Temporal profile of recovery of communication in patients with disorders of consciousness after severe brain injury
Publications
Model System:
TBI
Reference Type:
Journal article
Accession No.:
J84135
Journal:
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
, 101, 7, 1260-1264
Publication Website:
Abstract:
Study determined the time course to recovery of communication after severe brain injury. One hundred seventy-five patients admitted to rehabilitation with severe acquired brain injury and no evidence of communication were evaluated using the Coma Recovery Scale-Revised (CRS-R). Researchers analyzed the time from injury to recovery of intentional communication (IC, inconsistent yes/no responses) and functional communication (FC, consistent and accurate yes/no responses) on the CRS-R Communication subscale over a period of 8 weeks after admission. Fifty-four patients (31 percent) did not recover IC or FC. Thirty patients (17 percent) recovered IC only (median days from injury to IC = 40), 72 patients (41 percent) recovered IC followed by FC (days from injury to FC = 50), and 19 patients (11 percent) recovered FC without first recovering IC (median 43 days). The patients who recovered neither IC nor FC within 8 weeks of admission were admitted to rehabilitation later than those who recovered IC and/or FC. Sixteen patients who did not recover communication within 8 weeks of admission to rehabilitation subsequently recovered FC prior to discharge. In patients with severe brain injury receiving inpatient rehabilitation, discernible yes-no responses emerged approximately 6 weeks postinjury and became reliable 1 week later. Approximately 1 in 3 patients did not demonstrate IC or FC within 8 weeks of admission to rehabilitation, although 33 percent of these individuals recovered communication prior to discharge. In total, 61 percent of patients recovered FC prior to discharge from rehabilitation.
