrichment Program (CEP), helped adults aged 57 to 90 regain control over their thinking skills after TBI. The CEP, led by rehabilitation professionals such as occupational therapists and neuropsychologists, focused on strengthening executive functions, or higher-level cognitive skills such as planning, organizing, problem-solving, decision-making, and emotional regulation.

When seeking rehabilitation after TBI, you may discover occupational therapy (OT). OT’s help to identify and facilitate the rehabilitation of executive functioning skills such as memory, problem solving, and planning to name a few. In the CEP, participants practiced strategies for neurorehabilitation: setting goals, using structured routines, applying problem-solving steps to daily activities, and developing self-awareness of cognitive strengths and challenges. These higher-level cognitive skills can be re-learned after TBI to enable clients to formulate strategies for adapting, modifying, or building routines after brain injury.

Results

The results from the study were promising. Compared with those receiving standard rehabilitation, participants who completed the CEP showed greater improvement in planning and multitasking, fewer rule-breaking errors on cognitive tests, and better self-monitoring skills. Furthermore, six months after the program ended, they had resumed more of their previously abandoned daily activities, from hobbies to social engagements.

This kind of long-term impact reflects the need for TBI cognitive rehabilitation programs ensuring a client’s return to meaningful occupations. By guiding clients through self-reflection, graded challenges, and habit restructuring, OTs help older adults not only restore cognitive function but also rebuild confidence and autonomy in daily life.

For older adults recovering from a TBI, this research underscores a vital message: individualized neurorehabilitation is foundational in recovery after brain injury. Through individualized cognitive retraining, activity analysis, and real-life application, it is important to seek specialist guidance in retraining of the brain’s executive functions, in order to live more meaningfully after injury.

For more information: https://doi.org/10.1016/j.rehab.2021.101559

Summarized by Tulika Das, MS

October 2025

Doctors use a test called the Glasgow Coma Scale (GCS) to measure how serious a brain injury is. A higher score means a milder injury, and a lower score means a more serious one. Another test, called the Glasgow Outcome Scale Extended (GOSE), helps track how well someone recovers over time. While these tools are helpful, they don’t always show the full picture—especially for people with mild brain injuries, who might still experience lasting problems even when their test scores seem normal.

Researchers have found that looking at biomarkers—special proteins in the blood—can help doctors better understand brain injuries. When brain cells are damaged, these proteins increase in the bloodstream. Three biomarkers are especially useful: NFL, which shows nerve damage; UCH-L1, which signals injury to brain cells; and GFAP, which indicates changes in the brain’s support cells. Higher levels of these markers usually mean the brain has been more seriously hurt.

In a study of 2,479 people with different levels of brain injury, researchers found that biomarker levels increased as injuries became more severe. Even people with mild injuries showed patterns in their blood that matched how much damage showed up on brain scans. Those with higher biomarker levels were more likely to have ongoing problems or slower recovery, while those with lower levels tended to heal better.

Overall, this study suggests that blood tests for biomarkers can give doctors and families a clearer picture of brain injury and recovery. For patients with mild injuries, these tests can help doctors identify who might need extra care early on. For people with severe injuries, the results can guide families in understanding what to expect and making informed choices about treatment and long-term care.

For more information https://pubmed.ncbi.nlm.nih.gov/39191173/