The SSAM was developed as a tool for measuring the senses of an unconscious patient over a long period of time. It is intended to assist in treatment planning and to address the demands of scientific research.
15
30 minutes
Initially reviewed by Erin Donnelly, PT, MSPT, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 8/2012
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit:
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Abbreviations: |
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HR |
Highly Recommend |
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R |
Recommend |
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LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations based on level of care in which the assessment is taken:
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Acute Care |
Inpatient Rehabilitation |
Skilled Nursing Facility |
Outpatient Rehabilitation |
Home Health |
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TBI EDGE |
NR |
LS |
LS |
NR |
LS |
Recommendations for use based on ambulatory status after brain injury:
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Completely Independent |
Mildly dependant |
Moderately Dependant |
Severely Dependant |
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TBI EDGE |
N/A |
N/A |
N/A |
N/A |
Recommendations for entry-level physical therapy education and use in research:
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Students should learn to administer this tool? (Y/N) |
Students should be exposed to tool? (Y/N) |
Appropriate for use in intervention research studies? (Y/N) |
Is additional research warranted for this tool (Y/N) |
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TBI EDGE |
No |
No |
No |
Not reported |
According to the American Congress of Rehabilitation review of outcome measures, the expert panel concluded that the SSAM has well-defined administration and scoring procedures that facilitate consistent use (Seel et al, 2010). Overall, they recommend that the SSAM may be used to assess DOC with moderate reservations, because of concerns about possible bias in determining reliability (unblended assessors). This recommendation is supported by expert consensus that the SSAM has acceptable content validity and acceptable standardized administration and scoring procedures.
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Traumatic Brain Injury, Anoxia, and Aneurym: (Rader and Ellis, 1994; n= 20; mean age= 31 (range 16-59); average time post injury= 12.4 months (range2-33 months))
Traumatic Brain Injury, Anoxia, and Aneurym: (Rader and Ellis, 1994)
Traumatic Brain Injury: (Rader and Ellis, 1994)
Traumatic Brain Injury: (Davis and Gimenez, 2003; n=12 individuals with severe TBI who were 3 or more days post injury with stable ICP and Rancho Level I-III, mean age 30, GCS 5.5 for intervention group (n=9), GCS 6 for control group (n=3))
Traumatic Brain Injury: (Rader and Ellis, 1994)
American Congress of Rehabilitation Medicine, Brain Injury-Interdisciplinary Special Interest Group, Disorders of Consciousness Task Force, Seel, R.T., Sherer, M., Whyte, J., Katz, D.I., Giacino, J.T., Rosenbaum, A.M., Hammond, F.M., Kalmar, K., Pape, T.L., Zafonte, R., Biester, R.C., Kaelin, D., Kean, J., & Zasler, N. (2010). "Assessment scales for disorders of consciousness: evidence-based recommendations for clinical practice and research." Arch Phys Med Rehabil 91(12): 1795-1813.
Davis, A. E., & Gimenez, A. (2003). "Cognitive-behavioral recovery in comatose patients following auditory sensory stimulation." J Neurosci Nurs 35(4): 202-209, 214.
Rader, M. A., & Ellis, D. W. (1994). "The Sensory Stimulation Assessment Measure (SSAM): a tool for early evaluation of severely brain-injured patients." Brain Inj 8(4): 309-321.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.