The effect of sleep fragmentation on therapeutic engagement and rehabilitation progress after brain injury in a pediatric inpatient sample.

IF 1.5 4区医学 Q4 NEUROSCIENCES

Brain injury Pub Date : 2025-03-24 DOI:10.1080/02699052.2025.2482778

Anthony H Lequerica, Hannah Aura Shoval, Jessica Ace, Theodore W Yip, Sabrina S Dieffenbach, Claire M Marchetta, Jean Lengenfelder

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Abstract

Objective: This study evaluated the effect of sleep fragmentation after brain injury on therapeutic engagement and rehabilitation progress in pediatric inpatients.

Methods: Participants (N = 29) wore a wrist accelerometer for one week to calculate a sleep fragmentation index measuring restlessness during the sleep period. Therapists completed ratings of functional independence (using the WeeFIM) and therapeutic engagement (effort and active participation in physical therapy sessions measured using the Rehabilitation Therapy Engagement Scale).

Results: Controlling for time from injury to rehabilitation admission, sleep fragmentation is negatively associated with therapeutic engagement and rehabilitation progress (defined as improvement in WeeFIM scores from admission to discharge per day of rehabilitation). Hierarchical regression demonstrated a significant negative association between sleep fragmentation and rehabilitation progress. However, when therapeutic engagement was added to the model it accounted for a significant portion of the variance and the effect of sleep fragmentation was no longer a significant predictor of rehabilitation progress.

Conclusion: Findings demonstrate the detrimental impact of sleep fragmentation on therapeutic engagement and rehabilitation progress and also suggest a possible mediating role for therapeutic engagement on the effect of sleep fragmentation on rehabilitation progress.

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睡眠片段化对儿科住院患者脑损伤后治疗参与和康复进展的影响。

目的：探讨脑损伤后睡眠破碎对儿科住院患者治疗参与和康复进展的影响。方法：参与者（N = 29）佩戴腕部加速度计一周，计算睡眠碎片指数，测量睡眠期间的不安。治疗师完成了功能独立性（使用WeeFIM）和治疗参与（使用康复治疗参与量表测量物理治疗课程的努力和积极参与）的评分。结果：控制从受伤到康复入院的时间，睡眠碎片化与治疗参与和康复进展呈负相关（定义为康复每天从入院到出院的WeeFIM评分的改善）。层次回归结果显示，睡眠片段化与康复进展呈显著负相关。然而，当治疗参与被添加到模型中时，它占了方差的很大一部分，睡眠碎片的影响不再是康复进展的重要预测因子。结论：研究结果表明，睡眠碎片化对治疗参与和康复进展有不利影响，并可能在治疗参与对睡眠碎片化对康复进展的影响中起中介作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain injury 医学-康复医学

CiteScore

3.50

自引率

5.30%

发文量

148

审稿时长

12 months

期刊介绍： Brain Injury publishes critical information relating to research and clinical practice, adult and pediatric populations. The journal covers a full range of relevant topics relating to clinical, translational, and basic science research. Manuscripts address emergency and acute medical care, acute and post-acute rehabilitation, family and vocational issues, and long-term supports. Coverage includes assessment and interventions for functional, communication, neurological and psychological disorders.