Patients with brain injury or stroke patients with loss of consciousness they have multiple problems. Major problem is loss of consciousness, less arousal and alertness. Along with loss sensory motor control. Coma stimulation program emphasis on use of sensory stimuli of different nature. Such as use of auditory stimuli, olfactory, visual & somato sensory stimulation. These multiple stimuli works but it takes lot of time and slow process. The stimulation or arousal doesn’t persist longer.
During my experiences of treating these patients with brain injury and comatose patients. I learned that stimulus better and lasting result follow
PRINCIPLE OF TREATMENT
1.We have to give multiple sensory stimuli simultaneously
2. Stimulus should be able to stimuli larger area of body.
3. Work more on righting reactions.
4.Work reactive postural control stimulation
5.Target more on improving head control and postural control.
6. Work in upright position such as sitting or standing.
I GOT BEST RESULTS WITH
7.Working on bed mobility– initially when patients are not able to do it. Do repetitive passive rolling, supine to prone, supine to rolling to sit.
8. Standing – passive standing with maximum support. Either on tilt table or standing with 2 persons support. Use knee support and ankle foot orthosis (AFO).
9. Walking training- start early ambulation. Initially we have to passively assist him in walking.
The key of effectiveness of these techniques are involves the principle of treatment from 1 to 6.
This helps in multiple sensory stimuli, postural control training in upright position, improves reactive control and righting reactions of body. This ultimately improves arousal & Improves motor control and postural control of body.