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VOLUME 57 , ISSUE 1 ( January-March, 2023 ) > List of Articles


Effectiveness of “Coma Stimulation Technique” on Conscious Level and Brain Functioning among Comatose Patients with Traumatic Brain Injury

Varma A Sindhubhai, Sukhpal Kaur, Pravin Salunke, Sandhya Ghai

Keywords : Brain functioning, Coma stimulation technique, Consciousness, Glasgow coma scale, Traumatic brain injury

Citation Information : Sindhubhai VA, Kaur S, Salunke P, Ghai S. Effectiveness of “Coma Stimulation Technique” on Conscious Level and Brain Functioning among Comatose Patients with Traumatic Brain Injury. J Postgrad Med Edu Res 2023; 57 (1):3-7.

DOI: 10.5005/jp-journals-10028-1593

License: CC BY-NC 4.0

Published Online: 10-04-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Objective: To assess the effectiveness of the coma stimulation technique (CST) on consciousness and brain functioning among comatose traumatic brain injury (TBI) patients. Materials and methods: The study was conducted amongst admitted patients in neurosurgical units of a tertiary care center in North India. A single group was exposed to the intervention of CST, and its effectiveness was observed on the Glasgow Coma Scale (GCS) and Coma Recovery Scale (CRS). A total of 156 TBI patients were assessed for eligibility. The patients above 18 years with GCS between three and eight and patients with stable vital signs were included in the study. Patients having a past history of head injury, cardiac arrest lasting >4 minutes, and history of brain stem injury was excluded. Finally, 40 patients were analyzed. The intervention constituted CST, which involved promoting awakening, maintaining arousal, and enhancing the rehabilitative potential of comatose patients by stimulating all five senses, that is, visual, olfactory, gustatory, tactile, auditory, and kinesthetic. CST was administered once a day from day 1 to day 14 or till the discharge of the patients. Postintervention GCS and CRS scores were assessed on days 3rd, 7th, 10th, and 14th/at the time of discharge. The main outcome measures were the GCS and CRS scores. Statistical analysis: Continuous variables are presented as the median and interquartile range (IQR). McNemar and Wilcoxon's tests were used to analyze the effectiveness of CST on GCS and CRS scores. Results: Median GCS score of the patients was six at the baseline. After the intervention, it was 10 on day 14th/at the time of discharge. Before the intervention, the median CRS score was five. It increased to 14 on day 14th/at the time of discharge. There was a statistically significant improvement in GCS and CRS scores after the intervention, as per McNemar's test (p < 0.001) and Wilcoxon's test (p < 0.001). Conclusion: Early intervention with CST may help in the improvement of the level of consciousness and brain functioning of the comatose patient with TBI.

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