Effects of Subject Specific Integrated Multisensory Stimulation on Arousal in Traumatic Brain Injury-A Randomized Controlled Trial
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Abstract
Context: Enriched environment aims to improve arousal in subjects with disorders of consciousness. Adding a functional task-based arousal program with added personal salience could possibly enhance the recovery. However, the effect of one such program- “Subject specific integrated multisensory stimulation” on arousal for subjects with acute severe traumatic brain injury is lesser known.
Aim: The objective is to assess the effect of subject specific integrated multisensory stimulation program on arousal following traumatic brain injury.
Setting and design: Parallel arm randomized controlled trial in acute setup (Neuro intensive care unit and neuro wards)
Methods and materials:100 participants with Glasgow’s coma scale score of less than 8 (severe) after traumatic brain injury were allocated under two groups. Control group was administered with Multimodal sensory stimulation program and experimental group with subject specific integrated multisensory stimulation program by a session of 45 minutes thrice a day for 14 days. Coma recovery scale -revised was used to assess arousal. Participants were re-assessed on 7th day and on 14th day of intervention by a blinded outcome assessor.
Statistical analysis used: Analysis of variance test for within group analysis and t-test for between group analysis with level of significance fixed at P<0.05 were used. Sub-group analysis of coma recovery scale revised was also done using same.
Results: Both the groups improved from baseline. However, the improvement by wilks lambda value in the subject specific integrated multisensory stimulation group (0.193) was better compared to that of control group (0.235). Subscale analysis of CRS-R showed better improvements on arousal in the experimental group (0.174) compared to control group (0.290).
Conclusion: Subject specific integrated multisensory stimulation program serves as a better way to facilitate arousal following acute severe traumatic brain injury.