Research Reports - Effectiveness of sensory stimulation to improve arousal and alertness of people in a coma or persistent vegetative state after traumatic brain injury
Am J Occup Ther. 2016 May-Jun;70(3):7003180030p1-8. doi:
Padilla R(1), Domina A(2).
OBJECTIVE: This systematic review evaluates the effectiveness of sensory
stimulation to improve arousal and alertness of people in a coma or persistent
vegetative state after traumatic brain injury (TBI).
METHOD: Databases searched included Medline, PsycINFO, CINAHL, OTseeker, and the
Cochrane Database of Systematic Reviews. The search was limited to outcomes
studies published in English in peer-reviewed journals between 2008 and 2013.
RESULTS: Included studies provide strong evidence that multimodal sensory
stimulation improves arousal and enhances clinical outcomes for people in a coma
or persistent vegetative state after TBI. Moderate evidence was also provided for
auditory stimulation, limited evidence was provided for complex stimuli, and
insufficient evidence was provided for median nerve stimulation.
CONCLUSION: Interventions should be tailored to client tolerance and premorbid
preferences. Bimodal or multimodal stimulation should begin early, be frequent,
and be sustained until more complex activity is possible.