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Functional improvement after pediatric spinal cord injury
Ronald Allan Garcia1, Deborah Gaebler-Spira, Charles Sisung
1Department of Physical Medicine and Rehabilitation, Northwestern University Medical School, and the Rehabilitation Institute of Chicago, Illinois, USA.
Insights
Pediatric spinal cord injury rehabilitation leads to significant functional gains. Factors like injury severity and type show a trend toward greater improvement, but not consistently with rehabilitation length.
Area of Science:
- Pediatric Rehabilitation Medicine
- Neuroscience
- Clinical Outcomes Research
Background:
- Pediatric spinal cord injury (SCI) presents unique rehabilitation challenges.
- Understanding functional recovery is crucial for optimizing care.
Purpose of the Study:
- To quantify functional gain (FGain) in pediatric SCI inpatient rehabilitation.
- To explore factors influencing FGain in this population.
Main Methods:
- Retrospective chart review of 91 pediatric SCI patients (1993-1998).
- Functional status assessed using Pediatric Functional Independence Measure (WeeFIM) and Adult Functional Independence Measure (FIM).
- FGain calculated as discharge minus admission functional status.
Main Results:
- All patients demonstrated significant functional status improvements.
- FGain was not significantly correlated with age, sex, injury type, or level.
- A trend suggested higher FGain in incomplete and traumatic SCI cases.
Conclusions:
- Pediatric SCI inpatient rehabilitation effectively improves function.
- Less severe and traumatic injuries trend towards greater FGain.
- FGain is not solely dependent on rehabilitation length, indicating other influencing factors.
Objective:
To describe the functional gain (FGain) with pediatric spinal cord injury inpatient rehabilitation and to identify the relationship of various factors to FGain in pediatric spinal cord injury inpatient rehabilitation.
Design:
Retrospective chart review of a series of 91 children with spinal cord injury admitted from 1993 to 1998 in a freestanding rehabilitation hospital. Admission and discharge functional status were assessed with the Pediatric Functional Independence Measure (WeeFIM) instrument for children
Results:
Significant gains in functional status were observed in all patients. FGain was not significantly related to age, sex, length of inpatient rehabilitation, pathogenesis, or completeness or neurologic level of injury. However, there was a trend for higher FGain for patients with incomplete spinal cord injury and traumatic spinal cord injury.
Conclusions:
Functional improvement occurs with pediatric spinal cord injury inpatient rehabilitation. There is a trend for higher FGain in patients with less severe injury and traumatic injury. The lack of relationship between FGain and length of inpatient rehabilitation suggests that a variety of other factors influence the relationship between FGain and length of inpatient rehabilitation.