Coma Recovery Scale (Revised): Difference between revisions

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=== Reliability  ===
=== Reliability  ===


==== Test-retest Reliability ====
==== Test-retest Reliability ====


Disorder of Consciousness Presentation - TBI (Traumatic Brain Injury), CVA (Stroke), hypoxi-ischaemic Brain injury and Tumour:  
Disorder of Consciousness Presentation - TBI (Traumatic Brain Injury), CVA (Stroke), hypoxi-ischaemic Brain injury and Tumour:  


(Giacino et al, 2004)
(Giacino et al, 2004)  


n=20; mean age = 36.7 years (ranging from 17 to 57 years); mean time post injury = 57.15 days (range 22 to 169 days).
n=20; mean age = 36.7 years (ranging from 17 to 57 years); mean time post injury = 57.15 days (range 22 to 169 days).  


*Excellent test-retest reliability (Spearman fho = .94)
*Excellent test-retest reliability (Spearman fho = .94)

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Objective
[edit | edit source]

The Coma Recovery Scale [CRS-R] , also known as the JFK Coma Recovery Scale - Revised, is used to assess patients with a disorder of consciousness, commonly coma[1].

It may be used to differentiate between vegetative state (VS) and minimally conscious state (MCS)[2]. It can also be used to monitor emergence from minimally conscious state (EMCS or MCS+)[2].

Intended Population
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Traumatic Brain Injury (TBI)

Stroke (CVA)

Brain Tumour

Method of Use[edit | edit source]

The CRS consists of 23 items, grouped into 6 subscales:

  1. Auditory
  2. Visual
  3. Motor
  4. Oromotor
  5. Communication
  6. Arousal

The lowest score on each subscale represents reflexive activity, and the highest respresents behaviours mediated by cognitive input.

The total score ranges between 0 (worst) and 23 (best).

Equipment Required[edit | edit source]

  • Instruction sheet
  • Scoring sheet
  • 2 common functional objects (often a cup and a hairbrush or comb)
  • An object which produces a loud noise
  • Brightly coloured object
  • ADL items, eg. toothbrush, 'phone
  • Hand-held mirror
  • Baseball sized ball
  • Pencil
  • Tongue depressor

Available in several languages[edit | edit source]

As well as the original English version, there are French, German, Italian, Spanish, Dutch and Norwegian translations available.

Reference
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Giacino,Kalmar and Whyte [1] studied 80 patients with severe acquired brain injury. These individuals were aditted to an inpatient Coma Intervention Programme with a diagnosis of either vegetative state (VS) or minimally conscious state (MCS). They compared the CRS-R to the Disability Rating Scale (DRS), and found that the total scores showed "significant correlation" between the 2 scales, which indicates acceptable concurrent validity.

In addition, the CRS-R was able to distinguish 10 patients in an MCS who were scored as in VS by the DRS.

Evidence[edit | edit source]

Reliability[edit | edit source]

Test-retest Reliability[edit | edit source]

Disorder of Consciousness Presentation - TBI (Traumatic Brain Injury), CVA (Stroke), hypoxi-ischaemic Brain injury and Tumour:

(Giacino et al, 2004)

n=20; mean age = 36.7 years (ranging from 17 to 57 years); mean time post injury = 57.15 days (range 22 to 169 days).

  • Excellent test-retest reliability (Spearman fho = .94)

Validity[edit | edit source]

Responsiveness[edit | edit source]

Miscellaneous
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Links[edit | edit source]

A pdf of the CRS-R Administration and Scoring Guidelines:  

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. 1.0 1.1 Giacino, J. T., K. Kalmar and J. Whyte (2004). "The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility." Arch Phys Med Rehabil Dec 2004: 2020-9
  2. 2.0 2.1 Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessmentfckLRSchnakers C, Vanhaudenhuyse A, Giacino J, et al. "Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessment". BMC Neurol. 2009; 9:35.