Weaver Jennifer A, Watters Kelsey, Cogan Alison M
Colorado State University, Fort Collins, CO, USA.
Shirley Ryan Ability Lab, Chicago, IL, USA.
OTJR (Thorofare N J). 2023 Apr;43(2):322-336. doi: 10.1177/15394492221117779. Epub 2022 Sep 1.
People who experience disorders of consciousness (DoC) following a severe traumatic brain injury (TBI) have complex rehabilitation needs addressed by occupational therapy. To examine the effectiveness of interventions to improve arousal and awareness of people with DoC following a TBI. For this systematic review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched six databases in collaboration with a research librarian. Twenty-seven studies were included and grouped thematically. Multimodal sensory stimulation, familiar voices telling structured stories, and transcranial direct current stimulation had a moderate level of evidence. Multimodal sensory stimulation had the strongest evidence in support of its use in clinical practice. Occupational therapy practitioners should administer multimodal stimuli frequently as studies reported administering these interventions at least twice daily. Occupational therapy practitioners should incorporate personally relevant, meaningful, salient stimuli into interventions when treating patients with DoC.
重度创伤性脑损伤（TBI）后出现意识障碍（DoC）的患者有复杂的康复需求，需通过职业治疗来解决。为了检验改善TBI后DoC患者觉醒和意识的干预措施的有效性。对于本系统评价，我们遵循系统评价和Meta分析的首选报告项目指南。我们与一位研究馆员合作检索了六个数据库。纳入了27项研究并进行了主题分组。多模式感觉刺激、讲述结构化故事的熟悉声音以及经颅直流电刺激有中等程度的证据支持。多模式感觉刺激在支持其在临床实践中的应用方面有最有力的证据。职业治疗从业者应频繁给予多模式刺激，因为研究报告称这些干预措施至少每天实施两次。在治疗DoC患者时，职业治疗从业者应将个人相关、有意义、显著的刺激纳入干预措施中。
