The value of incorporating personally relevant stimuli into consciousness assessment with the Coma Recovery Scale - Revised: A pilot study

To explore whether the use of personally relevant stimuli, for some tasks in the Coma Recovery Scale - Revised (CRS-R), generates more responses in patients with prolonged disorders of consciousness compared with neutral stimuli. Multiple single-case design. Three patients with prolonged disorders o...

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Bibliographic Details
Published in:Journal of rehabilitation medicine 2018, Vol.50 (3), p.253-260
Main Authors: Stenberg, Jonas, Godbolt, Alison K, Möller, Marika C
Format: Article
Language:English
Subjects:
Adult
Bootstrap method
Brain injuries
Coma
Coma - diagnosis
Consciousness
Consciousness - physiology
consciousnessdisorders
Female
Fixation
Humans
Injuries
Inpatient care
Male
Medicin och hälsovetenskap
minimallyconsciousnessstate
personallyrelevantstimuli
Photography
Pilot Projects
Recovery
Recovery (Medical)
Rehabilitation
unresponsivewakefulnesssyndrome
vegetativestate
Visual stimuli
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Description
Summary:To explore whether the use of personally relevant stimuli, for some tasks in the Coma Recovery Scale - Revised (CRS-R), generates more responses in patients with prolonged disorders of consciousness compared with neutral stimuli. Multiple single-case design. Three patients with prolonged disorders of consciousness recruited from an inpatient department at a regional brain injury rehabilitation clinic in Stockholm, Sweden. Patients were repeatedly assessed with the CRS-R. Randomization tests (bootstrapping) were used to compare the number of responses generated by personally relevant and neutral stimuli on 5 items in the CRS-R. Compared with neutral stimuli, photographs of relatives generated significantly more visual fixations. A mirror generated visual pursuit to a significantly greater extent than other self-relevant stimuli. On other items, no significant differences between neutral and personally relevant stimuli were seen. Personally relevant visual stimuli may minimize the risk of missing visual fixation, compared with the neutral stimuli used in the current gold standard behavioural assessment measure (CRS-R). However, due to the single-subject design this conclusion is tentative and more research is needed.
ISSN:1650-1977
1651-2081
1651-2081
DOI:10.2340/16501977-2309