Role of LCF scale as an outcome prognostic index in patients with traumatic brain injury

Background: Hydrocephalus among Severe Acquired Brain Injury (SABI) patients remains overlooked during rehabilitation. Methods: A retrospective cohort study was carried out of traumatic and non-traumatic SABI patients with hydrocephalus, consecutively admitted over 9 years in a tertiary referral specialized rehabilitation hospital. Patients were treated with ventriculoperitoneal shunt before or during inpatient rehabilitation and assessed using the Level of Cognitive Functioning Scale and Disability Rating Scale. Logistic regression models were used to identify predictors of post-surgical complications. Linear regression models were used to investigate predictors of hospital length of stay (LOS), disability, and cognitive function. Results: Of the 82 patients, 15 had post-surgical complications and 16 underwent cranioplasty. Shunt placement complication risk was higher when fixed vs. when programmable pressure valves were used. A total of 56.3% achieved functional improvement at discharge and 88.7% improved in cognitive function; of the 82 patients, 56% were discharged home. In multiple regression analyses, higher disability at discharge was related to cranioplasty and longer LOS, while poorer cognitive function was associated with cranioplasty. Increase in LOS was associated with increasing time to shunt and decreasing age. Conclusions: A significant improvement in cognitive and functional outcomes can be achieved. Cranioplasty increased LOS, and fixed pressure valves were related to poorer outcomes.

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“…However, in SABI patients, LCF and DRS are commonly used in clinical practice as well as in research [ 26 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation

et al. 2021

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“…We evaluated the patients’ cognitive and motor profiles in two separate phases, at the beginning and the end of either the RVT or the MRV. The motor-cognitive assessment included: (1) Levels of Cognitive Functioning (LCF) [ 14 ], one of the earlier developed scales for assessing cognitive functioning in post-coma patients; (2) the Coma Recovery Scale-Revised (CRS-R) [ 15 ], used to integrate neuropsychological and clinical assessment and validated for patients in VS/MCS as an appropriate measure for characterizing level of consciousness and for monitoring recovery of neurobehavioral functioning; (3) the Functional Independence Measure (FIM), an 18-item (13 motor [motFIM] and 5 cognitive [cognFIM]) measurement tool that explores an individual’s physical, psychological, and social function, used to determine the level of dependence of patients in daily life [ 16 ]; (4) the Trunk Control Test (TCT), used to evaluate motor impairment in a patient who has had a SABI [ 17 ]; and (5) the Functional Communication Scale (FCS) for the evaluation of communication abilities [ 18 ]. For more details, see Table 2 .…”

Section: Methodsmentioning

confidence: 99%

Robotic Verticalization plus Music Therapy in Chronic Disorders of Consciousness: Promising Results from a Pilot Study

et al. 2022

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Background: Music stimulation is considered a valuable form of intervention in disorders of consciousness (DoC); for instance, verticalization may improve motor and cognitive recovery. Our purpose is to investigate the effects of a novel rehabilitative approach combining robotic verticalization training (RVT) with personalized music stimulation in people with DoC. Methods: Sixteen subjects affected by minimally conscious state due to traumatic brain lesions who attended our Intensive Neuro-Rehabilitation Unit were enrolled in this randomized trial. They received either music robotic verticalization (MRV) using the Erigo device plus a personalized music playlist or only RVT without music stimuli. Each treatment was performed 2 times a week for 8 consecutive weeks in addition to standard neurorehabilitation. Results: We found significant improvements in all patients’ outcomes in the experimental group (who received MRV): Coma Recovery Scale-Revised (CRS-R) (p < 0.01), Level of Cognitive Functioning (LCF) (p < 0.02), Functional Independence Measure (FIM)(p < 0.03), Functional Communication Scale (FCS) (p < 0.007), Trunk Control Test (TCT) (p = 0.05). Significant differences between the two groups were also found in the main outcome measure CRS-R (p < 0.01) but not for TCT and FIM. Conclusions: Our study supports the safety and effectiveness of RVT with the Erigo device in chronic MCS, and the achievement of better outcomes when RVT is combined with music stimulation.

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“…All individuals with SABI were assessed for common impairments using a multimodal assessment approach 29 that included: (1) motor impairments (i.e., weakness, altered tone, balance and incoordination) using the Glasgow Coma Scale (GCS), the functional independence measure (FIM) and the Trunk Control Test (TCT); (2) bulbar problems affecting speech and swallowing using the Functional Communication Scale (FCS) and the global communication (GC) scale; and (3) cognitive dysfunctions such as impairments in attention, orientation and memory, using the Levels of Cognitive Functioning (LCF) assessment scale. Details are as follows: LCF 30 is one of the earlier developed behavioural scales used to assess cognitive functioning in post-coma patients. It systematically describes and categorizes a patient's level of consciousness and cognitive and behavioural functioning through which the patient typically progresses. The GCS 31 objectively describes the extent of impaired consciousness in all types of acute medical and trauma patients.…”

Section: Methodsmentioning

confidence: 99%

‘Online therapy’ to reduce caregiver’s distress and to stimulate post-severe acquired brain injury motor and cognitive recovery: A Sicilian hospital experience in the COVID era

et al. 2021

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Introduction Severe acquired brain injury(SABI) often results in the deterioration of physical, cognitive and emotional functions in the patient and a significant caregiver's distress syndrome, which is now amplified by the social isolation, depression and financial difficulties related to the COVID-19 pandemic. The use of web-based online-therapy has been shown to be useful to overcome caregiver's distress syndrome and further stimulate cognitive-motor recovery of SABI-patients. Our study aimed to investigate whether a systematic online Skype-therapy(OLST) may be of support in favoring global cognitive and sensory-motor recovery in SABI-patients and reducing caregiver distress. Methods Twenty-five SABI-subjects in inpatient regimen were provided with intensive OLST with the caregiver for 12 weeks in addition to standard neurorehabilitation. Each subject and caregiver was evaluated before and after the treatment by administering an ad hoc battery. Furthermore, 18 of 27 patients were provided with EEG recording in resting state. Results We found a significant reduction in caregiver's anxiety (p<0.0001) and burden(p<0.0001). Patients showed significant improvement in trunk control (p<0.0001), functional independence (p = 0.005), functional (p = 0.01) and global communication (p = 0.004), cognitive functioning (p = 0.001), and behavioral responsiveness (p = 0.0004). The training yielded a significant connectivity change within the fronto-centro-parietal areas in the delta frequency band (p<0.0001) and the centro-parieto-occipital areas in the alpha range (p = 0.004). Discussion OLST may be a useful and complementary treatment to optimize global cognitive and functional recovery in SABI-subjects and reduce caregivers' concerns in the Covid-era. OLST can foster cognitive-motor recovery potentially by favoring the plasticity-dependent functional recovery. Therefore, OLST could be proposed as a tool allowing social conversations also in the hospital setting.

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Role of LCF scale as an outcome prognostic index in patients with traumatic brain injury

Cited by 15 publications

References 21 publications

From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation

From Shunt to Recovery: A Multidisciplinary Approach to Hydrocephalus Treatment in Severe Acquired Brain Injury Rehabilitation

Robotic Verticalization plus Music Therapy in Chronic Disorders of Consciousness: Promising Results from a Pilot Study

‘Online therapy’ to reduce caregiver’s distress and to stimulate post-severe acquired brain injury motor and cognitive recovery: A Sicilian hospital experience in the COVID era

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