Aurore Thibaut, Marta Aloisi, Joëlle Dreessen, Naji Alnagger, Nicolas Lejeune, Rita Formisano
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Neuro-orthopaedic assessment and management in patients with prolonged disorders of consciousness: A review.
Background: Following a severe acquired brain injury, neuro-orthopaedic disorders are commonplace. While these disorders can impact patients' functional recovery and quality of life, little is known regarding the assessment, management and treatment of neuro-orthopaedic disorders in patients with disorders of consciousness (DoC).
Objective: To describe neuro-orthopaedic disorders in the context of DoC and provide insights on their management and treatment.
Methods: A review of the literature was conducted focusing on neuro-orthopaedic disorders in patients with prolonged DoC.
Results: Few studies have investigated the prevalence of spastic paresis in patients with prolonged DoC, which is extremely high, as well as its correlation with pain. Pilot studies exploring the effects of pharmacological treatments and physical therapy show encouraging results yet have limited efficacy. Other neuro-orthopaedic disorders, such as heterotopic ossification, are still poorly investigated.
Conclusion: The literature of neuro-orthopaedic disorders in patients with prolonged DoC remains scarce, mainly focusing on spastic paresis. We recommend treating neuro-orthopaedic disorders in their early phases to prevent complications such as pain and improve patients' recovery. Additionally, this approach could enhance patients' ability to behaviourally demonstrate signs of consciousness, especially in the context of covert awareness.
期刊介绍：
NeuroRehabilitation, an international, interdisciplinary, peer-reviewed journal, publishes manuscripts focused on scientifically based, practical information relevant to all aspects of neurologic rehabilitation. We publish unsolicited papers detailing original work/research that covers the full life span and range of neurological disabilities including stroke, spinal cord injury, traumatic brain injury, neuromuscular disease and other neurological disorders.
We also publish thematically organized issues that focus on specific clinical disorders, types of therapy and age groups. Proposals for thematic issues and suggestions for issue editors are welcomed.
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