Recovery Scale Research Articles

Cross-cultural adaptation and psychometric validation of a Spanish version of the Maryland Assessment of Recovery Scale (MARS-12).

The aim of this study was to adapt and validate a Spanish version of the Maryland Assessment of Recovery Scale (MARS-12). It was carried out in strict accordance with internationally recognized guidelines for test adaptation. A preliminary Spanish version of the MARS-12 was first produced through a standardized translation/back-translation process, ensuring semantic, linguistic, and contextual equivalence with respect to the original scale. Its psychometric properties were then examined in a sample of 325 people with serious mental illness recruited from six different provinces in the Basque Country (northern Spain) and Catalonia (north-eastern Spain). They were users of a total of 20 community rehabilitation and psychiatry services. Confirmatory factor analysis supported a unidimensional structure, consistent with the original scale. Scores on the MARS-12 were positively correlated (.83) with scores on the Questionnaire about the Process of Recovery, supporting convergent validity, while validity evidence based on relationships with other variables was provided by positive correlations between MARS-12 scores and scores on the Dispositional Hope Scale (.82) and on the three dimensions of the Multidimensional Scale of Perceived Social Support (range .30 to .41). Reliability of MARS-12 scores was high (McDonald's ω = .97), as was temporal stability across a one-week interval (.89). The Spanish version of the MARS-12 is a valid and reliable scale that may be used by mental health professionals to assess recovery among Spanish people with serious mental illness.

Feasibility of overground exoskeleton gait training during inpatient rehabilitation after severe acquired brain injury

ABSTRACT Objective To describe the safety, feasibility, and tolerability of overground exoskeleton gait training (OEGT) integrated into clinical practice for patients after severe acquired brain injury (ABI). Setting Inpatient rehabilitation hospital. Participants Eligible patients with severe ABI met the following criteria: age > 18, medically stable, met exoskeleton frame limitations, and a score of ≤ 3 on the motor function portion of the Coma Recovery Scale – Revised (CRS-R). Presence of consciousness disorder was not exclusionary. Design Prospective observational study. Main Measures Outcomes examined safety (adverse events), feasibility (session count and barriers to session completion), and tolerability of OEGT (session metrics and heart rate). Results Ten patients with ABI completed 10.4 ± 4.8 OEGT sessions with no adverse events. Barriers to session completion included clinical focus on prioritized interventions. Sessions [median up time = 17 minutes, (IQR: 7); walk time = 13 minutes, (IQR: 9); step count = 243, (IQR: 161); device assist = 74, (IQR: 28.0)] were primarily spent in Very Light to Light heart rate intensities [89%, (IQR: 42%) and 9%, (IQR: 33%), respectively]. Conclusion OEGT incorporated into the rehabilitation plan of care during inpatient rehabilitation after severe ABI was observed to be safe, feasible, and tolerable. However, intentional steps must be taken to facilitate patient safety.

Cross-Cultural Collaborative Translation/Adaptation of Assessments Via International Working Groups

Abstract: Most neuropsychological assessments are developed in English, yet nearly 95% of the global population are not native English speakers. To further compound this problem, translating and adapting assessments is a complex, expensive, and time-consuming process that few individual psychologists can undertake on their own. To overcome these obstacles, we formed an international consulting group of bilingual pediatric rehabilitation/hospital clinicians to translate and adapt a common assessment of cognitive recovery, the Cognitive and Linguistic Scale (CALS), for use with youth in three linguistic/cultural groups: Spanish-speaking youth residing in the United States, Dutch-speaking youth residing in the Netherlands, and Hebrew-speaking youth residing in Israel. We describe the collaborative process of translating and adapting the CALS for the respective populations following the first two stages of the International Test Committee guidelines (Precondition and Test Development). We also present new, more culturally accessible versions of visual stimuli that can be used across many linguistic/cultural groups in the Western world. Initial examination of responses from a preliminary pilot sample of US youth ( N = 11) supported the acceptability of the Spanish translation and new visual stimuli. Next steps for each translated/adapted version of the CALS are discussed, including plans for validation in each respective population. We hope this overview will serve as a model for other groups to help decrease the translation burden on individual clinicians and promote higher-quality translated/adapted assessments that better serve diverse and often underserved patient populations.

