Auditory Stimulation for Comatose Brain Injury Patients

Davis, Alice

Abstract

Auditory Stimulation for Comatose Brain Injured Patients This study will examine the effects of a structured auditory sensory stimulation program (SASP) on traumatically brain injured patients in coma by answering the following research questions: 1) Will there be an increase in arousal from initial assessment (baseline) and discharge assessment scores as measured by the Sensory Stimulation Assessment Measure (SSAM), Glasgow Coma Scale (GCS), Ranchos Los Amigos Cognitive Functioning Scale (RLA), and the Disability Rating Scale (DRS) scores in comatose patients who receive a structured sensory stimulation program (SASP) compared to comatose patients who do not receive a SASP?; and 2) Which neurodiagnostic measure QEEG or EEG will demonstrate the greatest relationship to arousal as measured by the Sensory Stimulation Assessment Measure (SSAM), Glasgow Coma Score (GCS), Ranchos Los Amigos Cognitive Functioning Scale (RLA), and the Disability Rating Scale (DRS) before and after a SASP? This is a quasi-experimental study using a pre-test-post-test and comparative matched control design. Sixty male and female patients, ages 18-60, with a diagnosis of brain injury due to traumatic injury will be assigned to a treatment (Group 1, n = 30) or control (Group 2, n = 20) group. Patients will be deemed eligible for the study if they have a Glasgow Coma Score of 8 or less and are ranked as Level I, II, or III on the Ranchos Los Amigos Cognitive Functioning scale. Group 1 will participate in a SASP that is nurse directed and implemented in collaboration with occupational, speech, and physical therapists and family members. The SASP consists of 14 daily sessions of stimulation ranging between 3-30 minutes delivered between the hours of 8 am and 9 pm while they are in the intensive care unit. Group 2 will be matched to Group 1 based on gender, age (+/- 3 years), severity of GCS, and classification of injury and will receive the standard nursing and medical care appropriate for their diagnosis. Data will be analyzed using multivariate and univariate analysis of variance to answer research question #1 and hierarchial regression analysis to answer research question #2.