Effect of tactile stimulation on the level of consciousness and vital signs of patients with traumatic brain injury: a quasi- experimental study

Group		Description
Experimental	Control
Step-1 Enrolment	Step-1 Enrolment	Before starting the intervention, informed and obtained signed consent from the patient's next of kin. Later, patients were recruited into an experimental (n=20) and a control group (n=20).
Step-2 Sociodemographic and clinical variables	Step-2 Sociodemographic and clinical variables	The researcher collected data related to sociodemographic and clinical variables before starting the intervention.
Step-3 Assessment of vital signs and level of consciousness.	Step-3 Assessment of vital signs and level of consciousness.	Vital signs and GCS scores were measured five minutes prior to each session over a period of three consecutive days.
Step-4 Intervention (Tactile Stimulation)	Step-4 Conservative care	Tactile stimulation was provided to patients with mild to moderate TBI, three times a day at 8am, 12pm and 4pm, for three consecutive days, with each session lasting between 15–20 minutes. It was carried out in three steps, with a 1-minute gap between each. Firstly; the hand surfaces were touched from the wrist down. Next, the shoulders and hands of the patients were touched with a soft brush. Lastly, a cotton-wisp wool applicator was used to touch the hands and forearm of patients.
Step-5 Reassessment of vital signs and level of consciousness	Step-5 Reassessment of vital signs and level of consciousness	Vital signs and GCS scores were reassessed again five minutes after each session to examine the effects of tactile stimulation.

Table 1:

Socio-demographic variables of TBI patients (N=40)

Variable	Control Group (N=20) Freq. (%)	Experimental Group (N=20) Freq. (%)	Total (N=40) Freq. (%)	p value
Age (in yrs)
18–34	10(50)	10(50)	20(50)	0.189
35–50	8(40)	4(20)	12(30)
51–65	2(10)	6(30)	8(20)
Gender
Male	18(90)	17(85)	35(87.5)	0.633
Female	2(10)	3(15)	5(12.5)
Marital status
Married	11(55)	17(85)	28(70)	0.084
Unmarried	9(45)	3(15)	12(30)
Education
No education	3(15)	4(20)	7(17.5)
Primary & Secondary	15(75)	15(75)	30(75)	0.894
Graduation	2(10)	1(5)	3(7.5)
Occupation
Homemaker	3(15)	5(25)	8(20)
Private job	11(55)	10(50)	21(52.5)	0.710
Govt. job	1(5)	2(10)	3(7.5)
Unemployed	5(25)	3(15)	8(20)
Religion
Hindu	19(95)	18(90)	37(92.5)	0.486
Muslim	1(5)	2(10)	3(7.5)
Monthly income
>50,000	5(25)	9(45)	14(35)	0.185
<50,000	15(75)	11(55)	26(65)
Family type
Nuclear	4(20)	5(25)	9(22.5)	0.705
Joint	16(80)	15(75)	31(77.5)
Accompanying member
One member	11(55)	12(60)	23(57.5)	0.749
Two members	9(45)	8(40)	17(42.5)
Time spent by family member with patient/day
0–12hrs	4(20)	5(25)	9(22.5)	0.705
12–24hrs	16(80)	15(75)	31(77.5)

* Significance Level p<0.05 (Chi square test and Fisher's exact test)

Table 2:

Clinical variables of TBI patients (N=40)

