Free
Research Article  |   January 2004
Impact of Pediatric Rehabilitation Services on Children’s Functional Outcomes
Author Affiliations & Notes
  • Christine C. Chen, MA, MS, ScD, OT, is Assistant Professor, Department of Occupational Therapy, The Steinhardt School of Education, New York University, 35 West Four Street, 11th Floor, New York, New York 10012; christine.chen@nyu.edu. Dr. Chen was Assistant Professor, Department of Occupational Therapy, State University of New York at Buffalo when the study was conducted. She was Clinical Research Scientist at Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, Illinois, when this paper was written
  • Allen W. Heinemann, PhD, ABPP, is Director, Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, Illinois
  • Rita K. Bode, PhD, is Associate Director, Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, Illinois
  • Carl V. Granger, MD, is Professor and Chair Emeritus, Department of Rehabilitation Medicine, SUNY-Buffalo; Director Emeritus, Uniform Data System for Medical Rehabilitation (UDSMR®), Amherst, New York; and Director of Center for Functional Assessment Research, Amherst, New York
  • Trudy Mallinson, PhD, OTR/L, NZROT, is Clinical Research Scientist, Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, Illinois
  • UDSMR® is a registered trademark of the United Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.
    UDSMR® is a registered trademark of the United Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.×
Article Information
Neurologic Conditions / Pediatric Evaluation and Intervention / Rehabilitation, Participation, and Disability / Center for Outcomes Research and Education
Research Article   |   January 2004
Impact of Pediatric Rehabilitation Services on Children’s Functional Outcomes
American Journal of Occupational Therapy, January/February 2004, Vol. 58, 44-53. doi:10.5014/ajot.58.1.44
American Journal of Occupational Therapy, January/February 2004, Vol. 58, 44-53. doi:10.5014/ajot.58.1.44
Abstract

OBJECTIVES. Relatively little is known about the treatment effectiveness and functional outcomes of pediatric rehabilitation therapies. This study was conducted to gain knowledge of the type and quantity of inpatient rehabilitation services provided to children who received acute inpatient rehabilitation and compare functional gains by age and diagnosis.

METHOD. A retrospective cohort design was used. Records of rehabilitation therapies and functional assessments of 814 pediatric patients who received inpatient rehabilitation during 1996, 1997, and 1998 were collected. The admission and discharge item ratings of the WeeFIM® instrument were first transformed into inter-val-level measures of self-care, mobility, and cognition. Parametric analyses were used to compare functional gains across impairment groups and to examine the relationship between amount of treatment and functional gains.

RESULTS. Occupational therapy and physical therapy were the primary rehabilitation services received by patients across impairment groups (98% and 99%, respectively). A large proportion of children with traumatic brain injuries also received speech therapy (97%) and psychology services (60%). Across domains (selfcare, mobility, cognition), the largest gains were made by children who were older than 7 years and had traumatic injuries. Functional gains were significantly related to the amount of discipline-specific treatment received, after controlling for age, impairment, and functional status at admission.

CONCLUSION. Rehabilitation therapy provision in pediatric inpatient rehabilitation varies greatly depending on children’s age and the nature of the impairment. Systematic reporting of type and quantity of rehabilitation therapies along with functional assessments before and after hospitalization would allow researchers to track functional changes and study the determinants of functional improvement.