An Exploration of the Physiological and Psychological Aspects of Student Anxiety Using a Greenspace Restorative Environment Based on Virtual Reality: A Controlled Experiment in Nanjing College

Psychological anxiety among college students has attracted research interest. Previous studies have shown that greenspaces play a positive role in the recovery of student health. However, limited studies have explored the benefits of restorative environmental greenspace components. Therefore, this study used virtual reality to conduct control variable experiments. Considering the terrain scene, pavement material, and green vision rate as research elements, we monitored the skin conductance level and heart rate variability of 36 college students, as well as the positive and negative affect schedule and perceptual recovery scales, and we found that terrain elements have a significant impact on perceptual recovery, while pavement material has a significant impact on physiological recovery. Significant differences in perceptual recovery scores and changes in negative emotions among the different green vision levels were also observed. According to the regression relationship, the scene’s attractiveness rating was the highest when the scene’s green vision rate was 50%, while at 48%, the positive emotional improvement was the highest, and at 40%, the negative emotional improvement was the greatest.

Monitoring the recovery-stress states of athletes: Psychometric properties of the acute recovery and stress scale and short recovery stress scale among Dutch and Flemish athletes

ABSTRACT The Acute Recovery and Stress Scale (ARSS) and the Short Recovery and Stress Scale (SRSS) are recently-introduced instruments to monitor recovery and stress processes in athletes. In this study, our aims were to replicate and extend previous psychometric assessments of the instruments, by incorporating recovery and stress dimensions into one model. Therefore, we conducted five confirmatory factor analyses (CFA) and determined structural validity, internal consistency, and construct validity. Dutch and Flemish athletes (N = 385, 213 females, 170 males, 2 others, 21.03 ± 5.44 years) completed the translated ARSS and SRSS, the Recovery Stress Questionnaire for Athletes (RESTQ-Sport-76), the Rating of Perceived Exertion (RPE) and the Total Quality of Recovery (TQR). There was a good model fit for the replicated CFA, sub-optimal model fit for the models that incorporated recovery and stress into one model, and satisfactory internal consistency (α=.75 – .87). The correlations within and between the ARSS and SRSS, as well as between the ARSS/SRSS and the RESTQ-Sport-76 (r = .31 – -.77 for the ARSS, r = .28 – -.63 for the SRSS), the RPE (r = .19 – -.23), and the TQR (r = .63 – -.63) also supported construct validity. The combined findings support the use of the ARSS and SRSS to assess stress and recovery in sports-related research and practice.

Utility of salivary cortisol profile as a predictive biomarker in nurses' turnover risk: a preliminary study.

Predicting nurse turnover risk is crucial due to the global nursing shortage; however, existing predictors, such as fatigue and burnout, lack objectivity. Salivary cortisol is a non-invasive marker of stress and fatigue, but its utility in predicting nurse turnover risk is unknown. We examined whether salivary cortisol profiles across three different day shifts in a month are predictors of the extent of nurses' reluctance to stay in their current jobs. This preliminary longitudinal study followed forty female nurses who engaged in shift work at a university hospital for 3 months. Data at enrollment were collected including demographics, working conditions, chronic fatigue (the Japanese version of the Occupational Fatigue/Exhaustion Recovery Scale), and burnout (Japanese Burnout scale). Salivary cortisol was measured before the three different day shifts (after awakening) during the first month, and the means of these measurements were used as the cortisol profile. The extent of reluctance to stay was assessed using the numerical rating scale at 3 months. Among the forty female nurses (mean [SD] age, 28.3 [5.1]), all completed follow-up and were included in the analysis. The cortisol profile was associated with the extent of reluctance to stay (P = 0.017), and this association was significant despite adjustments for chronic fatigue and burnout (P = 0.005). A multiple regression model with chronic fatigue, burnout, and job tenure explained 41.5% of the variation in reluctance to stay. When the cortisol profile was added to this model, the association of the cortisol profile was significant (P = 0.006) with an R2 of 0.529 (ΔR2 = 0.114). This preliminary study conducted in an actual clinical setting indicated the potential of the salivary cortisol profile across three different day shifts in a month to predict nurses' reluctance to stay in their current jobs. The combination of subjective indicators and the cortisol profile would be useful in predicting nurses' turnover risk.

