Functional Trajectory of Childhood Stroke in the Inpatient Rehabilitation Setting

To examine the functional outcomes of a group of infants, children, and adolescents admitted to acute inpatient rehabilitation for neurologic impairments caused by a new childhood stroke.

Retrospective cross-sectional cohort study.

A pediatric inpatient rehabilitation program in a stand-alone inpatient rehabilitation facility (IRF) located within an academic medical center.

A total of 91 patients (N=91) aged 6 months to 17.8 years were admitted to a pediatric inpatient rehabilitation program with a new diagnosis of childhood stroke.

Standard of care pediatric inpatient rehabilitation treatment.

Change in the functional independence measure in children (WeeFIM) score across inpatient rehabilitation treatment.

The 51 boys/39 girls/and 1 transgender patient were 9.6±5.7 years old with ischemic stroke (n=53) or hemorrhagic stroke (n=38). At admission, they had moderate-to-severe functional impairments (WeeFIM total score=46.5±25.5 points). Inpatient rehabilitation length of stay was 33.7±28.5 (range, 3-134) days. WeeFIM total score improved to 71.2±31.6 points at IRF discharge. Hemorrhagic (compared with ischemic) stroke was associated with higher rates of craniectomy (X²=4.6, P=.03) and older age at IRF admission (Z=1.98, P<.05). Older age was associated with higher age-corrected WeeFIM total scores at admission (F=7.9, P=.0007) and discharge (F=18.1, P<.001), but age did not affect change in WeeFIM score.

Pediatric inpatient rehabilitation results in functional improvements for new neurologic impairments caused by childhood stroke.