International Clinical Neuroscience Journal

Vol. 13 No. Continuous (2026)

Analysis of Tilt Table and Coma Arousal Therapy Synergy Benefits in Severe TBI Cases – An Institutional Experience

International Clinical Neuroscience Journal, Vol. 13 No. Continuous (2026), 10 Ordibehesht 2026 , Page 1-7
https://doi.org/10.22037/icnj.v13iContinuous.51412

Abstract

Background: Severe traumatic brain injury (sTBI) is usually associated with Diffuse Axonal Injury (DAI) leading to significant prolonged neurological impairment, coma and long-term disability. Tilt table therapy (TTT) and Coma Arousal therapy (CAT) are used to re-stimulate the Reticular activating system (RAS). Mechanistically, TTT promotes cerebral perfusion, autonomic stability, and neuroplasticity through multisensory stimulation, complementing CAT’s neural activation strategies. The combination accelerates recovery by enhancing both physiological and cognitive functions. This study aims to evaluate the effectiveness of combining TTT with CAT vs CAT alone to enhance recovery in patients with DAI.

Methods: A retrospective cohort study involving 30 sTBI patients compared outcomes between two groups: 15 patients received both TTT and CAT, while 15 received CAT alone. TTT involved daily sessions of verticalization to 60–80°, stimulating proprioceptive and vestibular pathways, while CAT focused on structured sensory stimulation to activate the reticular activating system (RAS). Outcomes were assessed using the Coma Recovery Scale-Revised (CRS-R), Glasgow Outcome Scale-Extended (GOS-E), Rancho Los Amigos Scale (RLA), Functional Independence Measure (FIM), and Disability Rating Scale (DRS).

Results: The TTT + CAT group showed significantly greater improvements across all metrics. Notably, CRS-R and FIM scores improved markedly (p<0.01), while GOS-E and RLA scores also reflected enhanced recovery (p<0.05). Although the study’s limitations include a small sample size and short follow-up, the results underscore the potential of integrated therapy in severe TBI rehabilitation. The intervention was safe, with no adverse events reported.

Conclusion: Combining TTT with CAT rather than CAT alone, significantly improves consciousness and functional outcomes in sTBI patients, offering a cost-effective, promising strategy for early rehabilitation.

Keywords:
  • Coma therapy
  • Tilt table therapy
  • Rehabilitation of Diffuse axonal injury
  • Comparative analysis
  • severe traumatic brain injury rehabilitation
  • Institutional experience

How to Cite

1.
Duraisamy J, Dineshbalan M, Balaji TS, d vinoth, Thirumurthy KS. Analysis of Tilt Table and Coma Arousal Therapy Synergy Benefits in Severe TBI Cases – An Institutional Experience. Int Clin Neurosci J [Internet]. 2026 Aug. 27 [cited 2026 Sep. 5];13(Continuous):1-7. Available from: https://journals.sbmu.ac.ir/neuroscience/article/view/51412

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