Department of Rehabilitation Medicine, Danderyds Sjukhus AB, SE-182 20 Stockholm, Sweden.
J Rehabil Med. 2018 Feb 28;50(3):253-260. doi: 10.2340/16501977-2309.
To explore whether the use of personally relevant stimuli, for some tasks in the Coma Recovery Scale - Revised (CRS-R), generates more responses in patients with prolonged disorders of consciousness compared with neutral stimuli.
Multiple single-case design.
Three patients with prolonged disorders of consciousness recruited from an inpatient department at a regional brain injury rehabilitation clinic in Stockholm, Sweden.
Patients were repeatedly assessed with the CRS-R. Randomization tests (bootstrapping) were used to compare the number of responses generated by personally relevant and neutral stimuli on 5 items in the CRS-R.
Compared with neutral stimuli, photographs of relatives generated significantly more visual fixations. A mirror generated visual pursuit to a significantly greater extent than other self-relevant stimuli. On other items, no significant differences between neutral and personally relevant stimuli were seen.
Personally relevant visual stimuli may minimize the risk of missing visual fixation, compared with the neutral stimuli used in the current gold standard behavioural assessment measure (CRS-R). However, due to the single-subject design this conclusion is tentative and more research is needed.
探讨在修订后的昏迷恢复量表（CRS-R）的某些任务中使用个人相关刺激是否会比使用中性刺激产生更多的反应，从而促进意识障碍持续时间较长的患者的康复。
多项单病例设计。
3 名来自瑞典斯德哥尔摩地区脑损伤康复诊所住院部的意识障碍持续时间较长的患者。
患者反复接受 CRS-R 评估。随机化检验（自举法）用于比较 CRS-R 中 5 项个人相关和中性刺激产生的反应数量。
与中性刺激相比，亲属的照片产生了更多的视觉注视。镜子产生的视觉追踪比其他自我相关刺激更显著。在其他项目上，没有观察到中性和个人相关刺激之间的显著差异。
与当前行为评估标准（CRS-R）中使用的中性刺激相比，个人相关的视觉刺激可能最小化错过视觉注视的风险。然而，由于采用了单病例设计，该结论尚不确定，需要进一步研究。
