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Developing a responsive measure of change for paediatric brain injury inpatient rehabilitation
Gary M Bedell1, Stephen M Haley, Wendy J Coster
1Center for Rehabilitation Effectiveness, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA. gbedell@bu.edu
Insights
This study explored developing a responsive clinical performance measure for pediatric brain injury rehabilitation. The findings suggest the activity scales show potential for responsiveness in measuring patient progress.
Area of Science:
- Pediatric Rehabilitation
- Clinical Performance Measurement
- Neuroscience
Background:
- Developing responsive clinical performance measures is crucial for pediatric brain injury rehabilitation.
- Existing measures may not adequately capture functional changes in this population.
Purpose of the Study:
- To identify conceptual and methodological challenges in creating a responsive clinical performance measure for pediatric brain injury inpatient rehabilitation.
- To present statistical methods for evaluating the responsiveness of functional activity scales.
Main Methods:
- Retrospective chart review of 65 children (6 months to 18 years) from eight US sites (1998-1999).
- Analysis of daily and social behavioral activity scales using effect sizes and parametric/non-parametric tests.
Main Results:
- Significant improvements observed in all item and scale scores from admission to discharge (p < 0.001).
- Moderate significant correlations found between changes in activity scale scores and external change ratings.
Conclusions:
- The developed activity scales demonstrate potential responsiveness for pediatric brain injury rehabilitation.
- Future measurement development requires addressing identified conceptual and methodological issues.
Primary Objective:
To describe conceptual and methodological issues to be addressed in developing a responsive clinical performance measure for paediatric brain injury inpatient rehabilitation. Selected statistical approaches used to examine responsiveness of two functional activity scales (daily and social behavioural activity) of a prototype measure are presented to illustrate these issues.
Research Design:
Retrospective chart review.
Methods And Procedures:
Data on 65 children, aged 6 months to 18 years (X = 9.5 years) were collected during 1998 and 1999 from eight sites in the USA. Responsiveness was examined using effect sizes and a number of parametric and non-parametric tests.
Main Outcomes And Results:
Significant improvements from admission to discharge were found on all item and scale scores (p < 0.001). Moderate significant relationships were found between activity scale change scores and external ratings of change.
Conclusions:
Findings provide evidence that the activity scales have the potential to be responsive and point to issues that will need to be addressed in future measurement development.