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

Brain Inj. 2012;26(7-8):921-6. doi: 10.3109/02699052.2012.661911. Epub 2012 May 9.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Brain Injuries / complications
  • Brain Injuries / physiopathology*
  • Brain Injuries / rehabilitation
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Persistent Vegetative State / etiology
  • Persistent Vegetative State / physiopathology*
  • Persistent Vegetative State / rehabilitation
  • Prognosis
  • Psychomotor Performance*
  • Recovery of Function*
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Young Adult