Sensory training for arousal recovery by a transdisciplinary team for people with severe brain injury

Aim

• to identify and implement best practice rehabilitation practices for adults with disorders of consciousness due to severe acquired brain injury
• to promote arousal and functional recovery, decrease the burden of care and increase quality of life for adults with severe acquired brain injury

Benefits

• patients emerged from their disorder of consciousness
• patients made functional gains, particularly in the areas of cognition and communication
• improvements in patient engagement in therapy
• improvements in collaborative practice with families and their involvement in patient care

Background

The brain injury multidisciplinary team creates personally relevant multisensory stimulation program for patients. Collaboration with family and friends identifies salient memories to create a recorded memory narrated by a familiar voice.

Evaluation and results

Patients are assessed using the Coma Recovery Scale-Revised (CRS-R) and the Music Therapy Assessment Tool for Arousal in Disorders of Consciousness (MATADOC) prior to participating and at interval during the program. Trial results showed emergence for all three patients. Because the program now forms part of standard care and evaluation is a standard part of the program, clinical data continues to build to form a clearer picture of the program's impact.

Lessons learnt

• the importance of intentional implementation of emotionally salient sensory stimulation
• increased understanding of skills from other team members in order to implement the full program has resulted in more effective integration of strategies in all therapies (e.g. integration of more effective music listening and music-based strategies by other professionals)
• more effective collaboration with families
• challenges: the impact of staff movement on the level of knowledge and confidence to prescribe and implement the program