“The Vegetative State and the Minimally Conscious State are possibly the least understood and most ethically troublesome conditions in today’s medicine.”
Stefano Peca, Ph.D.
Since 2003, ARBI’s team found that existing assessment measures to assess the level of response in clients with severe brain injury were insufficient to detect changes that we normally see during clinical treatment or family reports. These measures do not adequately address functionality that is so important to improve the quality of life of these individuals. ARBI’s therapists including physiotherapists, occupational therapists and speech-language pathologists responded to this need by developing a highly sensitive assessment measure – the Comprehensive Assessment Measure for Minimally Responsive Individuals (CAMMRI).
The CAMMRI is an integrated, functional measure developed to objectively identify and track the incremental changes in adults who demonstrate minimal responsiveness to their environment (Ranchos Level II – III) as a result of severe acquired brain injury.
CAMMRI is divided into three major areas:
1. Response to the environment
2. Motor control
3. Communication and swallowing. Each area has specific sub-tests which can be used independently or as part of the overall measure. The sub-tests are:
- Response to the environment: sensory responses to the environment are assessed: visual, olfactory, auditory and arousal responses.
- Motor Control: analyzes the best motor response in head movement, upper and lower extremities.
- Communication and Swallowing: assessment of the potential of: following commands, communicating and using augmentative devices. The sub-tests included are swallowing, yes/no responses, vocalization, auditory comprehension, tactile, facial/gestural communication and augmentative/alternative communication.
The sub-tests are scored using a 7 point scale. For all items, the higher the score, the higher the level of function. The highest scores are representative of consistent and differentiated responses to command/stimuli or spontaneous/prompt responses to commands. End of intro”
Current Funding & Opportunities
We are grateful to the Dave Irwin Foundation for Brain Injury for their enduring support of this project.
Preliminary Results of the CAMMRI Pilot Project
The number of subjects involved in the pilot test was 12. While this is a small sample, it is representative of severe brain injury clients, based on the severity of the clientele.
The sample included 58% anoxic brain injury, 34% traumatic brain injury and 8% stroke.
All data was coded and entered into SPSS version 13 Intra-class correlations were used to examine inter-rater reliability. Item to item correlations and Cronbach’s Alpha was determined for each subscale.