Variable	Control Group (N=20) Freq. (%)	Experimental Group (n=20) Freq. (%)	Total (n=40) Freq. (%)	p value
GCS at admission
Moderate injury (9–12)	11(55)	9(45)	20(50)	0.595
Mild injury (13–15)	9(45)	11(55)	20(50)
Cause of hospitalization
RTA	16(80)	17(85)	33(82.5)	0.677
Falls	4(20)	3(15)	7(17.5)
Type of injury
SDH	2(10)	4(20)	6(15)
EDH	2(10)	3(15)	5(12.5)	0.001*
Contusions	1(5)	10(50)	11(27.5)
Mixed	15(75)	3(15)	18(45)
Accompanying injuries
No injuries	19(95)	17(85)	36(90)	0.486
Limb fracture	1(5)	3 (15)	4(10)
Co morbidities
No	20(100)	17(85)	37(92.5)	0.231
Hypertension	-	3(15)	3(7.5)
Previous history of head injury
Yes	1(5)	2(10)	3(7.5)	0.548
No	19(95)	18(90)	37(92.5)
History of hospitalization in ICU
Yes	4(20)	6(30)	10(25)
No	16(80)	14(70)	30(75)	0.465
Medical Treatment
Antipyretics (PCM)	14(70)	17(85)	31(77.5)
Diuretics (Mannitol)	3(15)	2(10)	5(12.5)	0.475
Antiseizures	3(15)	1(5)	4(10)
Management
Conservative	9(45)	10(50)	19(47.5)
Craniotomy	4(20)	1(5)	5(12.5)
Craniectomy	4(20)	4(20)	8(20)	0.641
Cranioplasty	2(10)	4(20)	6(15)
Hemicraniectomy	1(5)	1(5)	2(5)

GCS- Glasgow Coma Scale; RTA- Road Traffic Accident; SDH- Subdural Haemorrhage; EDH- Extradural Haemorrhage

* Significance Level (p<0.05), Chi- square test and Fisher's exact test

Table 3:

Between group comparison of vital signs and GCS on Day1, Day2 and Day3 (N=40)

Variable	Baseline		p value	After Intervention		p value
Variable	Control Group (n=20) Mean Rank	Exp. Group (n=20) Mean Rank	p value	Control Group (n=20) Mean Rank	Exp. Group (n=20) Mean Rank	p value
SBP
Day1	21.33	19.68	0.654	22.73	18.28	0.228
Day2	19.53	21.48	0.597	17.73	23.25	0.136
Day3	19.25	21.45	0.606	19.68	21.33	0.655
DBP
Day1	22.00	19.00	0.417	20.65	20.35	0.935
Day2	21.33	19.68	0.655	21.05	19.95	0.777
Day3	19.50	21.50	0.587	20.10	20.90	0.888
TEMP
Day1	20.28	20.73	0.890	20.65	21.00	0.747
Day2	19.00	22.00	0.317	21.05	22.15	0.370
Day3	19.00	22.00	0.262	20.10	23.68	0.85
PULSE
Day1	22.28	18.73	0.336	22.15	18.85	0.370
Day2	23.28	17.73	0.133	23.13	17.73	0.133
Day3	23.38	17.64	0.119	23.68	17.33	0.085
RESP
Day1	23.68	17.34	0.072	23.80	17.20	0.61
Day2	22.15	18.85	0.340	23.13	17.88	0.155
Day3	23.40	17.60	0.95	21.80	19.20	0.455
SPO2
Day1	21.43	19.58	0.594	19.98	21.03	0.762
Day2	22.08	18.93	0.370	17.75	23.25	0.136
Day3	20.20	20.20	0.862	20.20	21.33	0.133
GCS
Day1	21.25	19.75	0.676	21.60	19.40	0.541
Day2	21.35	19.65	0.635	20.78	20.23	0.879
Day 3	20.03	20.98	0.793	18.58	22.43	0.290

[i] SBP- Systolic Blood Pressure; DBP- Diastolic Blood Pressure, GCS- Glasgow Coma Scale*Significance Level p<0.05 (Mann- Whitney U Test)**

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DOI: https://doi.org/10.62838/jccm-2026-0032 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809

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Language: English

Page range: 351 - 358

Submitted on: Jun 24, 2025

Accepted on: Jun 9, 2026

Published on: Jul 27, 2026

Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

Traumatic brain injury,

tactile stimulation,

level of consciousness,

Related subjects:

Internal medicine, other,

Surgery,

Surgery, other,

Anaesthesiology,

Emergency medicine and intensive-care medicine

© 2026 Richa Bhogal, Nimarta Rana, Nipin Kalal, Khina Sharma, Suryanarayanan Bhaskar, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 12 (2026): Issue 3 (July 2026)