Validating the Western Neuro Sensory Stimulation Profile for patients with severe traumatic brain injury who are slow-to-recover.

Abstract

The Western Neuro Sensory Stimulation Profile (WNSSP) is designed to measure disorders of consciousness in people with severe traumatic brain injury who are slow-to-recover. This study explores internal consistency reliability and concurrent validity of the WNSSP with function and two other consciousness measures. Retrospective chart audit of all severe traumatic brain injury patients admitted to a specialist neurological rehabilitation centre from January 2001 to December 2006 in a vegetative or minimally conscious state. Medical record of demographical, clinical and Glasgow Coma Scale (GCS) data were recorded. To be included in the study, patients needed admission and discharge WNSSP results; plus Functional Independence Measure™ (FIM™) and Rancho Los Amigos Scale (RLAS) scores. Of 37 potential participants, 33 had required WNSSP results (mean age 28years; 27 male participants). Internal consistency reliability was very high (α=0.933). Concurrent validity in relation to function was significant but weak at admission for FIM™ Total-scale but not subscales (rs =-0.146, P=0.0424). At discharge, there was a modest relationship with FIM™ Motor-subscale (rs =0.374; P=0.045), and FIM™ Cognition-subscale (rs =0.412; P=0.026) scores, but not the FIM™ Total-scale. Concurrent validity in relation to the RLAS was strong at admission (rs =0.693, P=0.01) and discharge (rs =0.788, P=0.01). The WNSSP and GCS scores were not associated. The WNSSP is sensitive to behavioural change in slow-to-recover patients with severe traumatic brain injury. It demonstrates very high internal consistency reliability, and positive evidence of concurrent validity with FIM™ and the RLAS providing detailed description of cognitive-sensory behaviour within RLAS-levels.