Research Article  |   April 2016
Effectiveness of Sensory Stimulation to Improve Arousal and Alertness of People in a Coma or Persistent Vegetative State After Traumatic Brain Injury: A Systematic Review
René Padilla; Anna Domina
Author Affiliations
  • René Padilla, PhD, OT/L, FAOTA, LMHP, is Executive Director of Global Engagement and Associate Professor of Occupational Therapy, Creighton University, Omaha, NE; rpadilla@creighton.edu
  • Anna Domina, OTD, OTR/L, is Assistant Professor of Occupational Therapy and Academic Clinical Education Coordinator, Creighton University, Omaha, NE
Article Information
Evidence-Based Practice / Neurologic Conditions / Traumatic Brain Injury / Special Issue: Evidence Review
Research Article   |   April 2016
Effectiveness of Sensory Stimulation to Improve Arousal and Alertness of People in a Coma or Persistent Vegetative State After Traumatic Brain Injury: A Systematic Review
American Journal of Occupational Therapy, April 2016, Vol. 70, 7003180030p1-7003180030p8. doi:10.5014/ajot.2016.021022
American Journal of Occupational Therapy, April 2016, Vol. 70, 7003180030p1-7003180030p8. doi:10.5014/ajot.2016.021022
Abstract

OBJECTIVE. This systematic review evaluates the effectiveness of sensory stimulation to improve arousal and alertness of people in a coma or persistent vegetative state after traumatic brain injury (TBI).

METHOD. Databases searched included Medline, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews. The search was limited to outcomes studies published in English in peer-reviewed journals between 2008 and 2013.

RESULTS. Included studies provide strong evidence that multimodal sensory stimulation improves arousal and enhances clinical outcomes for people in a coma or persistent vegetative state after TBI. Moderate evidence was also provided for auditory stimulation, limited evidence was provided for complex stimuli, and insufficient evidence was provided for median nerve stimulation.

CONCLUSION. Interventions should be tailored to client tolerance and premorbid preferences. Bimodal or multimodal stimulation should begin early, be frequent, and be sustained until more complex activity is possible.