Intervention Review

Sensory stimulation for brain injured individuals in coma or vegetative state

  1. Francesco FL Lombardi1,*,
  2. Mariangela Taricco2,
  3. Antonio De Tanti3,
  4. Elena Telaro4,
  5. Alessandro Liberati4

Editorial Group: Cochrane Injuries Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 24 FEB 2002

DOI: 10.1002/14651858.CD001427

Database Title

Additional Information

How to Cite

Lombardi FFL, Taricco M, De Tanti A, Telaro E, Liberati A. Sensory stimulation for brain injured individuals in coma or vegetative state. Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD001427. DOI: 10.1002/14651858.CD001427.

Author Information

  1. 1

    Reparto di Riabilitazione Intensiva, 42015 Correggio (RE), Italy

  2. 2

    Ospedale di Passirana di Rho, U.O. di Riabilitazione, Passirana di Rho, Italy

  3. 3

    Presidio "Villa Beretta", Ospedale Valduce, Costamasnga (CO), Italy

  4. 4

    Mario Negri Institute, Italian Cochrane Centre, Milan, Italy

*Francesco FL Lombardi, Reparto di Riabilitazione Intensiva, Ospedale, Via Mandriolo Superiore, 42015 Correggio (RE), Italy. lombardif@ausl.re.it. taumaturgico@libero.it.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Coma and vegetative state follow traumatic brain injury in about one out of eight patients, and in patients with non traumatic injury the prognosis is worse. The use of sensory stimulation for coma and vegetative state has gained popularity during the 1980's but beliefs and opinions about its effectiveness vary substantially among health professionals.

Objectives

To assess the effectiveness of sensory stimulation programmes in patients in coma or vegetative state.

Search methods

We searched the Injuries Group specialised register, the Cochrane Controlled trials register, EMBASE, MEDLINE, CINAHL and PSYCHLIT from 1966 to January 2002, without language restriction. Reference lists of articles were scanned and we contacted experts in the area to find other relevant studies.

Selection criteria

Randomised or controlled trials that compared sensory stimulation programmes with standard rehabilitation in patients in coma or vegetative state.

Data collection and analysis

Abstracts and papers found were screened by one reviewer. Three reviewers independently identified relevant studies, extracted data and assessed study quality resolving disagreement by consensus.

Main results

Three studies were identified with 68 patients in total. The overall methodological quality was poor and studies differed widely in terms of outcomes measures, study design and conduct. We therefore did not carry out any quantitative synthesis but reviewed results of available studies qualitatively.

Authors' conclusions

This systematic review indicates that there is no reliable evidence to support, or rule out, the effectiveness of multisensory programmes in patients in coma or vegetative state.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

No strong evidence about the effects of sensory stimulation for a brain-injured person in a coma

About half of people in a coma (deep unconsciousness) because of traumatic brain injury will wake within a year of the accident. Speeding recovery to allow people to wake sooner is a priority for them and their family. One type of treatment uses sensory stimulation to try to keep the person's brain working normally. Sensory stimulation methods vary greatly, from one or two hourly sessions of a day, through to shorter sessions every hour for 12 to 14 hours a day. The review found there is no strong evidence to determine whether sensory stimulation benefits people in comas.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

昏迷或植物人狀態之腦受傷者的感覺刺激

大約八分之一的腦受傷患者其伴隨昏迷及植物人的狀態，且非創傷的患者其預後不佳。在1980年代已普遍對於昏迷及植物人狀態者使用感覺刺激，但健康專家有關其效果的看法及意見大不相同。

目標

評估感覺刺激計畫對於昏迷或植物人狀態患者的效果。

搜尋策略

我們檢索1966至2002年1月的Injuries Group專科登記資料庫，考科藍對照試驗資料庫，EMBASE，MEDLINE，CINAHL及PSYCHLIT，檢索條件不限制語言。瀏覽文章的參考文獻，且我們聯絡該領域的專家已發現其他相關的研究。

選擇標準

比較感覺刺激計畫與標準復健對昏迷或植物人狀態患者的隨機或對照試驗。

資料收集與分析

一名審閱者審查搜尋到的摘要及文章。三名審查者分別確定相關研究，摘錄資料並評估研究品質，藉由共識解決不同意見。

主要結論

確定了三篇研究，共68名研究對象。整體來說，研究品質不佳且研究的測量結果，研究設計與執行方式大不相同。因此我們無法進行任何量化的整合，但我們質性地回顧已取得研究的結果。

作者結論

這篇回顧指出沒有可信的證據以支持或排除多種感覺刺激計畫對於昏迷或植物人狀態患者的效果。

翻譯人

本摘要由高雄榮民總醫院金沁琳翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

沒有有力的證據關於感覺刺激對於腦受傷昏迷患者的效果。 大約一半因為腦部外傷的昏迷患者(深度的無意識狀態)會在事故發生的一年內甦醒。 加快復甦讓人們更快清醒過來，對他們和他們的家庭是一個優先的事項。有一種治療方式是使用感覺刺激來嘗試維持人們的大腦正常地運作。感覺刺激方法的差異性很大，從一天一至兩小時的療程到每天12至14小時而每小時較短的療程都有。回顧發現沒有有力的證據以確定是否感覺刺激對於昏迷患者具有效益。

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