[Indications, effectiveness and tolerance of the rehabilitation techniques aimed at improving recovery of awareness following a traumatic brain injury].
OBJECTIVE
In the context of a consensus conference, this review aims at identifying through a comprehensive review and critical analysis of the literature the different rehabilitation programs used to promote the level of consciousness of brain injured patients.


METHODS
By using the following data banks: Medline, Embase, Francis, Pascal, 97 articles published between 1980 and 2001 were found and 19 of them were finally selected. These 19 articles were synthesized through critical assessment charts. Six others articles, among those, expert opinion, literature reviews and consensus conferences were not assessed through critical assessment charts. RESULTS-DISCUSSION: Two non invasive interventions have been identified: these are sensory stimulation and sensory regulation. Neurostimulation, a surgical technique has not been discussed here. Most of the authors claim (16/19) for positive results. However, the major part of these studies contains serious methodological flaws which do not resist to critical analysis.


CONCLUSIONS
Because of these methodological flaws and despite the good results claimed by the authors, there is up to date no evidence that clearly demonstrate the effectiveness of sensory stimulation or sensory regulation programs. Further clinical research in this area is necessary.
Rigaux
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P
Etablissement Hélio-Marin, groupe Hopale, BP 2, 62608 cedex, Berck, France. prigaux@hopale.com <prigaux@hopale.com>
Kiefer
C
C
D001364:Awareness; D001925:Brain Damage, Chronic / Q000209:etiology / Q000534:rehabilitation; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D003244:Consciousness Disorders / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D010812:Physical Stimulation; D012107:Research Design