Initiation of Physical, Occupational, and Speech Therapy in Children With Traumatic Brain Injury
Abstract Objectives (1) To determine factors associated with physical therapy (PT) or occupational therapy (OT) evaluation and speech or swallow therapy evaluation in hospitalized children with traumatic brain injury (TBI); (2) to describe when during the hospital stay the initial therapy evaluation...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2013-07, Vol.94 (7), p.1268-1276 |
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| container_title | Archives of physical medicine and rehabilitation |
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| creator | Bennett, Tellen D., MD, MS Niedzwecki, Christian M., DO, MS Korgenski, E. Kent, MT, MS Bratton, Susan L., MD, MPH |
| description | Abstract Objectives (1) To determine factors associated with physical therapy (PT) or occupational therapy (OT) evaluation and speech or swallow therapy evaluation in hospitalized children with traumatic brain injury (TBI); (2) to describe when during the hospital stay the initial therapy evaluations typically occur; and (3) to quantify any between-hospital variation in therapy evaluation. Design Retrospective cohort study. Setting Children's hospitals participating in the Pediatric Health Information System database (January 2001–June 2011). Participants Children (age |
| doi_str_mv | 10.1016/j.apmr.2013.02.021 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4550591</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0003999313002001</els_id><sourcerecordid>1372080893</sourcerecordid><originalsourceid>FETCH-LOGICAL-c510t-850bd43074144cdb61bee1f6024c1ae0081d5f7acb2b1089c5e13071afa676d53</originalsourceid><addsrcrecordid>eNp9Ul2L1TAQDaK419U_4IP00Qd7nUn6CbKgFz8uLKywK_oW0nRqU3vTbtIu9N_4W_xlpt51UR-EgTCZc84kc4axpwhbBMxedls1HtyWA4ot8BB4j20wFTwuOH65zzYAIOKyLMUJe-R9F9IsFfiQnXCR5CKHZMPU3prJqMkMNhqa6GO7eKNV_yK60Hoef92vmbJ1dDkS6Ta6asmpcYmM_fF915q-dmSjz2YKFafmQ6Do6I1TxkZ7281uecweNKr39OT2PGWf3r292n2Izy_e73evz2OdIkxxkUJVJwLyBJNE11WGFRE2GfBEoyKAAuu0yZWueIVQlDolDGhUjcryrE7FKTs76o5zdaBak52c6uXozEG5RQ7KyL8r1rTy63AjkzSFtMQg8PxWwA3XM_lJHozX1PfK0jB7iSLnUITWIkD5Eard4L2j5q4Ngly9kZ1cvZGrNxJ4iFX_2Z8PvKP8NiMAXh0BFMZ0Y8hJrw1ZTbVxpCdZD-b_-mf_0HVv7OrmN1rId8PsgpfhH9IHgrxct2NdjjBG4BCEfgJy47bP</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1372080893</pqid></control><display><type>article</type><title>Initiation of Physical, Occupational, and Speech Therapy in Children With Traumatic Brain Injury</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Bennett, Tellen D., MD, MS ; Niedzwecki, Christian M., DO, MS ; Korgenski, E. Kent, MT, MS ; Bratton, Susan L., MD, MPH</creator><creatorcontrib>Bennett, Tellen D., MD, MS ; Niedzwecki, Christian M., DO, MS ; Korgenski, E. Kent, MT, MS ; Bratton, Susan L., MD, MPH</creatorcontrib><description>Abstract Objectives (1) To determine factors associated with physical therapy (PT) or occupational therapy (OT) evaluation and speech or swallow therapy evaluation in hospitalized children with traumatic brain injury (TBI); (2) to describe when during the hospital stay the initial therapy evaluations typically occur; and (3) to quantify any between-hospital variation in therapy evaluation. Design Retrospective cohort study. Setting Children's hospitals participating in the Pediatric Health Information System database (January 2001–June 2011). Participants Children (age <18y) with TBI (N=21,399) who were admitted to the intensive care unit and survived to hospital discharge. Interventions Not applicable. Main Outcome Measures PT or OT evaluation and speech or swallow therapy evaluation. A propensity score was calculated to allow comparison of expected with observed rates of therapy evaluations by the hospital. Results The median hospital length of stay was 5 days (interquartile range, 3–10d). Overall, 8748 (41%) of 21,399 children received either a PT or OT evaluation, and 