Effect of posture on levels of arousal and awareness in vegetative and minimally conscious state patients: a preliminary investigation

Moderate to severe brain injury is estimated to occur in 25 individuals per 100 000 population every year. Of these, 10–20% never fully regain consciousness but remain in a vegetative or minimally conscious state.1 Patients in the vegetative state may appear at times to be wakeful, with cycles of eye closure and eye opening resembling those of sleep and waking, but show no sign of awareness or of a functioning mind.2 In contrast, patients considered to be in a minimally conscious state are said to show inconsistent but definite evidence of awareness despite profound cognitive impairment.3 At present, the pathophysiology underlying the vegetative and minimally conscious states is unclear, a standard treatment approach is lacking, and very little has been discovered to advance rehabilitation techniques. It is widely acknowledged that active rehabilitation should begin …