Table 16.39 Electrical Stimulation for Recovery of Consciousness Post ABI
by Camila | Dec 12, 2018
Table 16.39 Electrical Stimulation for Recovery of Consciousness Post ABI
Author/Year/ Country/ Study Design/N |
Methods |
Outcomes |
Peri et al.
(2001)
USA
RCT
PEDro=6
N=10 |
Population: TBI; Mean Age=40 yr; Gender: Male=8, Female=2; Mean Time Post Injury=6 2hr; Mean GCS=5.
Intervention: Participants were randomized to receive right median nerve stimulation (RMNS, n=6), with 300 msec intermittent pulses at 40 Hz (20 sec on and 40 sec off), or sham stimulation (n=4) for 8 hr/ day up to 14 days. Outcomes were assessed at 3mo.
Outcome Measure: Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), Functional Independence/Assessment Measure (FIM/FAM), Coma Duration. |
- Mean coma duration was shorter in the RMNS group than the sham group, but this difference was not significant (9.5 days versus 11.5 days, p=0.31).
- There was no significant difference between RMNS and sham groups in GOS (3 versus 3) or FIM/FAM scores (114.4 versus 64.5).
|
Cooper et al.
(1999)
USA
RCT
PEDro=4
N=6 |
Population: TBI; Mean Age=28 yr; Time Post Injury<1 wk; Mean GCS=7.
Intervention: Patients were randomized to receive right median nerve stimulation (RMNS, n=3), with asymmetric biphasic pulses (20 mA, 300 µs, 40 Hz, 20 sec/min) or sham stimulation (control, n=3) for 8-12 hr/day for 2 wk. Outcomes were assessed at 1 wk, 2 wk, and 1 mo.
Outcome Measure: Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), Length of Stay (LOS). |
- At 1 wk, the RMNS group improved by an average of 4.0 on the GCS compared with 0.7 in controls.
- By 2 wk, the RMNS group improved by an average of 6.4 on the GCS compared with 1.3 in controls.
- The RMNS group LOS in the ICU was an average of 7.7 days compared with 17.0 days for controls.
- Mean GOS for the RMNS group was 3 compared with 2 for controls.
- No statistical comparisons were reported.
|
Liu et al.
(2003)
Taiwan
Pre-Post
N=6 |
Population: TBI=2, Hypoxia=2, Stroke=1, Aneurysm=1.
Intervention: Patients received right median nerve stimulation (RMNS): asymmetric biphasic pulses (20 mA, 300 µs,35 Hz, 20 sec on and 50 sec off). Stimulation was performed for 1 0 hr/ day (comatose) or 8 hr/ day (conscious) for 3 mo.
Outcome Measure: Cerebral Perfusion Pressure (CPP), Dopamine levels. |
- Significant increases in CPP were seen bilaterally in all patients following RMNS (p<0.05).
- Four patients regained consciousness within 35 days of initial RMNS.
- Dopamine levels were elevated in the majority of patients following RMNS.
- Younger patients (<40 yr) had better improvement than older patients.
|
PEDro=Physiotherapy Evidence Database rating scale score (Moseley et al., 2002).