A technology-assisted learning setup as assessment supplement for three persons with a diagnosis of post-coma vegetative state and pervasive motor impairment

Res Dev Disabil. 2009 Sep-Oct;30(5):1034-43. doi: 10.1016/j.ridd.2009.02.006. Epub 2009 Mar 13.

Abstract

Post-coma persons in an apparent condition of vegetative state and pervasive motor impairment pose serious problems in terms of assessment and intervention options. A technology-based learning assessment procedure might serve for them as a diagnostic supplement with possible implications for rehabilitation intervention. The learning assessment procedure adopted in this study relied on hand-closure and eye-blinking responses and on microswitch technology to detect such responses and to present stimuli. Three participants were involved in the study. The technology consisted of a touch/pressure sensor fixed on the hand or an optic sensor mounted on an eyeglasses' frame, which were combined with a control system linked to stimulus sources. The study adopted an ABABCB sequence, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. Data showed that the level of responding during the B phases was significantly higher than the levels observed during the A phases as well as the C phase for two of the three participants (i.e., indicating clear signs of learning by them). Learning might be deemed to represent basic levels of knowledge/consciousness. Thus, detecting signs of learning might help one revise a previous diagnosis of vegetative state with wide implications for rehabilitation perspectives.

MeSH terms

  • Adult
  • Aged
  • Blinking
  • Brain Injuries / rehabilitation
  • Coma / complications*
  • Communication Aids for Disabled
  • Female
  • Hand Strength
  • Humans
  • Male
  • Occupational Therapy / instrumentation
  • Persistent Vegetative State / diagnosis*
  • Persistent Vegetative State / etiology
  • Persistent Vegetative State / rehabilitation
  • Psychomotor Performance
  • Self-Help Devices*