title: Examining acute rehabilitation outcomes for children with total functional dependence after traumatic brain injury: a pilot study.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Kennedy 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.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Kramer
authors.forename: Stacy J
authors.initials: SJ
authors.lastname: Suskauer
authors.forename: James R
authors.initials: JR
authors.lastname: Christensen
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: DeMatt
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Trovato
authors.forename: Cynthia F
authors.initials: CF
authors.lastname: Salorio
authors.forename: Beth S
authors.initials: BS
authors.lastname: Slomine
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D001930:Brain Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003858:Dependency, Psychological; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000534:rehabilitation*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007297:Inpatients / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D010865:Pilot Projects; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome