Neuro-orthopaedic assessment and management in patients with prolonged disorders of consciousness: A review.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

NeuroRehabilitation Pub Date : 2024-01-01 DOI:10.3233/NRE-230137

Aurore Thibaut, Marta Aloisi, Joëlle Dreessen, Naji Alnagger, Nicolas Lejeune, Rita Formisano

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引用次数: 0

Abstract

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.

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长时间意识障碍患者的神经矫形评估和管理：综述。

背景：严重后天性脑损伤后，神经矫形障碍是一种常见病。虽然这些疾病会影响患者的功能恢复和生活质量，但人们对意识障碍（DoC）患者神经骨科疾病的评估、管理和治疗却知之甚少：目的：描述意识障碍背景下的神经矫形障碍，并就其管理和治疗提供见解：方法：对文献进行综述，重点关注长时间意识障碍患者的神经矫形障碍：很少有研究调查了长期卧床患者痉挛性瘫痪的发病率（极高）及其与疼痛的相关性。探索药物治疗和物理治疗效果的试验性研究结果令人鼓舞，但疗效有限。对异位骨化等其他神经骨科疾病的研究仍然很少：有关长期瘫痪患者的神经矫形障碍的文献仍然很少，主要集中在痉挛性瘫痪方面。我们建议在早期阶段治疗神经骨科疾病，以预防疼痛等并发症，改善患者的康复情况。此外，这种方法还能提高患者在行为上表现出意识迹象的能力，尤其是在隐蔽意识的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

NeuroRehabilitation CLINICAL NEUROLOGY-REHABILITATION

CiteScore

3.20

自引率

0.00%

发文量

178

审稿时长

6-12 weeks

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.