The effect on the incidence of rebound pain of the application of anterior suprascapular nerve block added to interscalene brachial plexus block for shoulder surgery: A randomized controlled study

This study aimed to compare the incidence of rebound pain applied with anterior suprascapular nerve block (ASSB) added to interscalene brachial plexus block (ISB) as postoperative analgesia in shoulder surgery. This prospective, observer-blinded, randomized study involved 60 patients who were to undergo shoulder surgery. The patients were divided into two groups: group ISB (n=30) received ISB block, while group ISB+ASSB (n=30) received ASSB in addition to ISB. The primary outcome was to determine the occurrence of rebound pain. Secondary outcomes were numerical rating scale (NRS) values of postoperative pain at 6, 8, 12, 16, 18, 24, and 48 hours, 48-hour opioid consumption, sleep scale for the postoperative night and subsequent 6 nights, and the quality of recovery (QoR) scale evaluated on postoperative days 1 and 7. No statistically significant difference was found between the ISB group (56.7%) and the ISB+ASSB group (40%) in the incidence of rebound pain following the resolution of peripheral nerve block (PNB) (p=0.196). The ISB+ASSB group had a significantly longer time to PNB wear off (14.77±2.07 ) compared to the ISB group (12.87±1.94) (p=0.001). The postoperative day 1 QoR-15 values were significantly better in the ISB+ASSB group (122.60±10.79) than in the ISB group (116.33±11.48) (p=0.031). Sleep evaluation on the postoperative night showed a significant difference between the groups; ISB+ASSB (3[2-3])–ISB (2[1-3]). The addition of ASSB to ISB did not have a sufficient effect with respect to the incidence of postoperative rebound pain following shoulder surgery. However, there was seen to be a positive effect on prolonging the PNB and on the QoR day 1 values.

Scoping Review on Measurement Tool for Work Fatigue

Measurement tools for assessing work fatigue are very diverse and developed according to research needs. The are several measurements that widely used to address or find out the work fatigue in industries. This research is a scoping review of “Swedish Occupational Fatigue Inventory”, “The Multidimensional Work Fatigue Inventory”, “Fatigue Severity Scale”, “Fatigue Assessment Scale”, “Short Form 36 Vitality Subscale”, and “The Occupational Fatigue Exhaustion Recovery Scale (OFER). This was reported under the guidance of PRISMA extension for Scoping Review (PRISMA-ScR). This study shows an inconsistency in use of measurement tools, even though researchers argue for practicality. The large number of studies on work fatigue allows confusion of researchers to choose a measurement tool for work fatigue that is suitable for the research population. This research helps other to describe various measurement tools of work fatigue that are often used globally. Further research can determine the measurement tool of fatigue according to needs and some considerations of advantages to be more accurate.

Training load and players’ readiness monitoring methods used in volleyball

Monitoring workloads during training and competition and players’ readiness seems to be key to increasing performance, reducing injury incidence and avoiding overtraining. We systematically reviewed the methods used to measure workloads and athletes’ readiness in volleyball to help coaches make the best decision when selecting monitoring methods. Databases Web of Science, Scopus, SPORTDiscus and PubMed were searched from inception to the 21st of February 2022. All peer-reviewed original research in English, Spanish, Portuguese and Italian, longitudinally monitoring loads and athlete readiness in indoor volleyball team settings of any level, gender and age were included. The quality of evidence was evaluated with a modified risk of bias assessment used in previous research by Castellano et al. (2014). This study has been registered in PROSPERO ID CRD42022316313. Out of 1774 records identified, 78 were screened of which 55 full texts were added for systematic review. For internal workload, the session rating of perceived exertion (sRPE) seems to be the “golden standard” used from 2010 to 2022 across all the studies. External workload has mainly been researched through quantified jumps. Even with technological advances and the introduction of microsensors in 2017, the use of video analysis is still present nowadays. Players’ readiness studies mainly used the total quality recovery scale (TQR) and wellness questionnaires in most research. New technological advances offer coaches more extensive and real-time data on external load. However, the use of the sRPE, TQR/WB, CMJ would create a monitoring system sufficient for teams at developmental stages and of a reduced cost.

