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The Effect of Admission Functional Independence on Early Recovery in Pediatric Traumatic and Nontraumatic Brain Injury

Marino, Cherylynn, PhD; Botticello, Amanda, PhD; Coyne, Julia H., PhD; Dribbon, Michael, PhD; DeLuca, John, PhD

The Journal of Head Trauma Rehabilitation: November/December 2018 - Volume 33 - Issue 6 - p E11–E18
doi: 10.1097/HTR.0000000000000374
Focus on Clinical Research and Practice

Objective: To examine functional independence at admission as a predictor of outcomes during an initial inpatient hospitalization for a pediatric brain injury.

Participants: A total of 531 pediatric inpatients with traumatic (n = 298) or nontraumatic (n = 233) brain injuries.

Design: Retrospective analysis of data extracted from the Uniform Data System for Medical Rehabilitation.

Main Measure: The Functional Independence Measure for Children, a measure of self-care, mobility, and cognitive independence.

Results: Logistic regression analyses indicated that children with traumatic brain injury showed greater odds of making large functional gains in comparison with children with nontraumatic brain injury. For both groups, children entering rehabilitation with a moderate level of functional independence had the highest probability of making large gains. Children with a nontraumatic brain injury entering treatment with a high level of functioning made greater gains than those entering with low functioning. The opposite trend emerged for children with traumatic injuries.

Conclusions: Level of functioning at admission may be a useful predictor of progress during an inpatient stay for youth with brain injuries. Children with nontraumatic brain injury entering treatment with low functioning are expected to make slower progress during hospitalization.

Kessler Foundation, West Orange, New Jersey (Drs Marino, Botticello, Coyne, and DeLuca); Children's Specialized Hospital, New Brunswick, New Jersey (Drs Marino, Coyne, and Dribbon); and Departments of Physical Medicine and Rehabilitation (Drs Botticello and DeLuca) and Neurology (Dr DeLuca), Rutgers University, New Jersey Medical School, Newark, New Jersey.

Corresponding Author: Cherylynn Marino, PhD, Kessler Foundation, 120 Eagle Rock Ave, East Hanover, NJ 07936 (

The authors declare no conflicts of interest.

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