Summarized by Dr. Kristen Harris
June 2023
A recent article titled, “Specialized intensive inpatient rehabilitation is crucial and time-sensitive for functional recovery from disorders of consciousness,” was published in the medical journal Frontiers in Neurology by authors Bei Zhang et al. Some patients with severe brain injuries may develop what is known as a “disorder of consciousness” related to their injury.
While patients may have sleep-wake patterns, appear to look at people and things in their room, or react to sounds or touch, they are unable to interact traditionally with their environment or communicate. Although inpatient rehabilitation can be very helpful for patients with disorders of consciousness, many patients do not have access to rehabilitation either because of financial and geographic barriers, or issues related to medical complexity.
The goal of this study was to report on how patients with disorders of consciousness progress when they are admitted to inpatient rehabilitation, including their “emergence” from disordered consciousness and their ability to achieve goals like starting an oral diet. The authors also wanted to understand whether patients admitted to inpatient rehabilitation soon after their injury were more likely to achieve these goals. 137 patients with disorders of consciousness admitted to acute inpatient rehabilitation in the United States were studied between 2014 and 2018. The average age of patients was 36, and most of the patients studied were men. Most patients had brain injuries related to trauma. The authors found that a large number of patients admitted to inpatient rehabilitation “emerged” from their disorders of consciousness, demonstrating more purposeful communication or interaction.
Patients were more likely to “emerge” from their disorder of consciousness if they were admitted to rehabilitation soon after their injury. Additionally, many patients were able to have their breathing tube removed or start eating, which can make it easier for patients to go home. At the time of discharge from rehabilitation, more than half of patients were able to transfer from their bed to a chair with a reasonable amount of assistance from one caregiver.
This article highlights that inpatient rehabilitation can be helpful for patients with severe problems after their brain injury. Many patients show some improvement with inpatient rehabilitation.
