Examining acute rehabilitation outcomes for children with total functional dependence after traumatic brain injury: A pilot study

Research output: Contribution to journalArticle

Abstract

OBJECTIVE:: To examine in a pilot cohort factors associated with functional outcome at discharge and 3-month follow-up after discharge from inpatient rehabilitation in children with severe traumatic brain injury (TBI) who entered rehabilitation with the lowest level of functional skills. PARTICIPANTS:: Thirty-nine children and adolescents (3-18 years old) who sustained a severe TBI and had the lowest possible rating at rehabilitation admission on the Functional Independence Measure for Children (total score = 18). METHODS:: Retrospective review of data collected as part of routine clinical care. RESULTS:: At discharge, 59% of the children were partially dependent for basic activities, while 41% remained dependent for basic activities. Initial Glasgow Coma Scale score, time to follow commands, and time from injury to rehabilitation admission were correlated with functional status at discharge. Time to follow commands and time from injury to rehabilitation admission were correlated with functional status at 3-month follow-up. Changes in functional status during the first few weeks of admission were associated with functional status at discharge and follow-up. CONCLUSIONS:: Even children with the most severe brain injuries, who enter rehabilitation completely dependent for all daily activities, have the potential to make significant gains in functioning by discharge and in the following few months. Assessment of functional status early in the course of rehabilitation contributes to the ability to predict outcome from severe TBI.

Original languageEnglish (US)
Pages (from-to)361-370
Number of pages10
JournalJournal of Head Trauma Rehabilitation
Volume28
Issue number5
DOIs
StatePublished - Sep 2013

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Brain Injuries
Rehabilitation
Wounds and Injuries
Glasgow Coma Scale
Inpatients

Keywords

  • children and adolescents
  • functional independence measure
  • outcome
  • rehabilitation
  • traumatic brain injury

ASJC Scopus subject areas

  • Rehabilitation
  • Clinical Neurology
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

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title = "Examining acute rehabilitation outcomes for children with total functional dependence after traumatic brain injury: A pilot study",
abstract = "OBJECTIVE:: To examine in a pilot cohort factors associated with functional outcome at discharge and 3-month follow-up after discharge from inpatient rehabilitation in children with severe traumatic brain injury (TBI) who entered rehabilitation with the lowest level of functional skills. PARTICIPANTS:: Thirty-nine children and adolescents (3-18 years old) who sustained a severe TBI and had the lowest possible rating at rehabilitation admission on the Functional Independence Measure for Children (total score = 18). METHODS:: Retrospective review of data collected as part of routine clinical care. RESULTS:: At discharge, 59% of the children were partially dependent for basic activities, while 41% remained dependent for basic activities. Initial Glasgow Coma Scale score, time to follow commands, and time from injury to rehabilitation admission were correlated with functional status at discharge. Time to follow commands and time from injury to rehabilitation admission were correlated with functional status at 3-month follow-up. Changes in functional status during the first few weeks of admission were associated with functional status at discharge and follow-up. CONCLUSIONS:: Even children with the most severe brain injuries, who enter rehabilitation completely dependent for all daily activities, have the potential to make significant gains in functioning by discharge and in the following few months. Assessment of functional status early in the course of rehabilitation contributes to the ability to predict outcome from severe TBI.",
keywords = "children and adolescents, functional independence measure, outcome, rehabilitation, traumatic brain injury",
author = "Kramer, {Megan E.} and Suskauer, {Stacy J.} and Christensen, {James R.} and Dematt, {Ellen J.} and Trovato, {Melissa K.} and Salorio, {Cynthia F.} and Slomine, {Beth S.}",
year = "2013",
month = "9",
doi = "10.1097/HTR.0b013e31824da031",
volume = "28",
pages = "361--370",
journal = "Journal of Head Trauma Rehabilitation",
issn = "0885-9701",
publisher = "Lippincott Williams and Wilkins",
number = "5",

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T1 - Examining acute rehabilitation outcomes for children with total functional dependence after traumatic brain injury

T2 - Journal of Head Trauma Rehabilitation

AU - Kramer,Megan E.

AU - Suskauer,Stacy J.

AU - Christensen,James R.

AU - Dematt,Ellen J.

AU - Trovato,Melissa K.

AU - Salorio,Cynthia F.

AU - Slomine,Beth S.

PY - 2013/9

Y1 - 2013/9

N2 - OBJECTIVE:: To examine in a pilot cohort factors associated with functional outcome at discharge and 3-month follow-up after discharge from inpatient rehabilitation in children with severe traumatic brain injury (TBI) who entered rehabilitation with the lowest level of functional skills. PARTICIPANTS:: Thirty-nine children and adolescents (3-18 years old) who sustained a severe TBI and had the lowest possible rating at rehabilitation admission on the Functional Independence Measure for Children (total score = 18). METHODS:: Retrospective review of data collected as part of routine clinical care. RESULTS:: At discharge, 59% of the children were partially dependent for basic activities, while 41% remained dependent for basic activities. Initial Glasgow Coma Scale score, time to follow commands, and time from injury to rehabilitation admission were correlated with functional status at discharge. Time to follow commands and time from injury to rehabilitation admission were correlated with functional status at 3-month follow-up. Changes in functional status during the first few weeks of admission were associated with functional status at discharge and follow-up. CONCLUSIONS:: Even children with the most severe brain injuries, who enter rehabilitation completely dependent for all daily activities, have the potential to make significant gains in functioning by discharge and in the following few months. Assessment of functional status early in the course of rehabilitation contributes to the ability to predict outcome from severe TBI.

AB - OBJECTIVE:: To examine in a pilot cohort factors associated with functional outcome at discharge and 3-month follow-up after discharge from inpatient rehabilitation in children with severe traumatic brain injury (TBI) who entered rehabilitation with the lowest level of functional skills. PARTICIPANTS:: Thirty-nine children and adolescents (3-18 years old) who sustained a severe TBI and had the lowest possible rating at rehabilitation admission on the Functional Independence Measure for Children (total score = 18). METHODS:: Retrospective review of data collected as part of routine clinical care. RESULTS:: At discharge, 59% of the children were partially dependent for basic activities, while 41% remained dependent for basic activities. Initial Glasgow Coma Scale score, time to follow commands, and time from injury to rehabilitation admission were correlated with functional status at discharge. Time to follow commands and time from injury to rehabilitation admission were correlated with functional status at 3-month follow-up. Changes in functional status during the first few weeks of admission were associated with functional status at discharge and follow-up. CONCLUSIONS:: Even children with the most severe brain injuries, who enter rehabilitation completely dependent for all daily activities, have the potential to make significant gains in functioning by discharge and in the following few months. Assessment of functional status early in the course of rehabilitation contributes to the ability to predict outcome from severe TBI.

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