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Article

When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence

1
NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Vithas, Callosa d’En Sarrià 12, 46007 València, Spain
2
Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Camino de Vera s/n, 46011 València, Spain
*
Author to whom correspondence should be addressed.
Brain Sci. 2020, 10(12), 990; https://doi.org/10.3390/brainsci10120990
Received: 27 October 2020 / Revised: 3 December 2020 / Accepted: 7 December 2020 / Published: 16 December 2020
(This article belongs to the Special Issue Recent Advances in the Study of Altered State of Consciousness)
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. View Full-Text
Keywords: unresponsive wakefulness syndrome; vegetative state; minimally conscious state; disorders of consciousness; brain damage; disability; independence; functionality unresponsive wakefulness syndrome; vegetative state; minimally conscious state; disorders of consciousness; brain damage; disability; independence; functionality
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MDPI and ACS Style

Olaya, J.; Noé, E.; Navarro, M.D.; O’Valle, M.; Colomer, C.; Moliner, B.; Ippoliti, C.; Ferri, J.; Maza, A.; Llorens, R. When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence. Brain Sci. 2020, 10, 990. https://doi.org/10.3390/brainsci10120990

AMA Style

Olaya J, Noé E, Navarro MD, O’Valle M, Colomer C, Moliner B, Ippoliti C, Ferri J, Maza A, Llorens R. When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence. Brain Sciences. 2020; 10(12):990. https://doi.org/10.3390/brainsci10120990

Chicago/Turabian Style

Olaya, José, Enrique Noé, María D. Navarro, Myrtha O’Valle, Carolina Colomer, Belén Moliner, Camilla Ippoliti, Joan Ferri, Anny Maza, and Roberto Llorens. 2020. "When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence" Brain Sciences 10, no. 12: 990. https://doi.org/10.3390/brainsci10120990

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