The Orientation–Log (O-Log) developed by Dr. Thomas A
Novack was the instrument used in this program. The O-Log is an
assessment instrument that measures orientation in terms of place,
time and situation in the TBI patient population. Mental confusion
can be a significant barrier to independent living and participation in
rehabilitation. Measuring orientation is a way to evaluate confusion
and is useful in documenting change over time. Orientation assessment
is a component of all measures of mental status largely because it is
quick to ascertain, can be scored objectively, and is generally agreed
to be within the cognitive capacity of normal individuals [10-11]. The
objective of the instrument is to introduce a brief quantitative measure
of cognitive orientation. It has been developed for daily use at the inpatient bedside. The O-Log is a 10-item scale which is formatted for
rapid visual analysis or orientation trends that can be used to evaluate
pharmacologic and cognitive-behavioral interventions. The ten items
of the O-log are scored 0-3 depending on the response provided. Scores
for each of the ten items are summed to obtain a total score that ranges
from 0 to 30. A score of greater than 25 on two consecutive assessments
signals the beginning of continuous day-to-day memory, and is the
most important index of TBI recovery [10-11]. The O-log’s reliability
(interrater and internal consistency) has been measured across fifteen
neurorehabilitation centers. It is the standard instrument used across
the country to measure cognition in TBI patients. For individual items,
a Spearman rho interrater reliability coefficient ranges from 0.851 to
1.00. The interrater reliability to the total score was 0.993. The O-Log
internal consistency (coefficient alpha) was 0.992.