Multimodal early onset stimulation (MEOS) in rehabilitation after brain injury

Abstract

An early and consistent administration of the correct rehabilitation programme is of crucial importance for the restoration and improvement of cerebral function, as well as social reintegration. This has led to the development of a multimodal onset stimulation therapy (MEOS), which the neurosurgical intensive care unit administers during an early phase of rehabilitation to patients who have been in a coma for more than 48 hours after trauma. This study, which was carried out over a period of 2 years, focuses on 89 patients aged 16-65 years suffering from severe brain injury. Sixteen of these (age mean: 43.6 years) fulfil the criteria required to start the MEOS. The authors were able to identify significant changes in two of the patients' vegetative parameters (viz. heart and respiratory frequencies), even in cases of deep coma (GCS 3-4). The most significant changes were caused by tactile and acoustic stimulation. Standardized behavioural assessment turned out to be particularly advisable in cases of medium coma. Here, too, a stimulation of the tactile and acoustic senses resulted mainly in head and eye movements.