Is the difference real, is the difference relevant: the minimal detectable and clinically important changes in the Montreal Cognitive Assessment

Background and aimsThe Montreal Cognitive Assessment (MoCA) is a widely used instrument for assessing cognitive function in stroke survivors. To interpret changes in MoCA scores accurately, it is crucial to consider the minimal detectable change (MDC) and minimal clinically important difference (MCID). The aim was to establish the MDC and MCID of the MoCA within 6 months after stroke. MethodsThis cohort study analysed data from the EFFECTS trial. The MoCA was administered at baseline and at 6-month follow-up. The MDC was calculated as the upper limit of the 95 % confidence interval of the standard error of the MoCA mean. The MCID was determined using anchor-based and distribution methods. The visual analogue recovery scale of the Stroke Impact Scale (SIS [primary anchor]) and Euro Quality of Life-5 Dimensions index (EQ-5D [confirmatory anchor]) were used as anchors. The distribution-based method, the Cohen benchmark effect size was chosen. ResultsIn total, 1131 (mean age [SD], 71 [10.6] years) participants were included. The mean (SD) MoCA scores at admission and 6-month follow-up were 22 (5.2) and 25 (4.2), respectively. The MDC of the MoCA was 5.1 points. The anchor method yielded the MCIDs 2 and 1.6 points for SIS and EQ-5D, respectively. Using the distribution method, the MCID for the MoCA was 1 point. ConclusionsEven a small change in MoCA scores can be important for stroke survivors; however, larger differences are required to ensure that any difference in MoCA values is a true change and is not related to the inherent variation in the test. Due to small sample sizes, the results of the anchor analysis need to be interpreted with caution.

Effect of transcranial direct current stimulation on the level of arousal in hypoglycemic ischemic encephalopathy: A case study

Abstract: The current study presents the use of transcranial direct current stimulation (tDCS) as a novel intervention for improving the level of arousal in a patient with hypoglycemic ischemic encephalopathy (HIE). HIE is a rare but potentially devastating condition that can lead to impaired consciousness, coma, and profound neurological deficits. The Coma Recovery Scale was utilized as the primary outcome measure for arousal, along with the Oral Motor Assessment Scale for the assessment of oromotor functions as a secondary outcome to assess the effectiveness of tDCS in promoting neurological recovery.

The measurement of fatigue in clinicians within hospital settings: A systematic review of measurement properties.

Medical staff fatigue leads to accidents and mistakes and puts patient safety at risk. A measure of fatigue in the workplace may help to quantify, predict, and manage fatigue. This review aimed to evaluate instruments used to measure fatigue in medical staff within hospitals. A systematic review following the JBI methodology was undertaken. A search for articles was conducted in 2021. Included articles (all validation studies) were assessed for methodological quality using the COSMIN checklist. Measurement property data was evaluated for Quality of Evidence using GRADE methodology. Ten studies representing five instruments were reviewed: Occupational Fatigue Exertion and Recovery scale (now superseded); Occupational Fatigue Exertion and Recovery scale (15-item); Multidimensional Fatigue Inventory; Need for Recovery Scale; and the Swedish Occupational Fatigue Inventory. Four instruments show promise for measuring fatigue in hospital medical staff, however, there is limited certainty in the measure property estimates. The Quality of Evidence for measurement properties for all instruments is insufficient. Further validation studies following the COSMIN standards are needed before recommendations for use can be made.

Prognosis for Recovery from a Vegetative State

The prognosis for recovery from a vegetative state (VS) remains underdeveloped.Objective. To determine the feasibility of prognosis for recovery from a vegetative state based on clinical comparison of 18- fluorodeoxyglucose-PET (18FDGPET) and MRI (SCT) data.Materials and methods. We compared and analyzed retrospectively cerebral PET and MRI (SCT) scans and relevant prognostic criteria (including revised coma recovery scale — CRS-R scores) prospectively during 6–84 months of follow-up in a cohort of 39 VS patients. All VS cases were of different etiologies, lasting for more than 2 months after brain damage (including 18 patients in chronic VS).Pairwise comparison of groups was used (significance level P0.05) and multiple comparison for three groups with a Bonferroni correction at P0.017 was employed.Results. Three patterns were identified when comparing 18FDGPET and MRI (SCT) neuro-images: pattern I — the area of functional alterations was larger than the area of structural damage, pattern II — complete matching of areas of structural and functional alterations, III — mixed pattern. Pattern I (69% of cases) was more common than patterns II (18%), and III (13%), P0.001. There were no differences in VS etiology, VC duration, CRS-R scores, patients’ gender and age between the groups of patients each falling into one of patterns. The outcome in a group with pattern I patients (all of them recovered from VS) was better than in other two groups exhibiting patterns II or III, each, P0.001. In a group of patients with pattern III the recovery was better than in pattern II (all patients remained in VS), P=0.018. The increases in the total CRS-R score values were as follows: 12,1±4,46; Me=12 (4–19), N=27 (patients with a pattern I); 0±1,54 (–2–1, Me=0, N=7 (patients with a pattern II); and 5,20±4,09/ Me=4 (1 — 10), N=5 (patients with a pattern III). Significant increases in neurological improvement were revealed in pattern I patients with non-chronic VS versus chronic VS, P=0.003.Conclusion. Clinical comparison of PET/MRI (SCT) data showed certain potential to predict patient’s recovery from VS in 87% of cases. A retrospectively confirmed favorable prognosis in patients with pattern I was established in 69% cases, unfavorable (pattern II patients) was defined in 18% cases, regardless of other prognostic criteria, including chronic VS. Therefore, the data confirms the feasibility and clinical relevance of neurophysiological justification as a candidate approach for evaluating the prospect of recovering patients from VS.

