In his article published in articlesbase. com, Nicholson defined sensory stimulation to be simply, the impact of the environment in our minds and bodies through information acquired from the five senses: sight (visual), hearing (auditory), taste (gustatory), smell (olfactory) and touch (tactile). (2009) How it began: studies, research and methods Hospital and medical policies have been constantly reviewed to check if there is a need to implement sensory stimulation activities on comatose patients.
They have based the changes policies on critical reviews of published materials that have studied the effect of the therapy. As part of Empire Blue Cross Blue Shield Medical Policy, they mentioned that before beginning with the program, assessment is made to identify who will most benefit from the therapy. (2006) In one of the reviews conducted by Regence, they have discovered a study made by Karma and Rawat. In their study, they divided a group of pediatric patients in coma due to non-traumatic causes. Thirty kids, named the control group, received standard care without additional stimulation.
Another thirty kids, named the treatment group, did no only receive standard care, but they were given stimulation in the form of, but not limited to, rolling, position change and full range of motion exercises. This was done five times a day for two weeks. (Karma and Rawat 2006 as cited in Regence 2008) In a quasi-experimental study by Davis and Gimenez, they tried to review the effect of a structured auditory sensory stimulation programme to patients who have had severe traumatic brain injury. They identified twelve male patients, aged 17 to 55 years to be the participants of the study.
The programme started three days after the injury that lasted for 7 days. (2003) In an article written by Oh and Seo for the Journal of Clinical Nursing, they examined brain-injured patients hospitalized in South Korea. They created a sensory stimulation programme composed of auditory, visual, olfactory, gustatory, tactile and physical stimulation. They carried out the programme twice for four weeks. After four weeks, they stopped with the programme. The second phase of the intervention happened after the recession, and was carried out for 4 more weeks. (2003)
In a study made by Lombardi, Taricco, De Tanti, Telaro and Liberati from The Cochrane Database of Systematic Reviews, they made the methods vary from one or two hourly sessions a day, to shorter sessions every hour for 12-14 hours a day. (2002) In an abstract written by Su-Chen and Mei-Yung that detailed their experience as nurses in caring for comatose patients with Middle Cerebral Artery Infarction, they mentioned that they introduced and slowly integrated a multi-sensory stimulation program that varied depending on the response to the different aspects of their program.
(2009) An abstract written by Urbenjaphol, Jutpanya and Khaoropthum for the Journal of Neruroscience Nursing, a quasi-experimental research was performed to see the effect of sensory stimulation programme in the recovery of unconscious patients after traumatic brain injury. Like Karma and Rawat, they divided the patients into control and experimental groups. All five senses were targeted for the stimulation programme. Stimulation response was checked using a modified Sensory Modality Assessment and Rehabilitation Technique score, together with the Glasgow Coma Scale.
(2009) Bassampour, Zakerimoghadam, Faghihzadeh and Goudarzi, in an original article for Tums eJournals, also conducted a study for 30 comatose patients hospitalized in the ICU of Shariati and Sina hospitals. They divided them between intervention group and control group. The intervention group were given auditory stimulation twice a day for 6 days in a week and lasted for 2 weeks. The stimulation was given in a form of a recorded familiar voice that went on for 30 minutes.
To check the effectivity of the study, they measured the level of consciousness of each patient before and after the activity. Both populations used the Glasgow Coma scale for measuring level of consciousness. Aside from this, they were also measured for homodynamic symptoms. (2007) A study made by Gruner for their department concentrated on 50 patients from 16-65 years who suffered from severe brain injury. What he called to be Multimodal-Early-Onset-Stimulation lasted for an average of 10 days, although the range is from 1-30 days.
Part of the MEOS program is as follows: speech, music and sounds for acoustic stimulation; touch, pressure and temperature for tactile stimulation; pleasant smells for olfactory stimulation; food and flavors for gustatory stimulation; coloured lights for visual stimulation and body position to show Kinaesthetic and proprioceptive stimulation. The reaction to stimuli was monitored and recorded through feedback system recording, aside from Coma-Observation Scale developed in the initial stages of their examination.
(2009) Ansell and Keenan likewise conducted an experiment in trying to monitor and predict changes for slow-to-recover patients. Sensory stimulation was administered to fifty seven patients with the mean age of 29, in the course of about eight months after injury. (1989) In examining Coma Arousal Procedures, Mitchell, Bradley, Welch and Britton experimented on a group of twelve severely head-injured patients by giving them a vigorous sensory stimulation programme, whereas another twelve did not. (1990)
Another study about Intense Multi-Sensory Stimulation and its effect in comatose patients was made by Doman, Wilkinson, Dimanescu, and Pelligra. They wanted to find out the benefits of IMS in managing profound coma. Upon admission to hospital, two hundred patients with Glasgow Coma Scale score of 6 or less were included in the programme. Twenty-seven patients were seen in the duration of the first month post-injury and onset of coma. The other 173 patients were seen about after 6 months after the onset. The longest period of coma was 2 years before the therapy.
(1993) Morarty’s study of the effectiveness of Sensory Stimulation in severe brain injury tried to determine a standardized program. He conducted a randomised control trial of seventy patients admitted to The Alfred Hospital over a period of eighteen months. He divided the population in two groups. The control group received the standard occupational therapy assessment which did not involve sensory stimulation. The experimental group had sensory stimulation included in their regular occupational therapy program that went on for 30 days. (2005)