Research Reports - Early motor predictors of recovery in patients with severe traumatic brain injury

Brain Inj. 2012 May 9

Tamashiro M, Cozzo D, Mattei M, Salierno F, Rivas ME, Alzúa O, Olmos L, Bonamico, L, Leiguarda R.

Research design: Retrospective observational study. Objective: To compare motor
variables between patients with severe traumatic brain injury who emerge and
patients who do not emerge from vegetative state, in an attempt to identify early
motor manifestations associated with consistent patient improvement. Methods and
procedures: Patients were divided into two groups: group 1, patients who emerged
from vegetative state attaining at least a state of functional interactive
communication and/or functional use of two different objects (n = 8); and group
2, patients who did not emerge (n = 7). Twenty-one motor variables were compared
weekly between groups until the end of the treatment programme. Results:
Significant differences were observed in head control (p = 0.051) and head
turning (p = 0.002) variables, as well as in visual fixation and pursuit
(p = 0.051) after a median of 41 days of therapy; and in head control and head
turning; visual fixation and pursuit; phonation; pain localization, reach and
grasp, and trunk movement (p ≤ 0.051) after a median of 212 days of programme
duration. Conclusions: Head turning, together with or immediately followed by
visual pursuit and fixation, proved to be clinically significant variables
associated with recovery from vegetative state to higher states of consciousness
beyond minimally conscious state.

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