Rehabilitation Interventions for an Individual With Disorders of Consciousness in the Acute Care Setting: A Case Report

Background and Purpose: Rehabilitation of individuals with disorders of consciousness in the acute care setting is poorly described, limiting rehabilitation practitioners' understanding of real-world intervention patterns and clinical decision making. This case report describes rehabilitation therapy sessions for an individual with disorders of consciousness and illustrates how these interventions align with the World Health Organization's International Classification of Functioning, Disability, and Health framework. Case Description: An adult male with an acquired brain injury resulting in disorders of consciousness received occupational and physical therapy as part of standard care in a Level I trauma center. Nine therapy sessions were observed during a period of clinical progression toward emergence from the minimally conscious state. Sessions involved four rehabilitation practitioners (three occupational therapists and one physical therapist), with the patient's care partner present at the start of each session. Outcomes: Audio recordings, deidentified transcripts, and fieldnotes were used to describe session characteristics and interventions. Observed interventions were categorized across International Classification of Functioning, Disability, and Health domains (body structures and functions, activities, participation, and environmental factors). Session duration and intervention distribution were documented. No standardized assessments observed during the nine sessions. Discussion and Conclusion: Interventions predominantly addressed body structures and functions, with frequent adaptations to accommodate medical complexity, environmental constraints, and patient preferences. This case highlights the responsive and context-sensitive nature of acute care rehabilitation for individuals with disorders of consciousness. The detailed description of interventions and rehabilitation practitioner adaptations provides educational value for rehabilitation practitioners in acute care and may inform future assessment strategies, clinical decision-making support, and intervention development.