MOTOR PROFILE OF PATIENTS IN MINIMALLY RESPONSIVE AND PERSISTENT VEGETATIVE STATES

The purpose of this descriptive clinical study is to document the moto r characteristics of patients in minimally responsive and persistent v egetative states. Twelve subjects, presenting a prolonged altered stat e of consciousness (x=7 . 82 years, range 2-27), aged 27-78 years (x=5 0, SD=15 . 26) were evaluated, using standardized protocols, on the fo llowing variables: passive range of motion, observed movements, reflex es, tonus, postural status and reactions. The subjects' level of aware ness and responsivity were measured with the Coma/Near Coma (CNC) scal e at each of the three data collection sessions. While group CNC score s were stable over the three sessions, fluctations in the level of awa reness of individual subjects was recorded, confirming the heterogenei ty of this clientele. Abnormal primitive reflexes were present in all subjects, with the flexor withdrawal (75%), the tonic labyrinthine (36 %) and the body-on-body righting reaction (25%) being the most frequen tly observed. All subjects presented altered tonus, considerable postu ring and varied degrees of reduced range of joint motion. A range of a bnormal (e.g. chewing, clonus) and normal patterned (e.g. bridging, sc ratching) movement behaviours was recorded, bur these did not translat e into functional use, such as rolling. Collectively, the findings str ess the complexity of the motor profile of patients in minimally respo nsive and vegetative states, and suggest the need for physiotherapists to become more actively involved in the evaluation and treatment of t his clientele.