Author/Editor		Groleger Sršen, Katja; Resnik Robida, Karmen; Brodnik, Jana
Title		Multimodalna senzorna stimulacija v obdobju zgodnje rehabilitacije otrok v vegetativnem stanju
Translated title		Multimodal sensory stimulation in early rehabilitation of children in vegetative state
Type		članek
Vol. and No.		Letnik 18, št. 2
Publication year		2019
Volume		str. 44-54
ISSN		1580-9315 - Rehabilitacija
Language		slv
Abstract		Izhodišče: Okrevanje po hudi poškodi možganov ima svoje zakonitosti, vključno z motnjami zavesti od kome in sindroma neodzivne budnosti do stanja minimale zavesti. Raziskave kažejo, da multimodalna senzorna stimulacija (MMSS) izboljša stanje zavesti in izid zdravljenja po hudi poškodbi možganov. Želeli smo oceniti uspešnost MMSS pri otrocih, ki so bili po hudi okvari možganov vključeni v program v obdobju 10 let. Metode: Iz dokumentacije smo želeli zbrati in analizirati podatke o vseh otrocih, ki so bili po hudi okvari možganov vključeni v program MMSS od leta 2007 do 2017. Zbrali smo splošne podatke o otrocih, podatke o oceni zavesti z lestvico za oceno ravni postakutne stopnje zavesti (PALOC) in podatke o odzivanju otroka na posamezen dražljaj (pet-stopenjska lestvica). Za štiri primere smo za odzivanje na dražljaje opravili enosmerno analizo ANOVA za ponovljene meritve. Rezultati: V program je bilo vključenih 10 otrok (5 dečkov; povprečna starost 10 let; SO 3,89). Pri šestih je šlo za nezgodno poškodbo možganov, pri dveh za hipoksično okvaro, eden je prebolel meningoencefalitis, eden pa obsežno krvavitev iz arteriovenske malformacije. Otroci so bili v MMSS vključeni povprečno 88,7 dni po poškodbi oz. okvari. Program MMSS smo izvajali povprečno 6,7 tednov. Štirje otroci so dosegli stanje polne zavesti, pri treh otrocih se stanje zavesti ni izboljšalo, pri dveh se je izboljšalo le deloma. V prispevku so natančneje predstavljeni štirje primeri. Statistična analiza je pri treh od štirih primerov pokazala pomembne razlike v odzivanju na dražljaje med stimulacijami. Zaključek: Glede na rezultate bi lahko sklepali, da je MMSS učinkovit program pri otrocih po nezgodni poškodbi možganov, česar pa ne moremo potrditi za otroke po hudi hipoksični okvari in drugih akutnih okvarah možganov. Ocena stanja zavesti PALOC je za oceno otrokovega napredka videti bolj zanesljiva kot pa ocene odzivov na dražljaje.Background: Recovery from severe brain damage has its typical features, including disorders of consciousness such as coma, unresponsive wakefulness syndrome or state of minimal consciousness. Research shows that multimodal sensory stimulation (MMSS) improves level of consciousness and treatment outcome after severe brain damage. We wanted to evaluate the efficiency of MMSS program in children after severe brain damage, who were enrolled into the program in the period of 10 years. Methods: We wanted to collect and analyse data on all children, who were enrolled in the MMSS program in the period from 2007 to 2017. We collected general data, data on consciousness level, using the Post-Acute Level of Consciousness Scale (PALOC), and data on the responses of children to different stimuli (five-level scale). For four cases, we performed a one-way ANOVA for repeated measures of responses to stimuli. Results: Ten children were included in MMSS program (5 boys; mean age 10 years; SD 3.89). Six suffered from traumatic brain injury, two had hypoxic impairment, one had meningoencephalitis and one had extensive bleeding from arteriovenous malformation. Children were enrolled in MMSS on average 88.7 days after the injury or impairment. The MMSS program was run in average of 6.7 weeks. Four children achieved a state of full consciousness, three children did not improve, two improved only partially. Four cases are presented in more detail. Statistical analysis revealed significant differences in stimulus response between stimuli in three of the four presented cases. Conclusion: Based on the results, we could conclude that MMSS is an effective program in children after traumatic brain injury, which cannot be confirmed for children after severe hypoxic and other acute brain impairments. To assess the child's progress, the PALOC's assessment of the state of consciousness seems to be more reliable than that of the stimulus responses.
Descriptors		Brain Injuries Child
Keywords		child consciousness level injury multimodal sensory stimulation otrok stanje zavesti poškodba multimodalna senzorna stimulacija