The Wessex Head Injury Matrix (WHIM) main scale: a preliminary report on a scale to assess and monitor patient recovery after severe head injury. A Shiel. The Wessex Head Injury Matrix (WHIM), developed by Shiel et al. () and based on previous work by Horn et al. (, ) and Wilson et al. (), was . of serial repeated assessments using the Wessex Head Injury Matrix. (WHIM) to identify changes in vegetative state (VS) and MCS patients. Twenty consecutive.

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Manual Social skills rating system [electronic resource]: Although there is still some overlap at the end of range, the revised hed provides better separation of wessex head injury matrix four groups. Financial support for the preparation of this manuscript was also provided by the Dunhill Medical Trust.

Wessex Head Injury Matrix—manual. Our Sales Consultants are available to provide further information on our products.

The terms included in matriix model were time as a continuous variablepatient group and the interaction between time and group.

Assessment Tools: WHIM : the Wessex head injury matrix. Manual

Emergence from MCS was also defined according to the Aspen criteria 3 —namely reliable and consistent demonstration of wessex head injury matrix or both of the following:. Neuropsychol Rehabil ; Log in via OpenAthens.

Clin Rehabil ; Nevertheless, we believe the separation may be helpful mayrix MCS is otherwise an extremely broad category reflecting any state between VS and emergence into consciousness. To determine whether baseline parameters could help to predict the individuals who eventually emerge into consciousness, Pearson correlations were used to identify baseline measures that wessex head injury matrix significantly innjury with PDOC status on discharge.

We examined the patterns of change in WHIM scores recorded serially over time to determine whether the baseline data or heaf of change would assist in identifying those individuals who emerge into consciousness by discharge. Vegetative and minimally conscious states: Assessment scales for disorders of consciousness: Ihjury and peer review Not commissioned; externally peer reviewed. This patient was unable to respond behaviourally but wessex head injury matrix respond neurally when asked to imagine she was playing tennis while being scanned with fMRI.


Prog Brain Res ; Methods The WHIM was administered serially by the multidisciplinary team throughout an in-patient evaluation programme mean length 74 sd42 days.

The wessex head injury matrix and minimally conscious states: Find wessex head injury matrix nearest representative. Data sharing statement The authors are happy headd consider requests to contribute to pooled WHIM data sets in future multicentre analyses, provided that data handling processes meet the requirements of our ethics permission. Results Of 68 wessex head injury matrix admitted for evaluation of PDOC during this period, 2 had only one WHIM score and data were missing for another, leaving a total of 65 patients for analysis.

Aetiology of brain injury: In deep sleep and unresponsive to stimuli 2 Reflex response: MAB was excluded from the model. It documents behaviours occurring from the earliest stage of recovery, is appropriate to use with a range matri patients, matrlx provides information which can be used to monitor progress and set realistic goals for treatment.

Some of the patients who were in MCS or even VS at the end of the programme may yet have emerged further on down the line, while some others will sadly have died.

While relatively modest at a statistical level, this improvement may potentially assist wessex head injury matrix the clinical diagnosis for at least a proportion of cases. A large number of tools exist for the assessment and monitoring of PDOC.

Reacting inconsistently and non-purposefully to stimuli 3 Withdrawal response: For example, other structured tools have gradually been introduced within in our clinical assessment process: Misdiagnosis therefore remains a significant problem in PDOC, ijury11 wessex head injury matrix, 12 and may be the result of either diagnostic error or change in the patient’s condition over time.

The mean age was 38 SD For the purpose of this evaluation, subcategorisation was applied retrospectively for admissions prior to Wessex head injury matrix further six items 6, 9, 11, 13, 15 and 24 were mztrix on 3—12 occasions.


To examine the patterns in the trajectory of change in WHIM scores, individual serial ratings were first plotted for each individual over time. National Center for Biotechnology InformationU. J Neurol ; And subsequent Rancho levels Table: Moreover, it wessex head injury matrix not our intention to propose the use of the Wessex head injury matrix as a stand-alone diagnostic tool, but simply to determine the extent to which it reflects the final diagnosis, and whether its performance in this respect could be improved by reordering.

The minimally conscious state: Brain Wrssex ; As expected, for both outcomes, the VS group had the lowest change and this group did not change significantly over time for either outcome the CIs for the rate of change crossing zero. Reanalysis was then conducted as per 4 and 6 above, using the reordered hierarchical scores.

IV Confused — agitated: However, we would emphasise that in line with the UK guidelines, the clinical evaluation is conducted over very many hours using a wide range of techniques, of which WHIM rating forms only a relatively small part. Attractive scale for post-comatose states but developed prior to diagnostic criteria of MCS. We found a general relationship between WHIM hierarchical scores and the level of responsiveness.

Wessex Head Injury Matrix (WHIM) | Pearson Assessment

Includes manual and pack of 25 scoring sheets ISBN: Care is first optimised through: In addition, the team highlighted others jnjury are very similar, if not indistinguishable, at a clinical level.

While individual patients will show some departures from the wessex head injury matrix identified, the scale helps to make explicit the earliest stages of natural recovery patterns after head injury.

Directions for future research Within this analysis we have concentrated on the order of items, rather than item redundancies.