Analysis of Inpatient Rehabilitation Interventions and Impact on Recovery Trajectory for Disorders of Consciousness (DoC) Patients

Date

2024

Authors

Scott, Stephanie

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Abstract

This capstone project aims to develop research skills to describe inpatient rehabilitation interventions and impact of verticalization on the trajectory of recovery for disorders of consciousness (DoC) patients. Many DoC are the result of a traumatic brain injury, however causes include: cardiovascular failure, progressive degenerative diseases, or metabolic diseases (Pistarini & Maggioni, 2021). Occupational therapists aim to deliver effective rehabilitation by improving arousal and awareness (Ng & King, 2021). However, there is limited evidence describing effective treatments (Weaver, Watters, & Cogan, 2021). Verticalization is a promising treatment for DoC patients and mobilizes patients into upright position using equipment such as tilt tables (Krewer et al., 2015). A retroactive sample of 24 adult DoC patients at TIRR Memorial Hermann DoC Program in Houston in 2022 was used. Quantitative data was compiled from demographics, functional status, Coma Recovery Score-revised (CRS-R) scores, and weekly treatment interventions. There was a positive significant correlation between time and CRS-R score, but no significant statistical correction between number of verticalizations and CRS-R score. Limitations in variability in length of stay, number of CRS-R scores, inconsistent documentation of verticalization minutes, blood pressure instability, and lost therapy minutes could have impacted correlation results. There is an opportunity in the future to mitigate these variables and test for impact of verticalization on CRS-R scores. Further research regarding the type of equipment used for verticalization could provide accessibility for continued improvement in arousal and awareness after discharge.

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Keywords

Disorders of consciousness, Traumatic brain injury, Coma, Verticalization, Upright mobility

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