Functional Trajectory of Childhood Stroke in the Inpatient Rehabilitation Setting

儿童卒中患者在住院康复治疗中的功能轨迹

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Abstract

OBJECTIVE: To examine the functional outcomes of a group of infants, children, and adolescents admitted to acute inpatient rehabilitation for neurologic impairments caused by a new childhood stroke. DESIGN: Retrospective cross-sectional cohort study. SETTING: A pediatric inpatient rehabilitation program in a stand-alone inpatient rehabilitation facility (IRF) located within an academic medical center. PARTICIPANTS: A total of 91 patients (N=91) aged 6 months to 17.8 years were admitted to a pediatric inpatient rehabilitation program with a new diagnosis of childhood stroke. INTERVENTIONS: Standard of care pediatric inpatient rehabilitation treatment. MAIN OUTCOME MEASURES: Change in the functional independence measure in children (WeeFIM) score across inpatient rehabilitation treatment. RESULTS: The 51 boys/39 girls/and 1 transgender patient were 9.6±5.7 years old with ischemic stroke (n=53) or hemorrhagic stroke (n=38). At admission, they had moderate-to-severe functional impairments (WeeFIM total score=46.5±25.5 points). Inpatient rehabilitation length of stay was 33.7±28.5 (range, 3-134) days. WeeFIM total score improved to 71.2±31.6 points at IRF discharge. Hemorrhagic (compared with ischemic) stroke was associated with higher rates of craniectomy (X(2)=4.6, P=.03) and older age at IRF admission (Z=1.98, P<.05). Older age was associated with higher age-corrected WeeFIM total scores at admission (F=7.9, P=.0007) and discharge (F=18.1, P<.001), but age did not affect change in WeeFIM score. CONCLUSIONS: Pediatric inpatient rehabilitation results in functional improvements for new neurologic impairments caused by childhood stroke.

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