Factors associated with gains in performance during rehabilitation following pediatric brain injury: growth curve analysis.Am J Phys Med Rehabil 2019AJ
Predicting recovery of functional performance within pediatric rehabilitation following brain injury is important for health professionals and families, but information regarding factors associated with change in functional skills ('what the child can do') and functional independence ('what the child does') is limited. This study examined change in functional skills and independence over time in children with moderate-severe brain injury during prolonged inpatient rehabilitation.
Retrospective cohort design. Longitudinal data from N=139 children (age 1.6-20.6y), hospitalized for 115.4±72 days, were examined. Growth curve analysis was used to examine factors associated with change in the Pediatric Evaluation of Disability Inventory (functional skills and caregiver assistance, i.e. functional independence) in mobility and self-care. Typical estimates for change per hospitalization day were obtained.
Traumatic brain injury and older age at injury, but not sex, were associated with faster recovery. Length of stay was associated with rate of change in functional skills but not in functional independence, suggesting that improvement in functional independence during rehabilitation may be associated with other factors.
Identifying the factors associated with individual profiles of functional improvement can provide valuable information for clinicians and decision-makers in order to optimize performance following prolonged inpatient rehabilitation.