Citation

Giacino JT, Whyte J, Nakase-Richardson R, Katz DI, Arciniegas DB, Blum S, Day K, Greenwald BD, Hammond FM, Pape TB, Rosenbaum A, Seel RT, Weintraub A, Yablon S, Zafonte RD, Zasler N. Arch. Phys. Med. Rehabil. 2020; ePub(ePub): ePub.

Affiliation

Concussion Care Centre of Virginia and Tree of life Services, Henrico, VA, and Virginia Commonwealth University, Department of Physical Medicine and Rehabilitation, Richmond, Virginia.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.apmr.2020.01.013

PMID

32087109

Abstract

Persons who have disorders of consciousness (DoC) require care from multidisciplinary teams with specialized training and expertise in management of the complex needs of this clinical population. The recent promulgation of practice guidelines for patients with prolonged DoC by the American Academy of Neurology (AAN), American Congress of Rehabilitation Medicine (ACRM), and National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) represents a major advance in the development of care standards in this area of brain injury rehabilitation. Implementation of these practice guidelines requires explication of the minimum competencies of clinical programs providing services to persons who have DoC. The Brain Injury Interdisciplinary Special Interest Group of the ACRM, in collaboration with the Disorders of Consciousness Special Interest Group of the NIDILRR-Traumatic Brain Injury Model Systems (TBIMS) convened a multidisciplinary panel of experts to address this need through the present position statement. Content area-specific workgroups reviewed relevant peer-reviewed literature and drafted recommendations which were then evaluated by the expert panel using a modified Delphi voting process. The process yielded 21 recommendations on the structure and process of essential services required for effective DoC-focused rehabilitation, organized into four categories: Diagnostic and Prognostic Assessment (four recommendations), Treatment (eleven recommendations), Transitioning Care/Long Term Care Needs (five recommendations), and Management of Ethical Issues (one recommendation). With few exceptions, these recommendations focus on infrastructure requirements and operating procedures for the provision of DoC-focused neurorehabilitation services across subacute and post-acute settings.

Copyright © 2020. Published by Elsevier Inc.

Language: en

Keywords

best practices; disorders of consciousness; health services; outcome; rehabilitation