A randomised controlled trial comparing quality of recovery between desflurane and isoflurane inhalation anaesthesia in patients undergoing ophthalmological surgery at a tertiary hospital in South Africa (DIQoR trial)

BackgroundThe patient's experience of their postoperative recovery is an important perioperative outcome, with the 15-item quality of recovery scale (QoR-15) recommended as a standardised outcomes measure. Desflurane has a faster emergence from anaesthesia compared with other volatile anaesthetics, but it is uncertain whether this translates to better subjective quality of recovery. The hypothesis for this study is that patients receiving desflurane for maintenance of anaesthesia would have better postoperative quality of recovery than patients receiving isoflurane. MethodsMale and female adult patients undergoing ophthalmological surgery under general anaesthesia were randomly allocated to receive desflurane or isoflurane for maintenance of anaesthesia. The primary outcome was to compare postoperative QoR-15 scores. Secondary outcomes included comparing preoperative QoR-15 scores, volatile agent consumption, and time spent in the recovery room. ResultsData from 164 patients were analysed (80 desflurane, 84 isoflurane). Median (Q1, Q3) postoperative QoR-15 scores were not significantly different (desflurane: 145 [141, 148], isoflurane: 144 [139, 147], 95% confidence interval 0–3, P=0.176, minimal clinically important difference=8). Median (Q1, Q3) volatile agent consumption was 15.4 (12.5, 19.3) ml hr−1 in the desflurane group, and 7.4 (5.9, 9.7) ml hr−1 in the isoflurane group. Median (Q1, Q3) time spent in the recovery room was significantly shorter in the desflurane group (desflurane: 18 [13, 23]; isoflurane: 25 [19, 32], 95% confidence interval −10 to 5, P<0.001). ConclusionsThis study found no difference in quality of recovery between patients who received desflurane or isoflurane for maintenance of general anaesthesia during ophthalmological surgery. A shorter time in the recovery room was not associated with improved QoR-15 scores. Clinical trial registrationNCT04188314.

Analyzing robotic surgery impact on recovery quality & emotions

BackgroundThe objective of this study is to investigate the postoperative recovery quality and emotional status of patients with non-small cell lung cancer (NSCLC) who underwent robot-assisted and video-assisted thoracoscopic surgery using the 15-item Quality of Recovery (QoR-15) scale and to analyze the correlation. MethodsWe collected clinical data from 320 patients with NSCLC who underwent lobectomy using either robot-assisted thoracoscopic surgery (RATS) or video-assisted thoracoscopic surgery (VATS) at our center from January 2021 to December 2022. We compared perioperative parameters and followed up after the operation using the QoR-15 scale to objectively assess the quality of postoperative recovery and physical and emotional status. ResultsApart from a notable distinction in anesthesia time, no significant differences were observed in other general data. Notably, the overall recovery rate for patients in the RATS group surpassed that of the VATS group (P < 0.05). Specifically, the recovery rates in the RATS group were significantly superior to those in the VATS group across nociceptive factors, emotional factors, activities of daily living, physiological factors, and cognitive ability (P < 0.05). Spearman correlation analysis between surgical methods and various indicators of the QoR-15 scale showed significant correlations between surgical methods (P < 0.05). ConclusionThe QoR-15 scale is a valuable tool for assessing the postoperative recovery quality in lung cancer patients. The RATS plays a significant role in promoting the swift postoperative recovery of patients and demonstrates excellent efficacy, safety, and reliability.

