CARE SIG Virtual Event: Recovery from Coma – Disorders of Consciousness in Acute Care
This virtual lecture provides clinicians and students with a practical, evidence-informed framework for evaluating and treating patients with disorders of consciousness (DoC) in the acute care setting. The course reviews diagnostic categories ranging from coma and unresponsive wakefulness syndrome/vegetative state to minimally conscious state and emergence from a minimally conscious state. Participants will examine patterns of recovery, prognostic uncertainty, and the importance of serial standardized behavioral assessment, with emphasis on the Coma Recovery Scale-Revised (CRS-R).
The speakers will connect foundational neuroanatomy and mechanisms of recovery with bedside clinical decision-making. Evidence for sensory stimulation, familiar and emotionally salient stimuli, music, upright positioning, mobilization, animal-assisted therapy, olfactory and tactile stimulation, communication, swallowing, tracheostomy management, and prevention of secondary complications will be summarized. Discipline-specific examples for physical therapy, occupational therapy, and speech-language pathology will be integrated throughout. Patient cases and practical implementation strategies will help learners translate course concepts into patient-centered care.
CARE SIG August Virtual Event: Recovery from Coma - Disorders of Consciousness in Acute Care
Speaker Bios:
Jessica Bombino-Elliott, PT, DPT, NCS, PhD Candidate, is an Assistant Professor in the Doctor of Physical Therapy program at Augustana University DPT-CO. She earned her Doctor of Physical Therapy degree from the University of Colorado Anschutz Medical Campus in 2011 and became an APTA board-certified Neurologic Clinical Specialist in 2016. Jessica continues to practice clinically as a Physical Therapist Specialist at the University of Colorado Hospital, where she specializes in acute care and intensive care rehabilitation with expertise in stroke, traumatic brain injury, vestibular rehabilitation, and disorders of consciousness. She is currently completing her PhD in Clinical Science at the University of Colorado Anschutz Medical Campus. Her research focuses on improving assessment and rehabilitation for individuals with disorders of consciousness, with an emphasis on translating evidence into clinical practice in acute care settings.
Kayla Butler, PT, DPT, NCS, is the Program Coordinator for the University of Colorado Cardiovascular and Pulmonary Physical Therapy Residency in Partnership with UCHealth. and board-certified Neurologic Clinical Specialist at University of Colorado Hospital. She earned her Doctor of Physical Therapy degree from Texas State University in 2011 and has over a decade of experience across acute care, critical care, inpatient rehabilitation, and outpatient neurologic practice Dr. Butler has contributed to the development and ongoing delivery of neurologic curriculum for an APTA-accredited Acute Care Residency and ICU Fellowship program and currently serves as an affiliate instructor at University of Colorado and Regis University. Her clinical and academic interests include complex critical care rehabilitation, disorders of consciousness, advanced mobility technologies, and clinician education. She is a published co-author in the Journal of Stroke and Cerebrovascular Disease and has presented her work at national and regional conferences, including the APTA Combined Sections Meeting.
Melissa Delvecchio, PT, DPT, NCS, is a board-certified Neurologic Clinical Specialist and Physical Therapist Specialist at the University of Colorado Hospital in Aurora, Colorado. She specializes in acute care neurologic rehabilitation with clinical expertise in spinal cord injury, disorders of consciousness, mobility optimization, and complex neurologic diagnoses. Melissa is an experienced educator who teaches continuing education courses, mentors Doctor of Physical Therapy students and clinicians, and is passionate about translating evidence into practical clinical application.
Course Objectives:
• Differentiate coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious state minus, minimally conscious state plus, and emergence from minimally conscious state using observable clinical features.
• Describe the role of serial standardized assessment, including the CRS-R, in identifying consciousness, monitoring change, and informing prognosis and treatment planning.
• Summarize current evidence and recommended clinical principles for arousal optimization, sensory stimulation, mobilization, and prevention of secondary complications in patients with DoC.
• Select and justify interprofessional, discipline-specific interventions that are individualized to the patient’s level of consciousness, medical stability, functional presentation, and personally salient stimuli.
• Identify practical strategies for family education, interdisciplinary communication, and longitudinal reassessment across acute care and rehabilitation settings.