• René Padilla and Anna Domina.
• René Padilla, PhD, OT/L, FAOTA, LMHP, is Executive Director of Global Engagement and Associate Professor of Occupational Therapy, Creighton University, Omaha, NE; rpadilla@creighton.edu.
• Am J Occup Ther. 2016 May 1; 70 (3): 7003180030p1-8.

ObjectiveThis systematic review evaluates the effectiveness of sensory stimulation to improve arousal and alertness of people in a coma or persistent vegetative state after traumatic brain injury (TBI).MethodDatabases searched included Medline, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews. The search was limited to outcomes studies published in English in peer-reviewed journals between 2008 and 2013.ResultsIncluded studies provide strong evidence that multimodal sensory stimulation improves arousal and enhances clinical outcomes for people in a coma or persistent vegetative state after TBI. Moderate evidence was also provided for auditory stimulation, limited evidence was provided for complex stimuli, and insufficient evidence was provided for median nerve stimulation.ConclusionInterventions should be tailored to client tolerance and premorbid preferences. Bimodal or multimodal stimulation should begin early, be frequent, and be sustained until more complex activity is possible.Copyright © 2016 by the American Occupational Therapy Association, Inc.

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