Deep neuromuscular blocking and sugammadex reversing-drug is an efficient strategy permitting successful laparoscopic surgery under low insufflation pressure: Prospective multicenter study

ABSTRACT Objectives To compare using deep neuromuscular blockade during low abdominal insufflation pressure (DNMB/LAIP; n = 67) to conventional blockade and pressure (CNMB/CAIP; n = 68) for laparoscopic cholecystectomy and to evaluate the speed and efficacy of NMB recovery using sugammadex (SGX) as assessed by the Postoperative Quality Recovery Scale. Patients & Methods Rocuronium initiation and maintenance doses were 0.6 and 0.15 mg/Kg, respectively, and neostigmine or SGX was used as reverse agent for CNMB and DNMB, respectively. Abdominal insufflation was terminated at 15 and 8-mmHg, for CAIP and LAIP, respectively. The study outcome is the surgical feasibility under DNMB/LAIP, as judged by the frequency of shift-to-CAIP, surgical field visibility and operative time. Results The frequency of shift-to-CAIP was 2.9% due to surgeons’ inconvenience of LAIP. DNMB allowed significant control of intraoperative (IO) hemodynamic response to surgical manipulations. SGX allowed 3.2 times faster NMB-reversal with significantly higher percentages of patients returned to baseline physiologic statuses. The percentage of patients free of pain and nausea was significantly higher after DNMB/LAIP. At hospital discharge and day-7 PO, 86.6% and 98.5% of patients regained normalcy of their overall perspectives after DNMB/LAIP with a significant difference than after CNMB/CIAP. At 2-week PO, the frequency of shoulder-tip pain (STP) was significantly lower and surgeons’ satisfaction rate was significantly with DNMB/LAIP. Conclusion Laparoscopic cholecystectomy under DNMB/LAIP procedure is feasible and safe with lower incidence and severity of STP and high surgeons’ satisfaction. Sugammadex hastened the recovery of DNMB 3.2 times that of neostigmine-induced recovery of CNMB. Registration NO: RC.3.9.2023

35 Preliminary reliability of the Coma Recovery Scale, Revised (CRS-R) in children with a history of disorders of consciousness after acquired brain injury

Objective:The Coma Recovery Scale-Revised (CRS-R) is the gold standard assessment of adults with disorders of consciousness (DoC); however few studies have examined the psychometric properties of the CRS-R in pediatric populations. This study aimed to demonstrate preliminary intra-rater and inter-rater reliability of the CRS-R in children with acquired brain injury (ABI).Participants and Methods:Participants included 3 individuals (ages 10, 15, and 17 years) previously admitted to an inpatient pediatric neurorehabilitation unit with DoC after ABI who were followed in an outpatient brain injury clinic due to ongoing severe disability. ABI etiology included traumatic brain injury (TBI; n=2) and encephalitis (n=1). Study participation took place on average 4.6 years after injury (range 2-9). The Glasgow Outcome Scale-Extended, Pediatric Version (GOS-E Peds), a measure of outcome after pediatric brain injury, was administered as part of screening. Two participants were placed in the GOS-E Peds “lower severe disability” category (i.e., score of 6) and one was placed in the “upper severe disability” category (i.e., score of 5). The CRS-R includes 6 subscales measuring responsivity including Auditory (range 0-4), Visual (range 05), Motor (range 0-6), Oromotor/Verbal (range 03), Communication (range 0-2), and Arousal (range 0-3) with higher scores indicating higherlevel function. Subscales are totaled for a CRS-R Total score. Behaviors shown during the CRS-R are used to determine state of DoC [Vegetative State (VS), Minimally Conscious State (MCS) or emergence from a minimally conscious state (eMCS)] based on 2002 Aspen Guidelines. Participants were administered the CRS-R three consecutive times on the same day. Administrations were completed by two raters in this order: Rater 1 (1A), Rater 1 (1B) and Rater 2. Intra-rater reliability was deemed by percent agreement across the 6 subscales between Rater 1A and 1B. Inter-rater reliability was deemed by percent agreement across the 6 subscales between 1A and 2.Results:Mean CRS-R Total score for Rater 1A was 22 (SD=1.73, range 20-23), Rater 1B was 22 (SD=1.73, range 20-23), and Rater 2 was 21.33 (SD=2.08, range 19-23). Intra-rater reliability was 100% and inter-rater reliability was 94% across all subscales. All participants were deemed eMCS at all 3 ratings.Conclusions:Data from this very small sample of children suggests that the CRS-R demonstrates both intra-rater and inter-rater reliability in patients with a history of DoC after ABI. Given that all children were at the high end of the scale (eMCS), further research is needed with a larger sample of children with a range of states of DoC.

