In this video, Beth Hansen, PT, DPT, explains why objective data is essential in rehabilitation for people with disorders of consciousness.
Beth describes how structured data tracking helps clinicians move beyond anecdotal observations to clearly measure progress, consistency, and emerging communication. By monitoring reliable behaviors—such as yes/no responses—and using standardized tools like the Coma Recovery Scale–Revised, rehabilitation teams can better understand changes in consciousness over time.
This approach allows clinicians to have clear, transparent conversations with families, support the development of communication tools, and make more informed plans for care and recovery.
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What is the role of objective data in rehab for patients with disorders of consciousness?
With Beth Hansen, PT, DPT
Lower Third
Beth Hansen, PT, DPT
Therapy Manager,
Spaulding Brain Injury Program Spaulding-Harvard TBI Model System
Having objective data is essential to our ability to give families a real picture of how their patient or loved one is progressing. Without this objective data, it's really just, oh, I saw them do this. Oh, I saw them do that. And without following it in a detailed manner that collects data, we are unable to develop a good communication tool for these folks based on what we have seen them able to do. So this data allows us to again, have an objective conversation with families. We can show them the progress or maybe the lack of progress that's being made and help them to make better plans for the future as well.
When we set up a tracking system for individual patients, we do notice and identify something that they do consistently; and then we're looking for that to happen over time. For example, the thumbs up or thumbs down. If they're doing that fairly consistently, we can ask them questions. We can ask them pretty basic yes/no questions. We can increase the complexity of the questions. And again, we're looking for do they actually do the thumbs up?
And then do they get the answer to the question correct? If we track that over time, then we know we're on the right track for developing the communication tool. And then the gold standard of assessment for this patient population is the Coma Recovery Scale - Revised. And within that, there are several subscales, and these also guide us to know where the patient is heading. So again, looking at that command following, looking at functional object use. So do they know how to use a comb? Can they demonstrate that … is a really nice example. So those things will show us over time how a patient's consciousness is progressing.
Recovering from Disorders of Consciousness follows the powerful true story of Hannah Strom, a young woman who survived a severe traumatic brain injury (TBI) and spent weeks in a disorder of consciousness. Through her journey — and the experiences of patients, families, and clinicians — this video explores how consciousness can slowly return, why early prognoses are often uncertain, and how specialized inpatient rehabilitation can change outcomes after severe brain injury.
Featuring insights from leading neurologists and rehabilitation specialists at the Spaulding‑Harvard TBI Model System, this documentary examines the science of recovery, the risks of early withdrawal of care, and the long‑term impact of evidence‑based neurorehabilitation. It also highlights the critical gaps in access to inpatient rehab for people with disorders of consciousness.
Produced by the Model Systems Knowledge Translation Center (MSKTC) and BrainLine, this story is part of the Recovering from Disorders of Consciousness Hot Topic Module.
About the author: Model Systems Knowledge Translation Center (MSKTC)
The Model Systems Knowledge Translation Center (MSKTC) is a national center operated by the American Institutes for Research® (AIR®) The MSKTC collaborates with Model System researchers to translate health information into easy to understand language and formats for people living with spinal cord injury (SCI), traumatic brain injury (TBI), and burn injury and those who support them.
