Neurorehabilitation for people with disorders of consciousness: an international survey of health-care structures and access to treatment, (Part 1)

ABSTRACT

Aims

The provision of rehabilitation services for people with disorders of consciousness (DoC) may vary due to geographical, financial, and political factors. The extent of this variability and the implementation of treatment standards across countries is unknown. This study explored international neurorehabilitation systems for people with DoC.

Methods

An online survey (SurveyMonkey®) was disseminated to all members of the International Brain Injury Association (IBIA) DoC Special Interest Group (SIG) examining existing rehabilitation systems and access to them.

Results

Respondents (n = 35) were from 14 countries. Specialized neurorehabilitation was available with varying degrees of access and duration. Commencement of specialized neurorehabilitation averaged 3–4 weeks for traumatic brain injury (TBI) and 5–8 weeks for non-traumatic brain injury (nTBI) etiologies. Length of stay in inpatient rehabilitation was 1–3 months for TBI and 4–6 months for nTBI. There were major differences in access to services and funding across countries. The majority of respondents felt there were not enough resources in place to provide appropriate neurorehabilitation.

Conclusions

There exists inter-country differences for DoC neurorehabilitation after severe acquired brain injury. Further work is needed to implement DoC treatment standards at an international level.

KEYWORDS:

• Disorders of consciousness
• unresponsive wakefulness syndrome
• minimally conscious state
• brain injury
• neurorehabilitation

Acknowledgments

This study was conducted on behalf of the IBIA DoC SIG. The authors would like to thank all the centers and professionals who participated in the survey as well as Ginger Vasquez with the IBIA Central Office for their support for survey development and data collection.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research did not receive any funding from agencies in the public, commercial or non-for-profit sectors.