Multimodalna senzorna stimulacija v obdobju zgodnje rehabilitacije otrok v vegetativnem stanju : učinkovitost v seriji primerov
Multimodal sensory stimulation in early rehabilitation of children in vegetative state : efficacy in a series of cases

slovenian

2019

volume 18, issue 2

consciousness level   injury   multimodal sensory stimulation

Univerzitetni rehabilitacijski inštitut RS – Soča
(Obvezni izvod spletne publikacije)

Background: Recovery from severe brain damage has its typical features, including disorders of consciousness such as coma, unresponsive wakefulness syndrome or state of minimal consciousness. Research shows that multimodal sensory stimulation (MMSS) improves level of consciousness and treatment outcome after severe brain damage. We wanted to evaluate the efficiency of MMSS program in children after severe brain damage, who were enrolled into the program in the period of 10 years. Methods: We wanted to collect and analyse data on all children, who were enrolled in the MMSS program in the period from 2007 to 2017. We collected general data, data on consciousness level, using the Post-Acute Level of Consciousness Scale (PALOC), and data on the responses of children to different stimuli (five-level scale). For four cases, we performed a one-way ANOVA for repeated measures of responses to stimuli. Results: Ten children were included in MMSS program (5 boys; mean age 10 years; SD 3.89). Six suffered from traumatic brain injury, two had hypoxic impairment, one had meningoencephalitis and one had extensive bleeding from arteriovenous malformation. Children were enrolled in MMSS on average 88.7 days after the injury or impairment. The MMSS program was run in average of 6.7 weeks. Four children achieved a state of full consciousness, three children did not improve, two improved only partially. Four cases are presented in more detail. Statistical analysis revealed significant differences in stimulus response between stimuli in three of the four presented cases. Conclusion: Based on the results, we could conclude that MMSS is an effective program in children after traumatic brain injury, which cannot be confirmed for children after severe hypoxic and other acute brain impairments. To assess the child's progress, the PALOC's assessment of the state of consciousness seems to be more reliable than that of the stimulus responses.

17.02.2020