The Role Of Respiratoy Physiotherapy In Improvement Of Consious Level (GCS) And Cognitive Level (RLA-R) Score In Acquired Brain Injury Patients Admitted In Intensive Care Unit: A Comparative Study

Sachin Agarwal; Rajasekar S

doi:10.37506/c2x99j03

Authors

Sachin Agarwal Head, Department of Physiotherapy, Solanki Hospital, Alwar (Rajasthan.)
Rajasekar S Dean, Srinivas Institute of Physiotherapy, Srinivas University, Manglore (Karnatka).

DOI:

https://doi.org/10.37506/c2x99j03

Keywords:

Acquired Brain Injury, Moderate to Severe Head Injury, Respiratory Physiotherapy, Chronic Pulmonary Infection Score, Intensive Care Unit, Cognition, Conscious.

Abstract

It was accounted for ABI as damage to the brain which brings about disintegration in subjective, physical, enthusiastic and autonomous working. Acquired brain injury can occur due to injury, hypoxia, contamination, tumor, substance manhandle, degenerative neurological sickness and stroke^1,2. Serious ABI is characterized as a GCS of 3-8 after cardiopulmonary revival in a patient with an irregular computer tomography (CT) output of the head which shows haematomas, wounds, oedema, and compacted basal cisterns^3,4. The definitions gave in this passage were embraced for use in this ABI investigation.

The Glasgow Coma Scale (GCS) is used to objectively describe the extent of impaired consciousness in all types of acute medical and trauma patients. The Glasgow Coma Scale divides into three parameters: best eye response (E), best verbal response (V) and best motor response (M). The levels of response in the components of the Glasgow Coma Scale are ‘scored’ from 1, for no response, up to normal values of 4 (Eye-opening response) 5 ( Verbal response) and 6 (Motor response). The total Coma Score thus has values between three and 15, three being the worst and 15 being the highest. The score is the sum of the scores as well as the individual elements. For example, a score of 10 might be expressed as GCS10 = E3V4M3.

The Rancho Los Amigos (RLA-R) Levels of Cognitive Functioning Scale is a renowned clinical tool used to rate how people with brain injury are recovering. The ten levels of recovery noted in the scale also help to decide when a patient is ready for rehabilitation. As patients "wake up" after a head injury, they go through different levels of recovery on the Rancho Scale. Each level describes a general pattern of recovery, with a focus on cognition and behavior.

Methods: Respiratory physiotherapy procedures assists to expand lung volumes, enhance gas diffuson, reduce work of breathing, reduce MV stay of patients and induce optimum recovery. In this the respiratory physiotherapy applications involved a regimen of Positioning, Manual Hyperinflation (MH), Airway Suctioning, PNF for Respiration, Passive Limb Movement protocol and Early Mobilisation protocol.

Results: The results shows that the Conscious level (GCS) and Cognitive level (RLA-R) Score improved from at the time of admission to at the time of discharge the significance of P<.005

Conclusion: Respiratory physiotherapy managed Conscious level (GCS) and Cognitive level (RLA-R) Score improved from at the time of admission to at the time of discharge and improved the outcome of the ABI patients.

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