Abstract for presentation at 6th World Congress on Brain Injury

The current tools for the monitoring of PTA are based on certain assumptions of PTA which again have not been fully examined empirically. This paper presents a study examining the order of recovery of orientation and memory. Twenty five patients treated in an ABI rehabilitation unit between January 2001 until January 2004 with seven days or longer of daily PTA measurement data were included in the analysis. The average rank order of recovery of each of the Westmead PTA measure items was calculated. The resulted of the rank order of recovery of items followed the pattern Date of Birth, Age, Month, Year, Time, the Face of the examiner, Picture one, Place, Picture two, Day, Name of examiner, and finally Picture three. Kendall’s W test of concordance supported a consistent pattern of rank order across these 25 subjects. Comparisons however showed that while Date of Birth recovers consistently and significantly ahead of all other Westmead items, Age, Month, Year, and Time of day, Picture one, and Face and Place recover next at similar frequency (non-significant difference between the rank order). In this sample these items can not be differentiated. Other items recover at a later point, including Picture Two and Day. The item testing Name recovers next, at about the same time as Day but after Picture two. Finally, Picture three recovers last, consistently and significantly.
The results indicate a number of interesting points; firstly there is evidence of new learning before full orientation is achieved. There is also evidence of recovery of orientation to time before place, however if items are summed, as in the previous research, then the true order of recovery is masked. The implication of these findings for the recovery of underlying cognitive processes is discussed.