Impact of intensive, multidisciplinary neurorehabilitation on functional independence following pediatric acquired brain injury (ABI): A matched cohort study.

Abstract

PurposeThe purpose of this matched cohort study was to determine the impact of intensive, multidisciplinary neurorehabilitation on functional independence following pediatric acquired brain injury.MethodsCohorts receiving lower-intensity (n = 19) and higher-intensity multidisciplinary neurorehabilitation (n = 19) were matched on age, injury characteristics, and admission functional status. Intensity was measured by time in physical, occupational (OT), and speech therapy over length of stay (LOS). Outcome measures included WeeFIM efficiency, WeeFIM developmental functional quotients (DFQs), and LOS.ResultsThere were no significant between-cohort findings in 1) WeeFIM efficiency, 2) WeeFIM DFQs or 3) LOS. There was a significant difference between admission and discharge WeeFIM DFQs for all participants (p < 0.001), demonstrating significant functional recovery regardless of intensity. Hierarchical linear regressions were significant for OT intensity and discharge WeeFIM DFQs (p = .003, ΔR² = .22). Total admission WeeFIM DFQs significantly predicted LOS in the lower-intensity (p = 0.016, R² = 0.29) and higher-intensity (p < 0.001, R² = 0.51) cohorts, indicating a greater variance explained with increased intensity.ConclusionWhile significant functional outcomes were not correlated with intensity, OT intensity did significantly predict variations in functional independence. Investigation into definitive parameters for intensive treatment, including the amount and context of therapeutic interventions, is needed.