Integration of intensive care treatment and neurorehabilitation in patients with disorders of consciousness: a program description and case report

Arch Phys Med Rehabil. 2013 Oct;94(10):1924-33. doi: 10.1016/j.apmr.2013.03.030. Epub 2013 Jun 26.

Abstract

Severe brain injuries frequently result in disorders of consciousness, requiring intensive care unit treatment. We present a rehabilitative system that integrates neurorehabilitation into intensive care treatment. The system will be described using the case report of a young man who was in a vegetative state after a severe traumatic brain injury that resulted in major medical problems and complications. Despite these challenges, interdisciplinary therapies can be applied throughout the rehabilitative process. The patient in our case report showed significant improvements and functional gains during the course of treatment. Additional data from other patients support the feasibility of this system and show that integrating neurorehabilitation into intensive care treatment is possible and can lead to improved outcomes in this patient population. We will discuss the advantages, special features, and limitations of the system. Additional studies are needed to further demonstrate the efficacy of this approach compared with standard treatment.

Keywords: ADL; CRS-R; Coma Recovery Scale-Revised; Consciousness disorders; DOCs; DRS; Disability Rating Scale; ICU; MCS; Persistent vegetative state; Rehabilitation; TBI; VS; activities of daily living; disorders of consciousness; intensive care unit; minimally conscious state; traumatic brain injury; vegetative state.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Brain Injuries / complications*
  • Humans
  • Intensive Care Units / organization & administration*
  • Male
  • Music Therapy / organization & administration
  • Neuropsychology / organization & administration
  • Patient Care Team / organization & administration
  • Persistent Vegetative State / etiology*
  • Persistent Vegetative State / rehabilitation*
  • Personnel, Hospital
  • Physical Therapy Specialty / organization & administration
  • Recovery of Function