IHad万uma RebabilVol.38,No.1,pp.52-64Copyright 2023 The Authors.Published by Wolters Kluwer Health,Inc.OPENINCOG 2.0 Guidelines for CognitiveRehabilitation Following TraumaticBrain Injury,Part III:ExecutiveFunctionsEliyas Jeffay,PhD,CPsych;Jennie Ponsford,A0,PhD,MA(Clinical Neuropsychology);Amber Harnett,RN,MSc;Shannon Janzen,MSc;Eleni Patsakos,MSc;Jacinta Douglas,PhD,MSc(Psych);Mary Kennedy,PhD,CCC-SLP;Ailene Kua,MSc,PMP;Robert Teasell,MD,FRCPC;Penny Welch-West,MCISc,SLP Reg CASLPO;Mark Bayley,MD,FRCPC;Robin Green,PhD,CPsychIntroduction:Moderate-to-severe traumatic brain injury (MS-TBI)causes debilitating and enduring impairmentsof executive functioning and selfawareness,which clinicians often find challenging to address.Here,we providean update to the INCOG 2014 guidelines for the clinical management of these impairments.Methods:Anexpert panel of clinicians/researchers (known as INCOG)reviewed evidence published from 2014 and developedupdated recommendations forthe management of executive functioning and self-awareness post-MS-TBI,as well as adecision-making algorithm,and an audit tool for review of clinical practice.Results:A total of8 recommendationsare provided regarding executive functioning and self-awareness.Since INCOG 2014,4 new recommendationswere made and 4 were modified and updated from previous recommendations.Six recommendations are based onlevel A evidence,and 2 are based on level C.Recommendations retained from the previous guidelines and updated,where new evidence was available,focus on enhancement of self-awareness (eg,feedback to increase self-monitoring;training with video-feedback),meta-cognitive strategy instruction (eg,goal management training),enhancementof reasoning skills,and group-based treatments.New recommendations addressing music therapy,virtual therapy,telerehabilitation-delivered metacognitive strategies,and caution regardingother group-based telerehabilitation(dueto a lack of evidence)have been made.Conclusions:Effective management ofimpairments in executive functioningAuthor Affdliations:KITE Researcb Istitute.Toronto RebabilitationInstitute-Unitersity Healtb Netork,Toronto,Ontario,Canada(DrsIfa),Bayle,and Green and Mss Patsakos and Kua);TimerInstitie for Brain and Mental Healtb,Soool of Pycbological Scienas,declare that the finders did not participate in the organization of the project norMonasb University,Melboun,Australia and Monasb-Epworththe expert panel process,evidence syntbesis nor formulation oftbe rocommenda-Rebabilitation Research Centre,Eporth Healbcare,Melboirne,tions.The opinions,resuls and conchsions reported are those of tbe authors.Australia(Dr Ponsford);Lawson Health Research Institute,ParkwoodNo edorsement by the Onario Ministry of Health is inerded or shoidd beInstitide,London,Ontario,Canada (Mss Harnett and janzen)Livinginfered.With Disability Rescanb Centre,La Trobe Univerity,Melboume,Australid,and Summer Foundation,Melboume,Australia (Dr Douglas)Supplemental digital content is available fo