Effectiveness of sensory stimulation and early mobility on consciousness, mental state, RLA stage, and hospital stay in patients with Traumatic brain injury: A research protocol

TBI is the most difficult to treat and has the highest mortality and morbidity rates in ICU. The most common cause of neurological abnormalities and physical disabilities in people is traumatic brain injury (TBI). Brain injury occurs when an external force causes a change in brain function or other signs of brain pathology. TBI is a leading cause of epilepsy and is linked to a high morbidity and mortality rate. Over the last few decades, India has seen an increase in traumatic brain injury (TBI) as a result of increased transportation development, a rapidly growing construction industry, and urbanization. A total of 30 patients with traumatic brain injuries will be included in this experimental study, and they will be evenly divided into two groups. Sensory stimulation with early mobility will be delivered to Group A, while traditional physiotherapy will be given to Group B for two weeks at 40 minutes per session, two sessions per day, 5 days a week. The Coma Recovery scale, Mini-mental scale examination (MMSE), Glasgow Coma Scale (GCS), Ranchos Los Amigos scale for cognitive functioning, and length of stay in ICU will be used as outcome measures. The goal of this study is to see how early mobility exercises and sensory stimulation affect consciousness, mental state, RLA, and hospital stay when used in conjunction with physiotherapy. CTRI Reference Number CTRI/2022/07/044127

Investigating microRNAs as biomarkers in disorders of consciousness: a longitudinal multicenter study

MicroRNAs (miRNAs) are involved in gene regulation and may affect secondary brain injury and recovery in patients with disorders of consciousness (DoC). This study investigated the role of five miRNAs (150-5p, 132-3p, 23b-3p, 451a, and 16-5p) in prolonged DoC. miRNA levels were assessed in serum samples from 30 patients with unresponsive wakefulness syndrome or minimally conscious state due to traumatic or hypoxic-ischemic brain injury (TBI, HIBI) at baseline (1–3 months) and 6 months post-injury. Patients’ diagnoses were determined using the Coma Recovery Scale revised, and functional outcomes were evaluated 6 months after injury with the Glasgow Outcome Scale Extended (GOSE) and the Functional Independence Measure (FIM). Compared to healthy controls, patients with TBI had lower levels of miRNAs 150-5p, 132-3p, and 23b-3p at baseline, while patients with HIBI had lower levels of miRNA 150-5p at baseline and 6 months post-injury and a reduction of miRNA 451a at baseline. Higher levels of miRNAs 132-3p and 23b-3p were associated with better outcomes in TBI patients as indicated by GOSE and FIM scores. This study highlights distinct miRNA dysregulated patterns in patients with prolonged DoC, dependent on etiology and post-injury time, and suggests that miRNAs 132-3p and 23b-3p may serve as prognostic biomarkers.

Validity and reliability study of the quality of recovery scale in Turkish.

The aim of this study was to adapt the "Quality of Recovery-15 Scale", developed to measure the postoperative recovery quality of individuals, into Turkish by carrying out validity and reliability studies. This methodological study was conducted with a total of 150 patients who underwent surgery under general anesthesia between November 2021 and January 2022 in a training and research hospital in the Black Sea region. Data was collected from the patients through the face-to-face interview method before the operation, on the 24th and the 48th hour postoperatively. First, the linguistic validity of the scale and then the validity and reliability analyses were carried out. Construct validity, confirmatory factor, and reliability analyses were then performed. The Cronbach's alpha coefficient of the scale was 0.851. The Kaiser-Meyer-Olkin test for goodness of fit of the one-dimensional 14-item scale was 0.853 and Bartlett's test was significant. The goodness of fit values of the scale were found to be RMSEA = 0.149, CFI = 0.769, and GFI = 0.745, and they were considered acceptable levels. The eighth item was removed from the scale, which had originally consisted of 15 items, because the item correlation coefficient of this item was <0.200. The "Quality of Recovery Scale" was found to be a reliable and valid scale that can be used to measure the quality of recovery after surgery in Turkish society.