Semin Neurol 2013; 33(02): 142-156
DOI: 10.1055/s-0033-1348960
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neurorehabilitation in Disorders of Consciousness

Joseph T. Giacino
1   Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
2   Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
,
Douglas I. Katz
3   Department of Neurology, Boston University Medical School, Boston, Massachusetts
4   Acquired Brain Injury Program, Braintree Rehabilitation, Braintree, Massachusetts
,
John Whyte
5   Moss Rehabilitation Research Institute, Albert Einstein Healthcare Network, Elkins Park, Pennsylvania
› Author Affiliations
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Publication History

Publication Date:
25 July 2013 (online)

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Abstract

Survivors of severe acquired brain injury often experience prolonged disturbance in consciousness following emergence from coma. Most individuals pass through the vegetative or minimally conscious states en route to eventual recovery of consciousness, although either condition may be permanent. Rehabilitation clinicians charged with the care of these patients face numerous challenges as there are many open questions concerning diagnostic and prognostic accuracy, the natural history of recovery, and the most effective approaches to prevent medical complications and facilitate functional recovery. The last 5 years have been witness to a marked increase in well-designed empirical investigations concerning the rehabilitation of patients with disorders of consciousness. In this article, the authors review recent evidence concerning key factors that influence the course of recovery, present a model of care designed to mitigate medical complications, describe a systematic approach to assessment, and review the effectiveness of treatment interventions utilized in the rehabilitation setting.