VA/DoD Clinical Practice Guideline for the Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury - Version 3 - June 2021

Sep 17, 2026

VA/DoD clinical practice guideline provides evidence-based, multidisciplinary direction for managing and rehabilitating post-acute mild traumatic brain injury. The guideline synthesizes clinical and epidemiological evidence, clarifies relationships between care options and health outcomes, and rates evidence quality and recommendation strength. It addresses scope, audience, patient population, and development methodology, and emphasizes patient-centered stepped care, shared decision making, and consideration of co-occurring conditions. An algorithm structures initial presentation and symptom persistence beyond 7 days, followed by recommendations for settings of care, diagnosis and assessment, and care approaches.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages128

Reading Time5 h 23 min

AccessFree to download

Introduction

Background

Terminology Conventions within this Guideline

Scope of this Guideline

Guideline Audience

Guideline Population

Highlighted Features of this Guideline

Highlights in this Guideline Update

Components of the Guideline

Guideline Development Team

Summary of Guideline Development Methodology

Evidence Quality and Recommendation Strength

Categorization of 2016 Clinical Practice Guideline Recommendations

Management of Potential or Actual Conflicts of Interest

Patient Perspective

External Peer Review

Implementation

Approach to Care in Department of Veterans Affairs and Department of Defense

Patient-centered, Stepped Care and a “Whole Health” Orientation

Shared Decision Making

Patients with Co-occurring Conditions

Algorithm

7 Days Post-injury)">Module A: Initial Presentation (>7 Days Post-injury)

7 Days After Mild Traumatic Brain Injury">Module B: Management of Symptoms Persisting >7 Days After Mild Traumatic Brain Injury

Recommendations

Setting of Care

Diagnosis and Assessment

VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT AND REHABILITATION OF POST-ACUTE MILD TRAUMATIC BRAIN INJURY Department of Veterans Affairs Department of Defense QUALIFYING STATEMENTS The Department of Veterans Affairs and the Department of Defense guidelines are based upon the best information available at the time of publication. They are designed to provide information and assist decision making. They are not intended to define a standard of care and should not be construed as one. Neither should they be interpreted as prescribing an exclusive course of management. This Clinical Practice Guideline is based on a systematic review of both clinical and epidemiological evidence. Developed by a panel of multidisciplinary experts, it provides a clear explanation of the logical relationships between various care options and health outcomes while rating both the quality of the evidence and the strength of the recommendation. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of these guidelines is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation. These guidelines are not intended to represent Department of Veterans Affairs or TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions within these guidelines does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found [at](at www.tricare.mil)[ ](at www.tricare.mil)[www.tricare.mil](at www.tricare.mil) by contacting your regional TRICARE Managed Care Support Contractor. Version 3.0 – June 2021 Prepared by: The Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury Work Group With support from: The Office of Quality and Patient Safety, VA, Washington, DC & Office of Evidence Based Practice, Defense Health Agency Version 3.0 – June 2021 Based on evidence reviewed through April 2020 Table of Contents I. Introduction..................................................................................................................................... 6 II. Background...................................................................................................................................... 6 A. Terminology Conventions within this Guideline ................................................................................ 8 III. Scope of this Guideline .................................................................................................................... 8 A. Guideline Audience.............................................................................................................................. 8 B. Guideline Population ........................................................................................................................... 8 IV. Highlighted Features of this Guideline.............................................................................................. 9 A. Highlights in this Guideline Update..................................................................................................... 9 B. Components of the Guideline ............................................................................................................. 9 V. Guideline Development Team.......................................................................................................... 9 VI. Summary of Guideline Development Methodology........................................................................ 11 A. Evidence Quality and Recommendation Strength ........................................................................... 11 B. Categorization of 2016 Clinical Practice Guideline Recommendations....

FAQs

What is the purpose of the VA/DoD clinical practice guideline?

It is designed to provide evidence-based information and assist decision making for the management and rehabilitation of post-acute mild traumatic brain injury. It explains relationships between care options and health outcomes while rating evidence quality and recommendation strength.

How does the guideline structure care over time?

It uses an algorithm with Module A for initial presentation (more than 7 days post-injury) and Module B for managing symptoms that persist beyond 7 days after mild traumatic brain injury.

What methodology is used to develop the recommendations?

The guideline is based on a systematic review of clinical and epidemiological evidence. A multidisciplinary work group explains evidence quality and recommendation strength, includes external peer review, and addresses implementation and conflicts of interest.

Sep 17, 2026

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