Sensory stimulation for brain injured individuals in coma or vegetative state.
BACKGROUND
Coma and vegetative state follow traumatic brain injury in about one out of eight patients, and in patients with non traumatic injury the prognosis is worse. The use of sensory stimulation for coma and vegetative state has gained popularity during the 1980's but beliefs and opinions about its effectiveness vary substantially among health professionals.


OBJECTIVE
To assess the effectiveness of sensory stimulation programmes in patients in coma or vegetative state.


METHODS
We searched the Injuries Group specialised register, the Cochrane Controlled trials register, EMBASE, MEDLINE, CINAHL and PSYCHLIT from 1966 to January 2002, without language restriction. Reference lists of articles were scanned and we contacted experts in the area to find other relevant studies.


METHODS
Randomised or controlled trials that compared sensory stimulation programmes with standard rehabilitation in patients in coma or vegetative state.


METHODS
Abstracts and papers found were screened by one reviewer. Three reviewers independently identified relevant studies, extracted data and assessed study quality resolving disagreement by consensus.


RESULTS
Three studies were identified with 68 patients in total. The overall methodological quality was poor and studies differed widely in terms of outcomes measures, study design and conduct. We therefore did not carry out any quantitative synthesis but reviewed results of available studies qualitatively.


CONCLUSIONS
This systematic review indicates that there is no reliable evidence to support, or rule out, the effectiveness of multisensory programmes in patients in coma or vegetative state.
Lombardi
F
F
Reparto di Riabilitazione Intensiva, Ospedale "S. Sebstiano" di Correggio, Via Mandriolo Superiore, 42015 Correggio (RE), Italy. lombardif@ausl.re.it or taumaturgico@libero.it
Taricco
M
M
De Tanti
A
A
Telaro
E
E
Liberati
A
A
D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation; D020207:Coma, Post-Head Injury / Q000534:rehabilitation*; D006801:Humans; D018458:Persistent Vegetative State / Q000534:rehabilitation*; D010812:Physical Stimulation / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012677:Sensation