{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T18:40:23Z","timestamp":1778784023168,"version":"3.51.4"},"reference-count":41,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"RISE-Marie-Slodowska-Curie of the European Commission","award":["Grant agreement 778234"],"award-info":[{"award-number":["Grant agreement 778234"]}]},{"name":"Conselleria de Educaci\u00f3n, Investigaci\u00f3n, Cultura y Deporte of Generalitat Valenciana","award":["SEJI\/2019\/017"],"award-info":[{"award-number":["SEJI\/2019\/017"]}]},{"name":"Vicerrectorado de Investigaci\u00f3n, Innovaci\u00f3n y transferencia of Universitat Polit\u00e8cnica de Val\u00e8ncia","award":["PAID-06-18"],"award-info":[{"award-number":["PAID-06-18"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Accurate estimation of the functional independence of patients with unresponsive wakefulness syndrome (UWS) is essential to adjust family and clinical expectations and plan long-term necessary resources. Although different studies have described the clinical course of these patients, they have methodological limitations that could restrict generalization of the results. This study investigates the neurobehavioral progress of 100 patients with UWS consecutively admitted to a neurorehabilitation center using systematic weekly assessments based on standardized measures, and the functional independence staging of those patients who emerged from a minimally conscious state (MCS) during the first year post-emergence. Our results showed that one year after emergence, most patients were severely dependent, although some of them showed extreme or moderate severity. Clinically meaningful functional improvement was less likely to occur in cognitively-demanding activities, such as activities of daily living and executive function. Consequently, the use of specific and staging functional independence measures, with domain-specific evaluations, are recommended to detect the functional changes that might be expected in these patients. The information provided by these instruments, together with that obtained from repeated assessments of the preserved consciousness with standardized instruments, could help clinicians to adjust expectations and plan necessary resources for this population.<\/jats:p>","DOI":"10.3390\/brainsci10120990","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T09:21:15Z","timestamp":1608110475000},"page":"990","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence"],"prefix":"10.3390","volume":"10","author":[{"given":"Jos\u00e9","family":"Olaya","sequence":"first","affiliation":[{"name":"NEURORHB, Servicio de Neurorrehabilitaci\u00f3n de Hospitales Vithas, Fundaci\u00f3n Vithas, Callosa d\u2019En Sarri\u00e0 12, 46007 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2547-8727","authenticated-orcid":false,"given":"Enrique","family":"No\u00e9","sequence":"additional","affiliation":[{"name":"NEURORHB, Servicio de Neurorrehabilitaci\u00f3n de Hospitales Vithas, Fundaci\u00f3n Vithas, Callosa d\u2019En Sarri\u00e0 12, 46007 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Dolores","family":"Navarro","sequence":"additional","affiliation":[{"name":"NEURORHB, Servicio de Neurorrehabilitaci\u00f3n de Hospitales Vithas, Fundaci\u00f3n Vithas, Callosa d\u2019En Sarri\u00e0 12, 46007 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myrtha","family":"O\u2019Valle","sequence":"additional","affiliation":[{"name":"NEURORHB, Servicio de Neurorrehabilitaci\u00f3n de Hospitales Vithas, Fundaci\u00f3n Vithas, Callosa d\u2019En Sarri\u00e0 12, 46007 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Colomer","sequence":"additional","affiliation":[{"name":"NEURORHB, Servicio de Neurorrehabilitaci\u00f3n de Hospitales Vithas, Fundaci\u00f3n Vithas, Callosa d\u2019En Sarri\u00e0 12, 46007 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bel\u00e9n","family":"Moliner","sequence":"additional","affiliation":[{"name":"NEURORHB, Servicio de Neurorrehabilitaci\u00f3n de Hospitales Vithas, Fundaci\u00f3n Vithas, Callosa d\u2019En Sarri\u00e0 12, 46007 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla","family":"Ippoliti","sequence":"additional","affiliation":[{"name":"NEURORHB, Servicio de Neurorrehabilitaci\u00f3n de Hospitales Vithas, Fundaci\u00f3n Vithas, Callosa d\u2019En Sarri\u00e0 12, 46007 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Ferri","sequence":"additional","affiliation":[{"name":"NEURORHB, Servicio de Neurorrehabilitaci\u00f3n de Hospitales Vithas, Fundaci\u00f3n Vithas, Callosa d\u2019En Sarri\u00e0 12, 46007 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anny","family":"Maza","sequence":"additional","affiliation":[{"name":"Neurorehabilitation and Brain Research Group, Instituto de Investigaci\u00f3n e Innovaci\u00f3n en Bioingenier\u00eda, Universitat Polit\u00e8cnica de Val\u00e8ncia, Camino de Vera s\/n, 46011 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Llorens","sequence":"additional","affiliation":[{"name":"NEURORHB, Servicio de Neurorrehabilitaci\u00f3n de Hospitales Vithas, Fundaci\u00f3n Vithas, Callosa d\u2019En Sarri\u00e0 12, 46007 Val\u00e8ncia, Spain"},{"name":"Neurorehabilitation and Brain Research Group, Instituto de Investigaci\u00f3n e Innovaci\u00f3n en Bioingenier\u00eda, Universitat Polit\u00e8cnica de Val\u00e8ncia, Camino de Vera s\/n, 46011 Val\u00e8ncia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"ref_1","first-page":"734","article-title":"Persistent vegetative state after brain damage","volume":"35","author":"Jennett","year":"1972","journal-title":"RN"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1136\/bmj.331.7531.1537","article-title":"Epidemiology and prognosis of coma in daytime television dramas","volume":"331","author":"Casarett","year":"2005","journal-title":"Br. 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