How to reduce disability after “vegetative” awake The follow-up visits to some patients after coma and wake-up call are very painful. Many patients are conscious and can speak or move their limbs in a simple way, but they are still bedridden due to the lack of rehabilitation in the early stage and the late stage of rehabilitation. This seriously affects the life of the patient and increases the burden of care for the family. When the patient is awake, he lives without dignity and cannot get out of bed, which becomes a long-term burden for the family. How to make the function of the patient’s limbs less affected after waking up? First of all, we mention the importance of early rehabilitation, because our wake-up center treats patients who have been in coma for a long time (a few years or even a year), so many patients come to our center with serious deformities in their joints, such as foot drop, inversion deformity, flexion deformity of the elbow joint and hooked wrist. Our philosophy is that rehabilitation starts in the care unit, but the current situation in China is that in the neurological intensive care unit, doctors focus more on surviving and treating the brain, while neglecting the rehabilitation of the limbs, resulting in serious deformities of the limbs. Second, talk about the truth that the patient is still unable to move after the promotion of waking up. The degree and location of brain injury determines the level of muscle tone, and the high muscle tone is more obvious in the early stage of the disease, which, together with the lack of early rehabilitation, leads to joint deformation. However, as the patient gradually wakes up, the muscle tone has gradually decreased, but the deformed joints and contracted tendons have made the patient lose the function of limb movement and can only lie awake in bed, even unable to turn over. The limbs that could be partially moved became “paralyzed in bed all the time” in the eyes of the family members, and sometimes they complained that the effect of our wake-up call was not satisfactory, and that the patient had changed from a vegetative person to a waking “disabled person”. The truth is that after the patient is awake, some of the preserved limb functions are submerged under the surface due to the delayed rehabilitation. Here I give a very obvious example of a male, 14 years old, a child boy. The patient has been in a coma for 7 months and has not received any professional rehabilitation treatment, but his parents have simply taken the body or broken the joints of the patient. But how can this degree of joint deformation be better rehabilitated after waking up? It is very difficult for the child to return to a normal life, because the child is only a teenager, which will cause great difficulties for the child and also increase the burden of the patient’s family. In conjunction with orthopedic specialists in Beijing, we evaluated the degree of muscle tone and joint deformity in all patients treated in Beijing for prolonged coma. Along with active wake-up promotion treatment, it is important to pay attention to the patient’s increased muscle tone, which leads to joint deformities, and to correct them in a timely manner. First, for milder deformities we apply braces for orthosis to gradually restore the normal ankle curvature and structure so that the patient can occupy the bed and perform basic walking training. Second, if the patient has a more severe deformity that cannot be orthopedically corrected by bracing, the contracted Achilles tendon can be lengthened and externally fixed to gradually elongate the Achilles tendon, and the ankle can be orthopedically corrected to a normal position within 1-2 months. The benefit of this surgical orthosis is that it can correct deformities in all directions of the ankle joint, such as ptosis or inversion. In conclusion, the goal of treatment is to promote wakefulness and active functional rehabilitation, so that the patient can live with dignity in the future. It is hoped that the patient will not only be able to wake up, but will also be able to stand up and even walk in the future, instead of being bedridden forever. We hope to minimize the degree of disability of each patient after waking up, reduce the burden of care for family members, and enable some patients to take care of themselves or even return to society as much as possible.