Investigation Of The Efficacy Of Sensoy Stimulation Program In Patients Recovering From Coma

ObjectTo assess the efficacy of sensory stimulation programs on the recovery of consciousness in chronic vegetative and minimally conscious patients.SubjectThis study recruited7chronic vegetative state (VS) and14minimally conscious state (MCS patients with traumatic (more than112days after brain injury) or non-traumatic (more than41days after brain injury) etiology.MethodThis program used an ABAB pattern. The stimulation duration and baseline were both4weeks (3times a week, twice a day for stimulation). There were5stimulation models:visual, auditory, tactile, olfactory and gustatory, the following were the details of these stimulation respectively:a picture of a close relative, the patient's favorite pop or classical music, massage, concentrated perfume (according to the patient's preference). We assessed the patients' conscious level in a standardized way with the scales of Coma Recovery Scale-Revised and the Wessex Head Injury Matrix once a week.ResultsThe SSP total score was higher significantly in SSP2than in SSP1(P<0.05), the score of the behavior assessment in week4was higher than in weekl (P<0.05); The SSP total score was higher in SSP2than in SSP1in non-traumatic patients(P<0.05); The score of the behavior assessment in week4was higher than in weekl in chronic patients(onset more than365days)(P<0.05); There was a significant difference in the total score according to the phase only between phase-B(4) and phase-A(l)(P<0.05);The scores of the behavior assessment in phase-A(3) and phase-B(4) were higher than in phase-A(1) in traumatic patients(P<0.05); The CRS-R total scores in phase-A(3) and phase-B(4) were higher than in phase-A(1) in acute patients (onset less than365days)(P<0.05);There was a significant difference in the frequency of oriented responses between SSP-1and SSP-2but different according to different senses(P<0.05); We found an significant increase in the frequency of oriented response in tactile and gustatory stimulation(P<0.05); There was a significant difference in the frequency of oriented behavior between SSP1and SSP2in traumatic and non-traumatic patients (P<0.05);There was an increase of oriented behavior in SSP2vs SSP1in non-traumatic patients(P<0.05); We found an increase in the frequency of oriented response in non-traumatic patients with tactile and gustatory stimulation(P<0.05); There was a changeable tendancy in the frequency of oriented behavior according to the time(weeks) between chronic and acute patients (P=0.08); There was an increase of oriented behavior in week4vs weekl in chronic patients ((P<0.05); We found an increase in the frequency of oriented response in chronic patients with tactile stimulation(P<0.05).ConclusionThere was a significant difference between the pre and after SSP therapy, especially in the non-traumatic and chronic patients. We found that the improvements only happened during the SSP therapy, which means these improvements were due to SSP effect instead of spontaneous recovery. There was a significant difference between phase-B(4) and phase A(1).There was an increase in the frequency of oriented behavior with the time-going, especially in the non-traumatic and chronic patients. It was proved that tactile and gustatory stimulation is more sensitive than other sense stimulus. It was not manesfested in the increase of CRS-R score probably because these stimulations are not used by the CRS-R scale.