This is a recording of the live session that was hosted on September 14 and 21, 2021.

Faculty

• Craig C. DiTommaso, MD, FAAPMR
• Alan H. Weintraub, MD, FAAPMR
• Brooke Murtaugh, OTD, OTR/L, CBIST
• Amy Rosenbaum, PhD, FACRM
• Katherine O’Brien, PhD

Description
Disorders of Consciousness are complex states that may affect survivors of severe brain injury. Historically, a disorder of consciousness was thought to be indicative of a poor prognosis and precluded patients from further rehabilitation efforts. However, recent long-term outcome studies demonstrate those with traumatic DOC can achieve better functional outcomes and quality of life than previously thought. That is why it is imperative for physiatrist to understand the potential of patients in DOC. Furthermore, physiatrist equipped with the appropriate knowledge and understanding of appropriate interventions can facilitate a positive trajectory of recovery. This course will provide an overview of recently published DOC Practice Guidelines with key clinical insights into applications. Our multi-disciplinary team will address guideline-related domains of assessment, diagnosis, medical management, prognosis, and confounders to further clinical treatment for this disorder. Appropriate medical management, rehabilitation interventions, and expectations for recovery will be illustrated with clinical examples. Case studies will be utilized to demonstrate application of the guidelines and to stimulate discussions regarding best practice concepts. Physiatrists will see how clinicians in the field use real-world cases to develop a road map to recovery for the severe brain injury survivors experiencing DOC. Virtual problem-solving case studies will be provided for all attendees.

Course Objectives:
At the conclusion of this activity, attendees will be able to:

• Describe an overview of the DOC Practice Guidelines (Giacino et al. 2018).
• Describe assessment tools and strategies for accurate diagnosis of DOC.
• Identify interdisciplinary approaches to assessment and treatment of DOC.
• Define behavioral and medical confounders impacting the presentation with DOC.
• Identify common medical complications in the DOC population and describe associated signs and symptoms.
• Develop rehabilitation concepts for promoting early mobility, communication, and cognition.
• Describe long term outcomes and prognosis of prolonged DOC.
• Participate in discussion, problem solving, and plan of care development related to DOC case studies through application of appropriate assessment and intervention strategies.

Agenda

• Introduction to Day and Overview of DOC Practice Guidelines
• Quantifiable Assessments, Behavioral Interventions Related to Assessment, Diagnosis
• Medical Management, Confounding Diagnostic and Management Considerations
• Prognostication, Outcomes, and Clinical Pearls
• Interdisciplinary Approach to DOC Assessment and Care Planning
• Caregiver/Family Training: DOC Recommendations & Timing it Right
• Case Studies and Discussion 

Accreditation Statement

The American Academy of Physical Medicine and Rehabilitation is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

 

Designation of Credit

The American Academy of Physical Medicine and Rehabilitation (AAPM&R) designates this enduring material for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. 

 

Financial Disclosures

AAPM&R requires all individuals who are in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest, which is any entity producing, marketing, re-selling or distributing health care goods or services consumed by, or used on, patients. Disclosures are made in written form prior to the start of the educational activity and any potential conflicts of interest that exist are resolved prior to the start of the activity through AAPM&R’s Conflict of Interest Disclosure and Resolution Policy Process. Individuals in a position to control content and their disclosed financial relationships are listed below.

 

Moderator

John C. Cianca, MD: Disclosed no relevant financial relationships.

 

Faculty

Katharine E. Alter, MD: Disclosed no relevant financial relationships.

D. Casey Kerrigan, MD: Ownership of OESH Shoes

David C. Morgenroth, MD: Disclosed no relevant financial relationships.

James K. Richardson, MD: Disclosed no relevant financial relationships.

 

AAPM&R Medical Education Committee

John C. Cianca, MD: Ownership or partnership with Musculoskeletal Ultrasound Consultants, LLC.

Karen P. Barr, MD: Disclosed no relevant financial relationships.

Anna-Christina Bevelaqua, MD: Disclosed no relevant financial relationships.

Rachel A. Brakke Holman, MD: Disclosed no relevant financial relationships.

Joseph E. Burris, MD: Serves on the Speakers Bureau for, and received clinical research grants from Allergan.

David S. Cheng, MD: Disclosed no relevant financial relationships.

Theresa A. Gillis, MD: Disclosed no relevant financial relationships.

Kevin N. Hakimi, MD: Disclosed no relevant financial relationships.

Rita G. Hamilton, DO: Disclosed no relevant financial relationships.

Scott E. Klass, MD, MS, ATCR: Disclosed no relevant financial relationships.

Chaitanya R. Konda, DO: Disclosed no relevant financial relationships.

Sam Mayer, MD: Royalties from Demos Medical Publishing.

Ameet S. Nagpal, MD MS MEd: Disclosed no relevant financial relationships.

Sunil Sabharwal, MD: Royalities from Demos Publishing; board member, American Board of Physical Medicine and Rehabilitation.

 

AAPM&R CME Committee

Karen P. Barr, MD: Disclosed no relevant financial relationships.

Cherry C. Junn, MD: Disclosed no relevant financial relationships.

Sheryl R. Levin, MD: Disclosed no relevant financial relationships.

Kentaro Onishi, DO: Disclosed no relevant financial relationships.

Evan R. Peck, MD: Disclosed no relevant financial relationships.

Cynthia G. Pineda, MD: Disclosed no relevant financial relationships.

Patricia T. Tan, MD: Disclosed no relevant financial relationships.

Brionn K. Tonkin, MD: Disclosed no relevant financial relationships.

Kristin A. Wong, MD: Disclosed no relevant financial relationships.

 

No other planners, faculty or other individuals in control of content disclosed any relevant financial relationships.

 

FDA Disclosures

All faculty members for this activity have disclosed they do not intend to discuss or demonstrate any pharmaceutical or medical device for which FDA clearance has not been approved.