The Sensory Modality Assessment Rehabilitation Technique - A tool for assessment and treatment of patients with severe brain injury in a vegetative state

Gill-Thwaites, Helen

doi:10.1080/026990597123098

Cited by 106 publications

(43 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An accurate diagnosis is indeed crucial not only for treatment but also for end-of-life decisions [21]. In this context, future studies should investigate the diagnostic sensitivity of the CRS-R as compared to other coma scales such as the SMART, which is also recognized to be very sensitive in detecting MCS patients [22,23].…”

Section: Discussionmentioning

confidence: 99%

A French validation study of the Coma Recovery Scale-Revised (CRS-R)

Schnakers

Majerus

Giacino³

et al. 2008

Brain Injury

129

101

View full text Add to dashboard Cite

Primary objective: The aim of the present study was to explore the concurrent validity, inter-rater agreement and diagnostic sensitivity of a French adaptation of the Coma Recovery Scale-Revised (CRS-R) as compared to other coma scales such as the Glasgow Coma Scale (GCS), the Full Outline of UnResponsiveness scale (FOUR) and the Wessex Head Injury Matrix (WHIM). Research design: Multi-centric prospective study. Method and procedures: To test concurrent validity and diagnostic sensitivity, the four behavioural scales were administered in a randomized order in 77 vegetative and minimally conscious patients. Twenty-four clinicians with different professional backgrounds, levels of expertise and CRS-R experience were recruited to assess inter-rater agreement. Main outcomes and results: Good concurrent validity was obtained between the CRS-R and the three other standardized behavioural scales. Inter-rater reliability for the CRS-R total score and sub-scores was good, indicating that the scale yields reproducible findings across examiners and does not appear to be systematically biased by profession, level of expertise or CRS-R experience. Finally, the CRS-R demonstrated a significantly higher sensitivity to detect MCS patients, as compared to the GCS, the FOUR and the WHIM. Conclusion:The results show that the French version of the CRS-R is a valid and sensitive scale which can be used in severely brain damaged patients by all members of the medical staff.

show abstract

Section: Discussionmentioning

confidence: 99%

A French validation study of the Coma Recovery Scale-Revised (CRS-R)

Schnakers

Majerus

Giacino³

et al. 2008

Brain Injury

129

101

View full text Add to dashboard Cite

show abstract

“…SMART jako narzędzie diagnostyczno-terapeutyczne umożli-wia ocenę zmysłów (wzrok, słuch, smak, węch, dotyk) oraz ocenę funkcjonalnej motoryki i komunikacji. Dzięki wnikliwej analizie badający może sporządzić dokładny obraz odpowiedzi, które podlegają hierarchizacji według pięciostopniowej skali [19]:…”

Section: Smart (Sensory Modality Assessment and Rehabilitation Techniunclassified

“…As a diagnostic and therapeutic tool, SMART enables examiners to assess sensory modalities (visual, auditory, tactile, olfactory and gustatory), functional motor abilities and communication. Owing to a thorough analysis, an examiner can build an accurate image of responses that are rated according to a 5-level hierarchical scale [19]:…”

