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促醒技术辅助下的处于微意识状态的昏迷患者治疗程序。

Technology-aided programs for post-coma patients emerged from or in a minimally conscious state.

机构信息

Department of Neuroscience and Sense Organs, University of Bari Bari, Italy.

Medical College of Georgia, Georgia Regents University Augusta, GA, USA.

出版信息

Front Hum Neurosci. 2014 Dec 5;8:931. doi: 10.3389/fnhum.2014.00931. eCollection 2014.

Abstract

Post-coma persons in a minimally conscious state (MCS) or emerged/emerging from such state (E-MCS), who are affected by extensive motor impairment and lack of speech, may develop an active role and interact with their environment with the help of technology-aided intervention programs. Although a number of studies have been conducted in this area during the last few years, new evidence about the efficacy of those programs is warranted. These three studies were an effort in that direction. Study I assessed a technology-aided program to enable six MCS participants to access preferred environmental stimulation independently. Studies II and III assessed technology-aided programs to enable six E-MCS participants to make choices. In Study II, three of those participants were led to choose among leisure and social stimuli, and caregiver interventions automatically presented to them. In Study III, the remaining three participants were led to choose (a) among general stimulus/intervention options (e.g., songs, video-recordings of family members, and caregiver interventions); and then (b) among variants of those options. The results of all three studies were largely positive with substantial increases of independent stimulation access for the participants of Study I and independent choice behavior for the participants of Studies II and III. The results were analyzed in relation to previous data and in terms of their implications for daily contexts working with MCS and E-MCS persons affected by multiple disabilities.

摘要

处于最小意识状态(MCS)或从该状态中苏醒/逐渐苏醒(E-MCS)的昏迷后患者,可能会因广泛的运动障碍和言语缺失而受到影响,但他们可以借助技术辅助干预计划,发挥积极作用并与环境互动。尽管在过去几年中,该领域已经进行了多项研究,但仍需要新的证据来证明这些干预计划的有效性。这三项研究就是朝着这个方向努力的。研究 I 评估了一种技术辅助计划,使六名 MCS 参与者能够独立获得他们喜欢的环境刺激。研究 II 和研究 III 评估了技术辅助计划,使六名 E-MCS 参与者能够做出选择。在研究 II 中,其中三名参与者被引导在休闲和社交刺激物以及自动呈现给他们的照护者干预措施之间进行选择。在研究 III 中,其余三名参与者被引导(a)在一般刺激/干预选项(例如歌曲、家庭成员的录像和照护者干预措施)中进行选择;然后(b)在这些选项的变体中进行选择。所有三项研究的结果都非常积极,研究 I 的参与者获得了更多独立的刺激访问机会,研究 II 和研究 III 的参与者表现出更多的独立选择行为。这些结果与之前的数据进行了分析,并考虑了它们对与受多种残疾影响的 MCS 和 E-MCS 患者一起工作的日常环境的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1aa/4257021/ba2d65e73c19/fnhum-08-00931-g0001.jpg

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