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Early recovery of walking in children and youths after traumatic brain injury

Published online by Cambridge University Press:  16 September 2003

Stephen M Haley
Affiliation:
Center for Rehabilitation Effectiveness, Sargent College of Health and Rehabilitation Sciences, Boston, MA, USA.
Helene M Dumas
Affiliation:
The Research Center for Children with Special Health Care Needs, USA.
Jeffrey P Rabin
Affiliation:
Physical Rehabilitation Program, Franciscan Children's Hospital, USA.
Pengsheng Ni
Affiliation:
Center for Rehabilitation Effectiveness, Sargent College of Health and Rehabilitation Sciences, Boston, MA, USA.
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Abstract

A consecutive series of 106 children and adolescents (mean age 10 years, 6 months; SD 4 years, 8 months) with recent traumatic brain injury admitted to a regional hospital-based rehabilitation program was assessed to determine the rate of walking recovery, and characteristics that distinguish between independent walkers, non-walkers, and device-assisted walkers at hospital discharge. Data were collected through a retrospective medical record review of patients admitted between 1994 and 2001. Mean hospital stays were 66.7 days (SD 88.5, range 7 to 140 days). All children (72 male, 34 female) had recent injuries (from 1 to 8 weeks after onset of traumatic brain injury) and were independent walkers before injury. Sixty-four children (60.4%) were discharged as independent walkers, 13 (12.3%) walked with the assistance of a device, and 29 (27.3%) were non-walkers. Non-walkers had a higher proportion of prolonged loss of consciousness, lower-extremity injury, impaired responsiveness, and lower-extremity spasticity than independent walkers. In addition, non-walkers had poorer discharge mobility and social function scores, longer average hospital stays, and a greater proportion of non-community discharges. Device-only walkers were older, more likely to be male, and had a higher proportion of lower-extremity injuries than independent walkers. Results highlight several demographic, clinical, and outcome variables that distinguish independent walkers from device-assisted walkers and non-walkers. These variables might help to determine the prognosis for ambulation, resource needs, and discharge plans for children and adolescents with traumatic brain injury after episodes of inpatient rehabilitation.

Type
Original Articles
Copyright
© 2003 Mac Keith Press

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