In this video, Beth Hansen, PT, DPT, explains how rehabilitation teams assess pain, stress, and tolerance during therapy for people with disorders of consciousness.
Beth describes how therapists closely monitor vital signs, facial expressions, muscle tone, and condition‑specific pain scales to understand how a patient is responding to treatment. She explains that while therapy teams carefully watch for signs of discomfort and adjust when needed, many patients are capable of participating in intensive rehabilitation more than people often expect. This video highlights the balance between pushing recovery forward and responding compassionately to patient cues, ensuring therapy is both safe and effective.
Full-screen Title
How do you know if therapy is painful or stressful for a patient in a disorder of consciousness?
With Beth Hansen, PT, DPT
Lower Third
Beth Hansen, PT,
DPT Therapy Manager,
Spaulding Brain Injury Program Spaulding-Harvard TBI Model System
I think that we, the therapists are very mindful of the patient's response to their treatments. We monitor their vital signs. We watch their facial expressions. We use a pain scale that's specific for this patient population so that we can identify when a patient is in pain and address it. But these patients can do a lot more, I think, than anyone realizes. So we do try to push them. We do try to get them through a full intensive rehab program. There are times when we might have to back off, so if their blood pressure is dropping or it seems like they're having more of that increased muscle tone, then we might need to give them a break or reposition or relieve some pain that is there. But most of these patients are fully capable of participating fully.
Produced by the Model Systems Knowledge Translation Center (MSKTC), this story is part of the Recovering from Disorders of Consciousness Hot Topic Module. The content of this video is based on research and/or professional consensus. This content has been reviewed and approved by experts from the Traumatic Brain Injury Model System (TBIMS) centers, funded by the National Institute on Disability, Independent Living, and Rehabilitation Research, as well as experts from the Polytrauma Rehabilitation Centers (PRCs), with funding from the U.S. Department of Veterans Affairs. The content of the video has also been reviewed by individuals with TBI and/or their family members.
Disclaimer: This information is not meant to replace the advice of a medical professional. You should consult your health care provider about specific medical concerns or treatment. The contents of this video were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DPKT0009). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this video do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the federal government.
Copyright © 2026 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.
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.
