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Short-term durability and improvement of function in traumatic brain injury: a pilot study using the Paediatric
H M Dumas1, S M Haley, J P Rabin
1Franciscan Children's Hospital and Rehabilitation Center, Boston, MA 02135, USA. fchcenter@tiac.net
Insights
Children with traumatic brain injury (TBI) maintain rehabilitation gains and improve mobility and social skills within 6 months post-discharge. Further research is needed to identify factors supporting continued recovery in the community.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Clinical Outcomes
Background:
- Traumatic brain injury (TBI) significantly impacts children's functional abilities.
- Understanding functional outcomes after inpatient rehabilitation is crucial for long-term recovery.
- Short-term durability and improvement of skills post-discharge require investigation.
Purpose of the Study:
- To assess the short-term durability of functional outcomes in children and adolescents with TBI.
- To evaluate functional improvements up to 6 months after inpatient rehabilitation discharge.
- To examine changes in self-care, mobility, and social function.
Main Methods:
- Retrospective, descriptive study design.
- Analysis of data from 89 children discharged from inpatient rehabilitation, with 25 available for 6-month follow-up.
- Utilized the Paediatric Evaluation of Disability Inventory (PEDI) for functional skill assessment.
- Employed the Wilcoxon matched pairs signed rank test for statistical analysis.
Main Results:
- Most children (64-80%) maintained their functional skill levels achieved at discharge.
- Significant improvements (p < 0.05) were observed in mobility and social function domains from discharge to follow-up.
- No significant differences in outcomes were found between children with and without follow-up, except for social function at discharge.
Conclusions:
- Children with TBI tend to sustain outcomes from inpatient rehabilitation.
- Significant functional gains in mobility and social skills are achievable within 6 months of returning home.
- Further research is necessary to predict continued recovery and identify facilitators for community-based rehabilitation.
Primary Objective:
To describe the short-term durability and improvement of functional outcomes for children and adolescents with traumatic brain injury (TBI) up to 6 months after discharge from inpatient rehabilitation.
Research Design:
Retrospective, descriptive.
Methods And Procedures:
Twenty-five (28.1%) of 89 children discharged from inpatient rehabilitation were available for outpatient follow-up within 6 months. The Paediatric Evaluation of Disability Inventory (PEDI) functional skill classification levels in the domains of self-care, mobility, and social function, recorded at discharge and follow-up, were examined using the Wilcoxon matched pairs signed rank test (two-tailed).
Main Outcomes And Results:
Most (64-80%) of the children sustained the outcome level achieved at hospital discharge in one or more of the three domains. Significant differences (p < 0.05) from discharge to follow-up were detected in mobility and social function levels. Differences between children with and without follow-up were non-significant in all but one variable (social function level at hospital discharge).
Conclusions:
The results of this study suggest that children after TBI sustain outcomes achieved during inpatient rehabilitation and make significant gains in mobility and social function skills within 6 months of returning home. More research is needed to predict those children who will continue to recover and to identify factors that facilitate recovery in the community setting.