Section: Smart (Sensory Modality Assessment and Rehabilitation Technimentioning

confidence: 99%

SMART - a tool for assessing patients with discordes of consciousness

Waraksa¹,

Wójcik²

2017

Advances in Rehabilitation

View full text Add to dashboard Cite

StreszczenieTrafna ocena pacjentów z zaburzeniami świadomości wciąż stanowi poważne wyzwanie medyczne. Pomimo zastosowania w ostatnim czasie nowoczesnych technik neuroobrazowania (EEG, fMRI, PET i innych) prawidłowa diagnoza wciąż jest znacząco utrudniona. Brak precyzyjnego rozpoznania skutkuje niewykorzystaniem możliwości i pełnego potencjału pacjenta. Ten aspekt jest szczególnie ważny w kontekście komunikowania się z pacjentem. Wysiłki zespołów interdyscyplinarnych powinny być skierowane na stworzenie oraz rozwinięcie kompleksowego narzędzia diagnostycznego. Miałoby to na celu zapewnienie kompletnej informacji dotyczącej stanu pacjenta oraz ewentualnej możliwości komunikowania się z nim. Według wielu zespołów badawczych zasadnym jest korzystnie w tym celu ze skal behawioralnych opartych na kryteriach obserwacyjnych w tym skali odpowiedzi sensomotorycznej SMART (Sensory Modality Assessment and Rehabilitation Techique). Słowa kluczowe:zaburzenia świadomości, skale, SMART, komunikacja AbstractAccurate assessment of patients with disorders of consciousness is still a great medical challenge. Despite a recent implementation of state-of-the-art neuroimaging techniques (EEG, fMRI, PET and others), proper diagnosis is still seriously hindered. The lack of accurate diagnosis results in the fact that patients' capacities and full potential are not used. This aspect is particularly important in terms of communicating with patients. The effort of interdisciplinary teams ought to be channelled into creating and developing a complex diagnostic tool. It would aim at providing complete information regarding patients' state and facilitating possible communication with them. Therefore, according to a number of research teams, it is necessary to make use of behavioural scales such as SMART (Sensory Modality Assessment and Rehabilitation Technique) that are based on observational criteria. StreszczenieWstęp: Liczba urodzeń przedwczesnych w Polsce, pomimo znacznego wzrostu poziomu medycyny oraz świadomości matek, w ostatnich latach utrzymuje się na stałym poziomie, oscylującym wokół 7%. Wskaźnik ten jest podobny w innych krajach Unii Europejskiej. Celem niniejszej pracy jest ocena wpływu wcześniactwa na moc wejścia i moc regulacji w badaniu wysiłkowym u kobiet dorosłych. Osiągnięta moc zależy od poziomu wydolności fizycznej i może być przeliczana na konkretne wartości VO 2max.Materiał i metody: W 11-osobowej grupie kobiet w wieku 25-30 lat (28,2±2,3) wykonano próbę wysiłkową zgodnie z zasadami testu wysiłkowego W 150 . 15 osób stanowiła grupa kontrolna 27-32 lat (28,5±2,4). Wyniki poddano analizie statystycznej przy użyciu testu t-Studenta i testu Shapiro-Wilka. Korelacji Pearsona poddane zostały wskaźniki wzrost/ moc regulacji i BMI/ moc regulacji.Wyniki: Stwierdzono znamienną statystycznie różnicę pomiędzy mocą wejścia i mocą regulacji w badaniu wysiłkowym pomiędzy grupą kontrolną a grupą badaną na korzyść tej pierwszej. Ponadto wykazano proporcjonalność mocy wejścia i mocy regulacji osiąganych w badaniu w dwóch grupach.Wnioski...

show abstract

“…Using data collected from care givers or insurance companies might be risky and lead to false statistics of AS when diagnosis of the most expensive brain damage is mentioned for medical care money considerations in the managed care system of our days [14,15,[59][60][61]127]. One has to be aware that patients suspected to be AS patients are often wrongly diagnosed by general practitioners and specialists, as it was the case in 43% of patients checked by Andrews et al [60,67,94,128,[134][135][136]. Prevalence of posttraumatic AS, as derived from the literature, is reported to be 0.5-2/100.000 population per year [2,37].…”

Section: Prevalencementioning

confidence: 99%

“…There is no single specific laboratory investigation, no specific medical treatment, no specific rehabilitative regimen or stimulating intervention that can be recommended on evidence class II (or III) level to improve higher cerebral mental cognitive functioning and independent social outcome [2,15,23,28,30,49,51,65,66]. The purpose of this contribution is to recommend quality management for patients suffering from full stage and emerging from AS of different functional stages as a consequence of posttraumatic and non-traumatic brain damage, needing an even better early assessment and ongoing monitoring of impaired functioning [2,6,22,26,27,34,37,54,60,[67][68][69][70][71][72]. Neurorehabilitation aimes at social reintegration or adequate humane nursing care [6,14].…”

Section: Introductionmentioning

confidence: 99%

Guidelines for Quality Management of Apallic Syndrome / Vegetative State

Wild

Gerstenbrand²,

Dolce

et al. 2007

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Management of AS aims at the social reintegration of patients or has to guarantee humanistic active nursing if treatment fails. Outcome depends on the cause and duration of AS/VS as well as patient's age. There is no single AS/VS specific laboratory investigation, no specific regimen or stimulating intervention to be recommended for improving higher cerebral functioning. Quality management requires at least 3 years of advanced training and permanent education to gain approval of qualification for AS/VS treatment and expertise. Sine qua non areas covering AS/VS institutions for early and long-term rehabilitation are required on a population base (prevalence of 2/100.000/year) to quicken functional restoration and to prevent or treat complications. Caring homes are needed for respectful humane nursing including basal sensor-motor stimulating techniques. Passive euthanasia is considered an act of mercy by physicians in terms of withholding treatment; however, ethical and legal issues with regard to withdrawal of nutrition and hydration and end of life discussions raise deep concerns. The aim of the guideline is to provide management guidance (on the best medical evidence class II and III or task force expertise) for neurologists, neurosurgeons, other physicians working with AS/VS patients, neurorehabilitation personnel, patients, next-of-kin, and health authorities.

show abstract

The Sensory Modality Assessment Rehabilitation Technique - A tool for assessment and treatment of patients with severe brain injury in a vegetative state

Cited by 106 publications

References 12 publications

A French validation study of the Coma Recovery Scale-Revised (CRS-R)

A French validation study of the Coma Recovery Scale-Revised (CRS-R)

SMART - a tool for assessing patients with discordes of consciousness

Guidelines for Quality Management of Apallic Syndrome / Vegetative State

Contact Info

Product

Resources

About