Evaluation methods
disorders of consciousness, coma, bipolar
COMA, UPPER LIMB
All evaluations included in the entire trial process and were performed by the same rehabilitation therapist from the Rehabilitation Evaluation Department of the Rehabilitation Medicine Department of the First Affiliated Hospital of Jinan University. The rehabilitation therapist has been engaged in PT clinical work for 6 years and was unaware of the grouping of patients and the purpose of the trial during the entire trial. After the patients were enrolled, the GCS and CRS‐R scale assessments, as well as EEG and upper limb SSEP examinations were performed before and after the trial, and then the results of the two assessments were compared and analyzed.Glasgow Scale (GCS) (Teasdale & Jennett, The coma recovery scale‐revised (CRS‐R) (Giacino et al., Electroencephalograph (EEG): The digital electroencephalograph imported from Italy was used. Electrodes were placed according to the international 10/20 system, single and bipolar leads were used for tracing, and each tracing was completed within 20 min. The EEG analysis tool of EEGLAB was used to analyze and extract the obtained patient data; mainly, the corresponding amplitude, frequency, waveform and phase data were extracted. The data obtained after analysis were classified into 5 levels according to the Hockaaday (1965) EEG grading standard for disorders of consciousness. The grading standard is as follows: Level I, normal range—the EEG waveform examined is an alpha rhythm or mainly an alpha rhythm, accompanied by a few theta waves; Level II—mild abnormality: the EEG waveform examined is based on theta waves mainly, accompanied by a few delta waves; Level III, moderately abnormal—the EEG waveform examined are delta waves, mixed with theta waves, or mainly alpha waves or delta waves, without other rhythmic activities; Level IV, severe abnormality—the examined EEG waveform consists of diffuse delta waves, accompanied by short‐term electrical resting or some channels scattered in delta waves, and the other channels with electrical resting; Level V, extremely abnormal—the examined EEG waveform consists of nearly all flat waves or no electrical brain activity.Upper limb somatosensory evoked potentials (SSEPs): The SSEPs use the electromyographic evoked potential meter produced by Oxford, UK, and are acquired by stimulating the median nerve of the wrist with a square wave with a wave width of 200 μs and a frequency of 2 times per second. Evoked potentials were recorded from points of Erb, scalp C4, C3, and neck; the reference electrode was placed at Fpz. The bandpass range was 20–2000 Hz, and the stimulus intensity was 4–10 Ma, which caused slight twitching of the thumb. The analysis time was 50 ms. The CCT (which is the latency between N13 and N20 waves) was measured. The measured evoked potential signals were stored on the computer hard disk, and then the mathematical analysis and processing software MATLAB were used to analyze and process the collected signals. The methods used mainly included coherent average and frequency domain analysis. According to the grading standard of Seel et al. (