title: Physical disability after injury-related inpatient rehabilitation in children.
abstract: OBJECTIVE
  To determine the residual physical disability after inpatient rehabilitation for children 7 to 18 years old with traumatic injuries.
  
  
  METHODS
  This was a retrospective cohort study of patients aged 7 to 18 years who underwent inpatient rehabilitation for traumatic injuries from 2002 to 2011. Patients were identified from the Uniform Data System for Medical Rehabilitation. Injuries were captured by using standardized Medicare Inpatient Rehabilitation Facility Patient Assessment Instrument codes. Functional outcome was measured with the Functional Independence Measure (FIM) instrument. A validated, categorical grading system of the FIM motor items was used, consisting of clinically relevant levels of physical achievement from grade 1 (need for total assistance) to grade 7 (completely independent for self-care and mobility).
  
  
  RESULTS
  A total of 13,798 injured children underwent inpatient rehabilitation across 523 facilities during the 10-year period. After a mean 3-week length of stay, functional limitations were reduced, but children still tended to have residual physical disabilities (median admission grade: 1; median discharge grade: 4). Children with spinal cord injuries, either alone or in combination with other injuries, had lower functional grade at discharge, longer lengths of stay, and more comorbidities at discharge than those with traumatic brain injuries, burns, and multiple injuries (P < .0001 for all comparisons).
  
  
  CONCLUSIONS
  Children had very severe physical disability on admission to inpatient rehabilitation for traumatic injuries, and those with spinal cord injuries had persistent disability at discharge. These traumatic events during critical stages of development may result in a substantial care burden over the child's lifespan.
authors.affiliation: Center for Injury Research and Prevention, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. zonfrillo@email.chop.edu
authors.forename: Mark R
authors.initials: MR
authors.lastname: Zonfrillo
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Durbin
authors.forename: Flaura K
authors.initials: FK
authors.lastname: Winston
authors.forename: Huaqing
authors.initials: H
authors.lastname: Zhao
authors.forename: Margaret G
authors.initials: MG
authors.lastname: Stineman
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000453:epidemiology / Q000534:rehabilitation*; D002648:Child; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D019988:Children with Disabilities / Q000534:rehabilitation*; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D012047:Rehabilitation Centers / Q000639:trends; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000534:rehabilitation*; D016896:Treatment Outcome