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Abstract
Disorders of consciousness: rehabilitation of pain
published in March - April 2018 - in Il Fisioterapista - issue n.2
Federico Scarponi, Giulio Tinelli

Pain can affect the attention and cognitive capacities of anyone, and probably even more so in patients affected by neurological conditions. Hence, it can interfere with the rehabilitative treatment after brain injury. Although it is still not clear to what extent patients with disorders of consciousness have a conscious experience of the unpleasantness of pain, and not just an autonomic response to harmful stimuli, the evaluation of physiological and behavioral nociceptionrelated signs is critical, especially before nursing maneuvers and physiotherapy sessions. The use of validated scales and a multiprofessional approach are mandatory in defining the presence, intensity and duration of signs, determining factors which could trigger or relieve pain, and ensuring a patient-centered treatment to optimize the rehabilitative pathway.