title: Cognitive-behavioural stimulation protocol for severely brain-damaged patients in the post-acute stage in developmental age.
abstract: OBJECTIVE
  To present a cognitive-behavioural stimulation (CBS) protocol designed to help severely damaged patients in the early post-acute stage by describing the underlying methodology and assessing its efficacy compared to traditional rehabilitation methods. This protocol combines multisensory stimulation and cognitive-behavioural techniques to elicit and intensify the occurrence of adaptive responses and reduce maladaptive behavioural patterns.
  
  
  METHODS
  A control group and an experimental group--both evaluated with the Levels of Cognitive Functioning Assessment Scale (LOCFAS)--were compared at the beginning of the rehabilitation programme and at the end of it. The control group consisting of patients assessed and treated before receiving the CBS protocol was enrolled in a traditional rehabilitation programme (only physical therapy and speech therapy). Besides the traditional therapy, the experimental group also received the CBS protocol.
  
  
  RESULTS
  Patients on the CBS protocol show a greater improvement and are therefore more responsive than the control group after the 16-week remediation programme. The mean LOCFAS improvement of the experimental group is more marked during the first month of rehabilitation and is associated to the entry LOCFAS level, while in the control group the improvement on LOCFAS is considered to be 'spontaneous' and is associated to the aetiology of the brain damage.
  
  
  CONCLUSIONS
  Our results show a better initial outcome for patients receiving the CBS protocol.
authors.affiliation: IRCCS 'Eugenio Medea', Bosisio Parini, LC, Italy. mariarosaria.liscio@bp.lnf.it
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Liscio
authors.forename: Annarita
authors.initials: A
authors.lastname: Adduci
authors.forename: Susanna
authors.initials: S
authors.lastname: Galbiati
authors.forename: Geraldina
authors.initials: G
authors.lastname: Poggi
authors.forename: Daniela
authors.initials: D
authors.lastname: Sacchi
authors.forename: Sandra
authors.initials: S
authors.lastname: Strazzer
authors.forename: Enrico
authors.initials: E
authors.lastname: Castelli
authors.forename: Jeanne
authors.initials: J
authors.lastname: Flannery
mesh_terms: D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006040:Goals; D006801:Humans; D002534:Hypoxia, Brain / Q000145:classification / Q000534:rehabilitation*; D008297:Male; D010291:Paresis / Q000145:classification; D010812:Physical Stimulation; D012720:Severity of Illness Index; D016896:Treatment Outcome