Neurorecovery Program: helping patients emerge from coma
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  • Many people, including families and friends of patients, have questions about the Neurorecovery concept and what the chances are that a patient who has sustained a brain injury, and is in a coma, will eventually recover. Common questions include the history of the Neurorecovery concept, when it was established, length of the process and more specifically, how the Helen Hayes Hospital Neurorecovery Program works. I thought we would use this blog as an opportunity to better explain how the Neurorecovery Program operates and how it can improve the recovery of a patient in a coma.
    New York State developed the concept for a Neurorecovery Program in 1993. The program, a portion of the comprehensive system of brain injury rehabilitation services that was established at the same time, was specifically designed to prevent or minimize secondary complications of traumatic brain injury, which were commonly observed in comatose head injury survivors. The New York Sate Neurorecovery Program specifically serves a “patient (who) may be completely unresponsive to any stimuli or may exhibit a generalized response by reacting inconsistently and non-purposefully to stimuli in a non specific manner.” It was recognized that survivors of traumatic brain injury will often emerge from a coma within several months of the injury and that secondary complications limited and slowed recovery when the patient became able to participate in acute rehabilitation.
    Helen Hayes offers a unique multifaceted Neurorecovery Program which includes diagnostic, treatment, and educational components. In fact, the hospital is one of only a few centers offering a comprehensive Neurorecovery Program. The criteria for admission is based on the New York State Technical Advisory Committee Recommendations. Intensive rehabilitation during a 30 to 60 day period enables patients who emerge to improve more rapidly and make better progress when they are ready for acute rehabilitation. Minimizing long-term secondary complications is a major goal during the neurorecovery stay.
    An interdisciplinary care plan is developed to meet the patient’s needs including medical intervention, rehabilitation treatment and goals and case management support, and patients are re-evaluated on a weekly basis. After the first 30 days, for a patient to be eligible for an additional 30 days, the patient must have improved by six points on the JFK Coma Recovery Scale.
    The majority of patients who go through the Neurorecovery Program recover sufficiently so that they are able to move on to acute rehabilitation. During this stage, patients can regain significant functional and cognitive abilities. Recent outcome studies tell us that 95 percent of surveyed brain injury patients report being satisfied with the services they have received at Helen Hayes Hospital.
    The entire traumatic brain injury rehabilitation team at Helen Hayes Hospital remains committed to helping patients emerge from coma so that they may go on to take full advantage of the acute inpatient, outpatient and transitional programs for brain injury patients at the hospital.
    -Glenn M. Seliger, M.D.
    Director, Traumatic Brain injury Rehabilitation Services

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