Sensory regulation as a method to promote recovery in patients with altered states of consciousness

Abstract

A controlled pilot study to assess the clinical application of a sensory regulation procedure to patients in vegetative states produced results that were sufficiently encouraging to evaluate the procedure with a larger group of patients. This study looks at the use of sensory regulation with 15 consecutively admitted patients (ten traumatic brain injury; five subarachonid haemorrhage) who met the following criteria: aged 60 or below; at least 28 days post-injury; at a low level of arousal/awareness (vegetative or altered state of consciousness); and discharged from treatment for clinical (and not financial), reasons. Each patient's response capabilities were evaluated daily using a behaviourally defined stimulus-response hierarchy (SRH). Clinical outcome was also measured using the Glasgow Coma Scale (GCS), Rancho Level (RL), and clinical discharge placements. The results of this study show that seven patients achieved a “good” clinical outcome (acute rehabilitation). Of the remainder, five increased their level of awareness (a “moderate” outcome) and three showed no evidence of response change or other clinical improvement. These results compare favourably with data from the Traumatic Coma Data Bank showing recovery from vegetative conditions, over a comparable interval.