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

Brain Inj. 2022 Jun 7;36(7):850-859. doi: 10.1080/02699052.2022.2059813. Epub 2022 Jun 16.


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; brain injury; minimally conscious state; neurorehabilitation; unresponsive wakefulness syndrome.

MeSH terms

  • Brain Injuries* / complications
  • Consciousness
  • Consciousness Disorders / etiology
  • Health Services Accessibility
  • Humans
  • Neurological Rehabilitation*
  • Surveys and Questionnaires