Reality Orientation Program in RLA Stage 4 Traumatic Brain Injury Patients

AIM : To find the effectiveness of Reality Orientation Program for RLA stage 4 traumatic brain injury patients. METHODS : 20 patients were recruited for the study. Of which 10 patients underwent Reality Orientation Program (ROP) and 10 underwent Conventional therapy. The patients were administered with Galveston Amnesia and Orientation Test (GOAT), Mini Mental Status Examination (MMSE), Rancho Los Amigos Scale (RLA), Glasgow Coma Scale (GCS) and Glasgow Outcome Score (GOS). The study period was for 4 weeks, two weeks given by the therapist and family members (under the supervision of therapist) in the hospital and remaining two weeks orientation was provided by the family members either in home or hospital. RESULTS : The duration of Post Traumatic Amnesia (PTA) was reduced by 10 days for the patients who received ROP. Even though the results were not statistically significant perhaps were clinically relevant (p= 0.096). Correlation between age & GCS (r=.234), age & PTA (r=.242) and GCS & PTA (r=.050) showed no positive correlation. On comparison of the MMSE scores between groups it exhibited statistical significance at the end of fourth week. Other scales did not display statistical significance. On comparison of scales within the group it revealed high statistical significance. On comparing the significance of effectiveness it was found that MMSE scores had medium effect (ηp2=.070), GCS had very low effect ηp2=.000, small effect size (ηp2=.049) for RLA, and GOAT revealed medium effect (ηp2=.087) between group. Resolution of time, place and person in experimental group had a mean of 30, 22 and 14 days respectively whereas in control group the mean was 38, 23 and 17 days. CONCLUSION : Length of PTA was shorter in the patients who received ROP. ROP included the orientation board which reduced the confusion of the therapist and burden on the family members and enabled them to participate more actively in the treatment