title: Early rehabilitation of comatose patients after traumatic brain injury.
abstract: OBJECTIVE
  As a result of improvements in the rescue system and progress in intensive care therapy, an increasing number of patients have survived severe traumatic brain injury in recent years. Early and consistent administration of the correct rehabilitation programme is of crucial importance for the restoration and improvement of cerebral function, as well as social reintegration. This prospective study was conducted at the neurosurgical department of a university hospital to assess the one-year outcome of comatose patients after severe traumatic brain injury.
  
  
  METHODS
  Twenty-seven patients were included. Patients received multimodal early-onset stimulation and continuous inpatient and outpatient rehabilitation therapy. One-year outcome was assessed by means of the Glasgow Outcome Scale, Barthel Index, Functional Independence Measure (FIM) and need of care.
  
  
  RESULTS
  Seven patients died, 4 remained in a vegetative state, 7 were severely disabled, 6 were moderately disabled, and 3 achieved a good recovery 12 months after injury. Median Barthel Index was 65 and median FIM score was 84. The majority of patients were still at least intermittently dependent on care.
  
  
  CONCLUSIONS
  Despite intensive rehabilitation treatment, severe traumatic brain injury is still burdened with significant mortality and morbidity.
authors.affiliation: Department of neurological Rehabilitation, University of Cologne, Germany. marcela.lippert-gruener@uk-koeln.de
authors.forename: Marcela
authors.initials: M
authors.lastname: Lippert-Grüner
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D003128:Coma / Q000209:etiology / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012720:Severity of Illness Index; D017741:Survivors / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult