Recovery curves for patients who have suffered very severe brain injury

Abstract

Twenty-nine patients were admitted to a study of recovery of function following very severe brain injury and contributed detailed information towards the plotting of recovery curves. The patients were followed up longitudinally for periods of up to one year two months, and comprised three cohorts: those entering the study zero to 12 months, 13-24 months and 25 plus months post injury. Every two weeks, nurses completed a structured observation schedule containing 13 scales. Also every two weeks, patients were directly observed using a time sampling technique with 12 categories of behaviour. Recovery upon entry into the study was steeper in the first three months and then slowed, but did not asymptote in the period of observation, and recovery was best for those in the zero to 12 months post injury group. An overall recovery curve from the time of injury was plotted, which showed a steeper rise in the first year, but recovery clearly continued for three or four years. Marked individual differences were noted. Most recovery related to attempts to communicate, general alertness, motor control and more normalized mood. Implications for treatment are discussed.