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Functional changes during inpatient rehabilitation for children with musculoskeletal diagnoses
Helene M Dumas1, Stephen M Haley, Barbara J Steva
1The Research Center for Children with Special Health Care Needs, Franciscan Children’s Hospital and Rehabilitation Center (H.M.D., S.M.H., B.J.S.), Boston, Mass, The Center for Rehabilitation Effectiveness (S.M.H.), Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Mass, and the University of New England Community Occupational Therapy Clinic (B.J.S.), Saco, Maine.
Insights
Children with musculoskeletal conditions showed significant functional improvements in self-care and mobility during inpatient rehabilitation. Those with traumatic injuries experienced greater gains compared to those with preexisting conditions undergoing surgery.
Area of Science:
- Pediatric Rehabilitation
- Musculoskeletal Disorders
- Functional Outcomes
Background:
- Inpatient rehabilitation is crucial for children with musculoskeletal diagnoses.
- Assessing functional changes in self-care and mobility is vital for recovery.
- The Pediatric Evaluation of Disability Inventory (PEDI) is a key assessment tool.
Purpose of the Study:
- To describe functional self-care and mobility changes in children with musculoskeletal diagnoses during inpatient rehabilitation.
- To compare outcomes between children with traumatic injuries and those with preexisting conditions.
Main Methods:
- Retrospective record review of 50 children and youth (3-20 years).
- Utilized the Pediatric Evaluation of Disability Inventory (PEDI) scales for Self-Care and Mobility.
- Paired t tests and effect-size coefficients analyzed changes from admission to discharge.
Main Results:
- Significant improvements in PEDI Self-Care and Mobility scores were observed at discharge for the total group.
- Children with traumatic injuries showed greater improvements in Self-Care and Mobility compared to postsurgical groups.
- Effect-size coefficients indicated varying degrees of change, ranging from 0.23 to 1.76.
Conclusions:
- Children with musculoskeletal diagnoses demonstrate significant functional gains during inpatient rehabilitation.
- Traumatic injuries lead to greater functional improvements than preexisting conditions requiring orthopedic surgery.
- The PEDI is a responsive tool for measuring functional changes in this pediatric population.
Purpose:
The purpose of this study was to describe functional self-care and mobility changes of children with musculoskeletal diagnoses during inpatient rehabilitation.
Methods:
A retrospective record review was completed for 50 children and youth aged three to 20 years admitted to inpatient rehabilitation after a traumatic musculoskeletal injury or after orthopedic surgery because of a preexisting musculoskeletal or neuromuscular disorder. Admission to discharge changes in summary scaled scores on the Pediatric Evaluation of Disability Inventory's (PEDI) Functional Skills and Caregiver Assistance Self-Care and Mobility scales for the total group and two diagnostic subgroups were examined using paired t tests and effect-size coefficients. Independent t tests were used to determine differences between change scores for the subgroups.
Results:
Mean PEDI Functional Skills Self-Care and Mobility scaled scores were significantly higher at discharge for the total group. For the subgroups, both Functional Skills and Caregiver Mobility scaled scores were significantly higher at discharge, but only the trauma group made a significant change in Self-Care, on the Caregiver Assistance scale. Effect-size coefficients ranged from 0.23 to 1.76. The trauma group demonstrated significantly greater changes than the postsurgical group on both scales in both domains.
Conclusions:
During inpatient rehabilitation, children with musculoskeletal diagnoses demonstrated significant functional improvements. Children with traumatic injuries made greater gains than children with preexisting conditions after orthopedic surgery. These results support the PEDI as a responsive measure of change during inpatient rehabilitation for children with musculoskeletal diagnoses.
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