coma test 1         

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coma patient therapy or treatment in movement

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h p i - COMA THERAPY


NOBODY between Shore and Ship after coma


It will not hurt if the patient in coma is moved with love and patience and one has come into movement oneself by doing so.



Direct research and connecting the ways of care, has to better the treatment of ex-comapatients and give clearness to the family, can be read in the hersenletsel magazine lente 2017.

It is also written about the treatment with VIN (Vroege Intensieve Neurorevalidatie - early intensive neurorevalidation) that is used in Tilburg to activate patients under 26 years old and about a research group "Niemand tussen Wal en Schip" (Nobody between Shore and Ship) that was grounded for patients with severe non-born brain damage and their family.

Thanks to technical improvement, there are more patients in coma than before and it is the question, when someone is "in coma" or "ex-patient in coma". Usually one talks about non or hardly awakening or being awake, for what was used vegetative state or low awakeness, which has been changed into "non-responding wakesyndrome".

The goal of the change of name is to meet the situation of the patient more positive. The name "vegetative state" is combined with a state of no possible change for the patient and one wonders if a change of name will change that idea.

Another question that can be asked is, whether the non responsive awake syndrom state is combined with a disorder of the awareness. A patient that just had a simple CVA and stays at the hospital to recover, told that he has his eyes closed now and than and sometimes, he does not react on people that enter the room and the nursing personal that pass, think that he is asleep, but he is awake, lying in bed with his eyes closed and not reacting on hearing noises or being spoken to.

His awareness is not disturbed, but he does not have energy to react, is not in the mood to react and does not react on stimulus by moving, opening his eyes or using his voice like is expected in the GLASGOW COMA SCALE TEST.

His diagnose is not 'patient in coma', but his behaviour is like one? No will the specialist say, because the patient will react later when the nurse enters the room again, but maybe the patient in coma is continuously in the state of the CVA-patient written above?

The technical knowledge has been bettered a lot in the last decennia and much more can be measured than before. The Coma Science Group has proved scientifically that the coma patient has mental activity and it is the question what consequences this knowledge has had? Has the treatment of coma patients been changed by it?

The technical development costs money and it seems that, in the medical world too, the trend to exchange human resources by machines, has priority. The medication than is delivered in the room of the patient by drone, as well as the coffee, tea or orange juice and more and more patients get fear attacks, waht is not understood.

They all have their seperate room and fear that they will not been able to push the red button when they need help. The patient that did not have any energy left, was happy that he shared a room with a young man that was glad to keep an eye on the old one and pushed the bell when the old man needed help.

The idea about privacy has resulted in a lot of one-person rooms, but that is not for all patients positive. Treatments that do not have the wanted result, should be changed. For the coma patient this means that he must be helped to move to be able to move.

There are investigations on known treatment methods, without an opening to alternatives, it seems. Science seems to have the opinion that first there must be scientifical papers about a possibly better treatment, before the investigators want to investigate the alternative treatmentmethod, which means that what not has been scientifically investigated, is not investigated, although it may have proved its function in practice?

Can that be the reason of all these unknown treatment methods, that are effective? Most therapists are no writers or people that write about the treatment they give, which may be the reason that is spoken about 'luck' of a patient can be heard again. A father told that his daughter, that became patient in coma afer a car accident, had reacted 3 weeks after a man whispered in her ear something unknown, with opening her eyes and saying 'Dad, I slept well', not knowing that she had been in coma for 5 years.

A nurse told that she sat at the side of the patient in coma during her night shift and let the Reiki energy flow and 2 patients were awaken next morning. Nothing was told about this "alternative therapy" because she might have last her job for using it.

Another nurse told that she had cancelled her job in the rehab hospital, because she felt that the method that was used, was not good for the patients. She could not prove what was wrong about it, but she had the feeling that the pain that was caused through the treatment, was not healing stimulating for the patients.

For the patients that can not move visibly, guided movements can make the difference. Not half an hour a day, but whole day and night long. They do not get tired of moving, but moving gives them energy like it also gives energy to people that come home after work and are tired and jump on their bike or put on their jogging or tennis shoes and move in their sport.

Every movement is sports for the patient, if this is made in the right speed ánd if it is the right movement. There are movements that cost energy to the patient and the patient will try with all power to event them to be made!

In Internet the COMA RECOVERY SCALE-REVISED TEST can be found. It is used to measure the changes in the state of the comapatient (or is it ex-comaptiant ?):

 

COMA RECOVERY SCALE-REVISED TEST  

Points

Auditory function

Visual function

Motor function

Oromotor
verbal function

Communication

Arousal

6

-  

-  

Functional use object

-  

-  

-  

5

-  

Recognition objects

Automatic motor response

-  

-  

-  

4

Consistent movement to command

Reaching localization object

Manipulation object

-  

-  

-  

3

Reproducible movement to command

Visuel pursuit

Localization to painful stimulation

Intelligible verbalization

-  

Attention

2

Localization to sound

Fixation

Flexion withdrawal

Vocalization / oral movement

Functional: accurate

Eye opening without stimulation

1

Auditory startle

Visual startle

Abnormal posturing

Oral reflexive movement

Non-functional: intentional

Eye opening with stimulation

0

no visible reaction

no visible reaction

no visible reaction, flaccid

no visible reaction

no visible reaction

no visible reaction

If we take the starting point that the patient in coma / (ex)comapatient has an active awareness and that the coma state is not a neurological problem (which can be concluded from the fact that neurological treatment does not have the wanted effect), no visible reaction will be expected of the patient in coma.

Dependend of the neurological damage is the possibility to move that can be expected and the chance that the patient comes into movement is big if the patient is moved with the knowledge of the neurological damage.

There is a good chance that will be discovered what alternative treatment of patients in coma will result in being able to move, if those alternative treatments are investigated.

 


De onbeweeglijkheid van patiënt in coma veranderen in beweging


Change the immobility of the patient in coma into movement


Ändere die Unbeweglichkeit des Patienten im Wachkoma in Bewegung


Change l'immobilité du patient comateux mouvant


Endre det ubevegelige livet av pasient i koma i bevegelse

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Believe what you want to believe
investigate what you want to research
and move with the patient in coma