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Updated: May 22, 2026
Detecting Behavioral Deficits in Rats After Traumatic Brain Injury
Published on: January 30, 2018
Examining acute rehabilitation outcomes for children with total functional dependence after traumatic brain injury: a
Megan E Kramer1, Stacy J Suskauer, James R Christensen
1Kennedy Krieger Institute, Baltimore, Maryland (Drs Kramer, Suskauer, Christensen, Trovato, and Salorio and Mrs DeMatt); and Departments of Psychiatry and Behavioral Sciences (Drs Salorio and Slomine), Physical Medicine and Rehabilitation (Drs Suskauer, Christensen, Trovato, Salorio, and Slomine), and Pediatrics (Drs Suskauer and Christensen), Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
Children with severe traumatic brain injury (TBI) can improve functioning after inpatient rehabilitation. Early assessment of functional status aids in predicting outcomes for pediatric TBI patients.
Area of Science:
- Pediatric rehabilitation
- Neuroscience
- Clinical outcomes
Background:
- Severe traumatic brain injury (TBI) in children can result in profound functional deficits.
- Children with the lowest functional skills at rehabilitation admission present a unique challenge for recovery.
- Understanding factors influencing functional outcomes is crucial for optimizing care.
Purpose of the Study:
- To identify factors associated with functional outcomes in children with severe TBI.
- To examine outcomes at discharge and 3-month follow-up.
- To investigate predictors of functional recovery in a pilot cohort.
Main Methods:
- Retrospective review of clinical data from 39 children and adolescents (3-18 years) with severe TBI.
- Participants had the lowest possible functional rating (Functional Independence Measure for Children score = 18) at admission.
- Data included initial injury severity and time-based metrics.
Main Results:
- At discharge, 59% were partially dependent and 41% fully dependent for basic activities.
- Initial Glasgow Coma Scale score, time to follow commands, and time to rehabilitation admission predicted discharge function.
- Time to follow commands and time to rehabilitation admission also predicted 3-month follow-up function.
- Early functional changes in rehabilitation correlated with later outcomes.
Conclusions:
- Children with severe TBI and complete dependence at admission can achieve significant functional gains.
- Functional improvements are possible by discharge and continue in the subsequent months.
- Early functional status assessment is a valuable predictor of long-term outcomes in pediatric TBI rehabilitation.
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.
