PubMed Health⌕ Search

Biomedical subjects

H Thwaites

Publications and source records attributed to H Thwaites.

4 recordsLinked to original sources

Vegetative state and responses to sensory stimulation: an analysis of 24 cases.

A meta-analysis was performed on data from 24 single-case experimental studies evaluating the immediate effects of sensory stimulation treatment on patients in vegetative state following traumatic brain injury. Response to treatment was evaluated by time sampling behaviour pre- and post-treatment, and examining for changes in behaviour that suggested increased arousal. In this analysis the relative effectiveness of different treatment protocols was examined. The effects of variables such as age, gender and time since injury on magnitude of behaviour change was examined; also whether there was a relationship between response to treatment and outcome in terms of whether patients emerged from vegetative state or not. Analyses showed that multimodal stimulation produced greater behavioural changes than unimodal stimulation, and the use of personally salient stimuli in multimodal stimulation the greatest changes of all. Age and gender both showed effects on the magnitude of the behaviour change, but time since injury did not. Patients who did not emerge from the vegetative state were no less likely that those who did to produce statistically significant changes in behaviour in response to treatment. The paper includes a discussion of general issues concerning vegetative state.

Adolescent↗

Behavioural differences between patients who emerged from vegetative state and those who did not.

This paper reports on a meta-analysis of behavioural data gathered using single case research methodology, while evaluating the immediate effects of a treatment (sensory stimulation) on 24 individuals diagnosed as being in vegetative state following trauma. The data derived from time sampling have been used to compile measures of behavioural change in response to environmental events, which are referred to as arousal profiles. In addition to this, interviews were conducted regularly to elicit structured observations from the nursing staff concerning behavioural changes that they had observed. The subjects were divided into two groups according to whether they had emerged from vegetative state or not at the time the meta-analysis commenced. Statistically significant differences were found between the outcome groups in terms of modal arousal profile characteristics; one profile type was characteristic only of those that emerged. The two groups could also be differentiated by the mean recovery curves derived from the interview data. Behavioural differences between the outcome groups have been found which are detectable while the patients are in vegetative state. These findings have prognostic potential.

Adolescent↗

Constructing arousal profiles for vegetative state patients--a preliminary report.

Arousal profiles are a method that we have developed for using data derived from time sampling to examine how behaviours such as the frequency with which the eyes are observed open, and the frequency of spontaneous movements, vary in the periods immediately before and immediately after sensory stimulation treatment. We believe changes in such behaviours reflect changes in arousal. The use of this new technique is illustrated with examples from a pilot study using data from 15-day treatment blocks, gathered for 10-minute periods immediately before and after sensory stimulation treatment from three patients using single-case research methods. The patients were diagnosed as being in vegetative state following traumatic brain injury. The possible significance of the differing characteristics of the profiles is discussed.

Adult↗

Sensory stimulation in prolonged coma: four single case studies.

Patients diagnosed as being in prolonged coma (vegetative state) in this hospital are routinely treated according to a sensory stimulation protocol. This paper reports an evaluation of the efficacy of this procedure using the comparison of behavioural measures taken immediately prior to and post-stimulation. Four single cases produced significant behavioural changes suggesting increased arousal as a result of stimulation. The results and implications for further evaluation studies are discussed.

Adult↗