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Titre : | Assessment of Nociception and Pain in Participants in an Unresponsive or Minimally Conscious State After Acquired Brain Injury: The Relation Between the Coma Recovery ScaleRevised and the Nociception Coma ScaleRevised (2018) |
Auteurs : | Camille Chatelle ; Solveig L. Hauger ; Charlotte Martial |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 99, n° 9, 2018) |
Article en page(s) : | p. 1755-1762 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Douleur ; Évaluation de résultat (soins) ; Nociception ; Pain ; Rééducation et réadaptation |
Mots-clés: | Brain injuries ; Lésions encéphaliques ; Consciousness disorders ; Troubles de la conscience ; Outcome Assessment (Health Care) |
Résumé : |
Objectives To investigate the relation between consciousness and nociceptive responsiveness (ie, Nociception Coma ScaleRevised [NCS-R]), to examine the suitability of the NCS-R for assessing nociception in participants with disorders of consciousness (DOC), and to replicate previous findings on psychometric properties of the scale. Design Specialized DOC program. Setting Specialized DOC program and university hospitals. Participants Participants (N=85) diagnosed with DOC. Interventions Not applicable. Main Outcome Measures We prospectively assessed consciousness with the Coma Recovery ScaleRevised (CRS-R). Responses during baseline, non-noxious, and noxious stimulations were scored with the NCS-R and CRS-R oromotor and motor subscales. Results CRS-R total scores correlated with NCS-R total scores and subscores. CRS-R motor subscores correlated with NCS-R total scores and motor subscores, and CRS-R oromotor subscores correlated with NCS-R total scores as well as verbal and facial expression subscores. There was a difference between unresponsive wakefulness syndrome and minimally conscious state in the proportion of grimacing and/or crying participants during noxious conditions. We replicated previous findings on psychometric properties of the scale but found a different score as the best threshold for nociception. Conclusions We report a strong relation between the responsiveness to nociception and the level of consciousness. The NCS-R seems to be a valuable tool for assessing nociception in an efficient manner, but additional studies are needed to allow recommendations for clinical assessment of subjective pain experience. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999318302168 |