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New Jersey researchers link admission scores with recovery patterns in pediatric brain injury

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Submitted by nmiller on Mon, 01/07/2019 - 16:14

The study by researchers at Kessler Foundation and Children’ Specialized Hospital is the first to examine the level of functional independence at admission as a predictor of gains during inpatient pediatric rehabilitation for acquired brain injury

East Hanover, NJ. January 07, 2019. A recent article by a team of New Jersey researchers. The article, "The evidence of admission functional independence on early recovery in pediatric traumatic and nontraumatic brain injury" was published in a special issue of the Journal of Head Trauma Rehabilitation (2018 Nov/Dec;33(6):E11-E18. doi: 10.1097/HTR.0000000000000374). The study is the first to examine the child’s level of function at admission as a predictor of gains during inpatient rehabilitation for brain injury. The findings underscore the differences in TBI recovery patterns between adult and pediatric populations.

This retrospective study, which focused on outcomes of pediatric inpatient rehabilitation for acquired brain injury, including traumatic (TBI) and nontraumatic (nTBI), revealed the level of function at time of admission to be an important predictor of recovery. This study is the first in more than a decade to examine the differential gains between TBI and nTBI. The authors are Cherylynn Marino, PhD, Amanda Botticello, PhD, MPH, Julia H. Coyne, PhD, Michael Dribbon, PhD, and John DeLuca, PhD.  Drs. Marino and Coyne are affiliated with Children’s Specialized Hospital and Kessler Foundation; Dr. Dribbon is with Children’s Specialized, and Drs. Botticello and DeLuca are with Kessler Foundation.

The team accessed the registry of the Uniform Data System for Medical Rehabilitation, identifying 531 admissions for brain injury from 2001 to 2012 (298 TBI; 233 nTBI). The Functional Independence Measure for Children (WeeFIM) was used to measure functional independence, including the domains of cognition, mobility, and self-care.

Overall gains were greater for the TBI group than for the nTBI group. For both groups, moderate levels of functional independence on admission predicted moderate to large gains in self-care and mobility during rehabilitation. Certain findings differed from the outcomes seen in the adult population, underscoring the importance of using measures specific to the pediatric population.      

“For children with high or low levels of functional independence, important differences were identified by domain for each group,” according to lead author, Dr. Marino. “For example, children with nTBI with low or high mobility scores at admission were likely to make small gains, while children with TBI with low mobility scores were much more likely to make large gains,” she noted. “Also, high scores on admission for nTBI correlated with larger gains in self-care and cognition. We saw the opposite in TBI, that is, low functional scores were associated with higher gains.

The study’s findings have implications for rehabilitation professionals and caregivers of children with acquired brain injury, according to Dr. Dribbon, vice president of Business Development & Chief Innovation and Research Officer at Children’s Specialized Hospital. "Clearly, many different factors influence the recovery process in the developing brain," said Dr. Dribbon. “Examining these factors helps us improve our ability to provide prognoses for children with acquired brain injury,” he said, “which is fundamental to helping families plan for the future of their children, and to tailoring rehabilitative care for maximal outcomes in this population."

Article link: https://insights.ovid.com/pubmed?pmid=29385015

Since 2014, Kessler Foundation and Children's Specialized Hospital have worked together to improve the mobility, cognition, and educational outcomes of children and adolescents with neurological conditions, including brain and spinal cord injuries, cerebral palsy, autism and learning disabilities. For more information on research studies at Children’s Specialized Hospital, visit https://www.childrens-specialized.org/research/

This research was supported by Children’s Specialized Hospital and Kessler Foundation.

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About Children’s Specialized Hospital

Children’s Specialized Hospital is the nation’s leading provider of inpatient and outpatient care for children from birth to 21 years of age facing special health challenges—from chronic illnesses and complex physical disabilities like brain and spinal cord injuries, to developmental and behavioral issues like autism and mental health. At 13 different New Jersey locations, our pediatric specialists partner with families to make our many innovative therapies and medical treatments more personalized and effective...so children can achieve more of their goals.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org.

For more information, or to interview an expert, contact: Carolann Murphy, 973.324.8382, CMurphy@KesslerFoundation.org.