The JFK coma recovery scale: Further evidence for applicability in grading level of neurobehavioral responsiveness following severe brain injury

Giacino, Joseph T.; Kalmar, Kathleen; Chase, Robert F.

doi:10.1016/0003-9993(93)90189-h

Cited by 4 publications

(2 citation statements)

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“…Secondary diagnoses were not considered. Severity of the disorder of consciousness was assessed via the original JFK Coma Recovery Scale (CRS) [11,12] that does not include all of the behavioral criteria necessary to diagnose the minimally conscious state. The diagnosis was therefore based on clinical assessment by the responsible physician according to the Aspen diagnostic criteria [13] and to Bruno and colleagues [14] for the division of MCS+ and MCS-.…”

Section: Methodsmentioning

confidence: 99%

Animal-assisted therapy for patients in a minimally conscious state: A randomized two treatment multi-period crossover trial

et al. 2019

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ObjectiveTo investigate if animal-assisted therapy (AAT) leads to higher consciousness in patients in a minimally conscious state during a therapy session, measured via behavioral reactions, heart rate and heart rate variability.MethodsIn a randomized two treatment multi-period crossover trial, 10 patients in a minimally conscious state participated in eight AAT sessions and eight paralleled conventional therapy sessions, leading to 78 AAT and 73 analyzed control sessions. Patients’ responses during sessions were assessed via behavioral video coding and the Basler Vegetative State Assessment (BAVESTA), heart rate and heart rate variability (SDNN, RMSSD, HF and LF). Data were analyzed with generalized linear mixed models.ResultsPatients showed more eye movements (IRR = 1.31, 95% CI: 1.23 to 1.40, p < 0.001) and active movements per tactile input during AAT compared to control sessions (IRR = 1.13, 95% CI: 1.02 to 1.25, p = 0.018). No difference was found for positive emotions. With BAVESTA, patients’ overall behavioral reactions were rated higher during AAT (b = 0.11, 95% CI: 0.01 to 0.22, p = 0.038). AAT led to significantly higher LF (b = 5.82, 95% CI: 0.55 to 11.08, p = 0.031) and lower HF (b = -5.80, 95% CI: -11.06 to -0.57, p = 0.030), while heart rate, SDNN, RMSSD did not differ.ConclusionsPatients in a minimally conscious state showed more behavioral reactions and increased physiological arousal during AAT compared to control sessions. This might indicate increased consciousness during therapeutic sessions in the presence of an animal.Trial registrationClinicalTrials.gov NCT02629302.

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Section: Methodsmentioning

confidence: 99%

Animal-assisted therapy for patients in a minimally conscious state: A randomized two treatment multi-period crossover trial

et al. 2019

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“…The Comprehensive Level of Consciousness Scale (CLOCS) [24] and the Glasgow‐Liege Coma Scale (GLCS) [25] also are associated with moderate disability [22] at time of acute discharge or up to 6 months after injury [26,27]. Neurobehavioral change during rehabilitation hospitalization, defined with the Coma Recovery Scale (CRS) [28,29], also is known to be associated (r = −0.78) with DRS scores at rehabilitation discharge [30].…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of the Disorders of Consciousness Scale (DOCS)

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Tang

Guernon

et al. 2009

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For persons with prolonged disorders of consciousness, the findings indicate that evidence-based prognostication for individual patients is possible. The implications for research are that the DOCS can be used as a meaningful, reliable, and valid primary outcome to measure treatment effects in clinical trials. The evidence indicates further that DOCS measures merit inclusion in future research that aims to develop multivariate prognostication models.

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