Interventions Facilitating Recovery of Consciousness Following Traumatic Brain Injury: A Systematic Review

Abstract

People who experience disorders of consciousness (DoC) following a severe traumatic brain injury (TBI) have complex rehabilitation needs addressed by occupational therapy. To examine the effectiveness of interventions to improve arousal and awareness of people with DoC following a TBI. For this systematic review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched six databases in collaboration with a research librarian. Twenty-seven studies were included and grouped thematically. Multimodal sensory stimulation, familiar voices telling structured stories, and transcranial direct current stimulation had a moderate level of evidence. Multimodal sensory stimulation had the strongest evidence in support of its use in clinical practice. Occupational therapy practitioners should administer multimodal stimuli frequently as studies reported administering these interventions at least twice daily. Occupational therapy practitioners should incorporate personally relevant, meaningful, salient stimuli into interventions when treating patients with DoC.

Prognosis and enhancement of recovery in disorders of consciousness

“…As mentioned earlier, several studies have emphasized the importance of rehabilitation in DoC. A systematic review by analyzed the existing literature on the effectiveness of rehabilitation interventions in patients with DoC and found evidence supporting the positive impact of various rehabilitation interventions (Weaver et al, 2023). The review highlighted the potential benefits of various rehabilitation approaches, including physical therapy, occupational therapy, speech therapy, and cognitive rehabilitation.…”

“…The acknowledgement of a large percentage of DoC patients eventually achieving consciousness and a level of functional recovery supports the need for access to specialized rehabilitation to support optimal outcomes. A compendium of evidence have demonstrated the need and benefit of specialized post-acute rehabilitation for individuals in DoC (Giacino et al, 2022(Giacino et al, , 2020Giacino & Trott, 2004;Hux, 2019;Kowalski et al, 2021;Mackay et al, 1992;Pignat et al, 2015;Roberts & Greenwood, 2019;Seel et al, 2013;Tepas et al, 2009;Weaver et al, 2022).…”

“…The review highlighted the potential benefits of various rehabilitation approaches, including physical therapy, occupational therapy, speech therapy, and cognitive rehabilitation. It emphasized the need for tailored and individualized rehabilitation programs to address the specific needs and goals of each patient (Weaver et al, 2023).…”

Effect of Family Participation in Sensory Stimulation for Patient with consciousness disorder after TBI Prognosis: Randomized Controlled Trial Protocol

“…In recent years, domestic and foreign scholars have researched and attempted to rehabilitate consciousness disorders and awakening in many fields, including drugs, hyperbaric oxygen, sensory stimulation, electrical stimulation, exercise therapy, acupuncture, and moxibustion [11][12][13][14]. Experts have pointed out that nursing staff should work closely with multidisciplinary teams to carry out rehabilitation and awakening care to improve patients' clinical outcomes and maximize the recovery of patients' consciousness.…”