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When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence
Accurate estimation of the functional independence of patients with unresponsive wakefulness syndrome (UWS) is essential to adjust family and clinical expectations and plan long-term necessary resources. Although different studies have described the clinical course of these patients, they have metho...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765669/ https://www.ncbi.nlm.nih.gov/pubmed/33339138 http://dx.doi.org/10.3390/brainsci10120990 |
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author | Olaya, José Noé, Enrique Navarro, María Dolores O’Valle, Myrtha Colomer, Carolina Moliner, Belén Ippoliti, Camilla Ferri, Joan Maza, Anny Llorens, Roberto |
author_facet | Olaya, José Noé, Enrique Navarro, María Dolores O’Valle, Myrtha Colomer, Carolina Moliner, Belén Ippoliti, Camilla Ferri, Joan Maza, Anny Llorens, Roberto |
author_sort | Olaya, José |
collection | PubMed |
description | Accurate estimation of the functional independence of patients with unresponsive wakefulness syndrome (UWS) is essential to adjust family and clinical expectations and plan long-term necessary resources. Although different studies have described the clinical course of these patients, they have methodological limitations that could restrict generalization of the results. This study investigates the neurobehavioral progress of 100 patients with UWS consecutively admitted to a neurorehabilitation center using systematic weekly assessments based on standardized measures, and the functional independence staging of those patients who emerged from a minimally conscious state (MCS) during the first year post-emergence. Our results showed that one year after emergence, most patients were severely dependent, although some of them showed extreme or moderate severity. Clinically meaningful functional improvement was less likely to occur in cognitively-demanding activities, such as activities of daily living and executive function. Consequently, the use of specific and staging functional independence measures, with domain-specific evaluations, are recommended to detect the functional changes that might be expected in these patients. The information provided by these instruments, together with that obtained from repeated assessments of the preserved consciousness with standardized instruments, could help clinicians to adjust expectations and plan necessary resources for this population. |
format | Online Article Text |
id | pubmed-7765669 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-77656692020-12-27 When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence Olaya, José Noé, Enrique Navarro, María Dolores O’Valle, Myrtha Colomer, Carolina Moliner, Belén Ippoliti, Camilla Ferri, Joan Maza, Anny Llorens, Roberto Brain Sci Article Accurate estimation of the functional independence of patients with unresponsive wakefulness syndrome (UWS) is essential to adjust family and clinical expectations and plan long-term necessary resources. Although different studies have described the clinical course of these patients, they have methodological limitations that could restrict generalization of the results. This study investigates the neurobehavioral progress of 100 patients with UWS consecutively admitted to a neurorehabilitation center using systematic weekly assessments based on standardized measures, and the functional independence staging of those patients who emerged from a minimally conscious state (MCS) during the first year post-emergence. Our results showed that one year after emergence, most patients were severely dependent, although some of them showed extreme or moderate severity. Clinically meaningful functional improvement was less likely to occur in cognitively-demanding activities, such as activities of daily living and executive function. Consequently, the use of specific and staging functional independence measures, with domain-specific evaluations, are recommended to detect the functional changes that might be expected in these patients. The information provided by these instruments, together with that obtained from repeated assessments of the preserved consciousness with standardized instruments, could help clinicians to adjust expectations and plan necessary resources for this population. MDPI 2020-12-16 /pmc/articles/PMC7765669/ /pubmed/33339138 http://dx.doi.org/10.3390/brainsci10120990 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Olaya, José Noé, Enrique Navarro, María Dolores O’Valle, Myrtha Colomer, Carolina Moliner, Belén Ippoliti, Camilla Ferri, Joan Maza, Anny Llorens, Roberto When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence |
title | When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence |
title_full | When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence |
title_fullStr | When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence |
title_full_unstemmed | When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence |
title_short | When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence |
title_sort | when, how, and to what extent are individuals with unresponsive wakefulness syndrome able to progress? functional independence |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765669/ https://www.ncbi.nlm.nih.gov/pubmed/33339138 http://dx.doi.org/10.3390/brainsci10120990 |
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