5490 (26%) out of 21,399 children received either a speech or swallow evaluation. Older children and those with higher energy injury mechanisms, more severe injuries, extremity fractures, more treatment with neuromuscular blocking agents or pentobarbital, and admission to a hospital with an American College of Surgeons Level I pediatric trauma designation were more likely to receive therapy evaluations. The median time until the first therapy evaluation was 5 (PT or OT) and 7 days (speech or swallow). Expected hospital evaluation rates were 25% to 54% (PT or OT) and 16% to 35% (speech or swallow), while observed hospital evaluation rates were 11% to 74% (PT or OT) and 4% to 55% (speech or swallow). Conclusions There is wide between-hospital variation in provision of rehabilitation therapies for children with TBI. Evidence-based criteria for initiation of routine therapy evaluations after TBI are needed.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2013.02.021</identifier><identifier>PMID: 23473704</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Brain Injuries - rehabilitation ; Child ; Child, Preschool ; Craniocerebral trauma ; Deglutition ; Female ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Male ; Occupational therapy ; Occupational Therapy - statistics & numerical data ; Pediatrics ; Physical Medicine and Rehabilitation ; Physical Therapy Specialty - statistics & numerical data ; Rehabilitation ; Retrospective Studies ; Speech therapy ; Speech Therapy - statistics & numerical data ; Time Factors ; Trauma Severity Indices</subject><ispartof>Archives of physical medicine and rehabilitation, 2013-07, Vol.94 (7), p.1268-1276</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2013 American Congress of Rehabilitation Medicine</rights><rights>Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-850bd43074144cdb61bee1f6024c1ae0081d5f7acb2b1089c5e13071afa676d53</citedby><cites>FETCH-LOGICAL-c510t-850bd43074144cdb61bee1f6024c1ae0081d5f7acb2b1089c5e13071afa676d53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.apmr.2013.02.021$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23473704$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bennett, Tellen D., MD, MS</creatorcontrib><creatorcontrib>Niedzwecki, Christian M., DO, MS</creatorcontrib><creatorcontrib>Korgenski, E. Kent, MT, MS</creatorcontrib><creatorcontrib>Bratton, Susan L., MD, MPH</creatorcontrib><title>Initiation of Physical, Occupational, and Speech Therapy in Children With Traumatic Brain Injury</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Abstract Objectives (1) To determine factors associated with physical therapy (PT) or occupational therapy (OT) evaluation and speech or swallow therapy evaluation in hospitalized children with traumatic brain injury (TBI); (2) to describe when during the hospital stay the initial therapy evaluations typically occur; and (3) to quantify any between-hospital variation in therapy evaluation. Design Retrospective cohort study. Setting Children's hospitals participating in the Pediatric Health Information System database (January 2001–June 2011). Participants Children (age <18y) with TBI (N=21,399) who were admitted to the intensive care unit and survived to hospital discharge. Interventions Not applicable. Main Outcome Measures PT or OT evaluation and speech or swallow therapy evaluation. A propensity score was calculated to allow comparison of expected with observed rates of therapy evaluations by the hospital. Results The median hospital length of stay was 5 days (interquartile range, 3–10d). Overall, 8748 (41%) of 21,399 children received either a PT or OT evaluation, and 5490 (26%) out of 21,399 children received either a speech or swallow evaluation. Older children and those with higher energy injury mechanisms, more severe injuries, extremity fractures, more treatment with neuromuscular blocking agents or pentobarbital, and admission to a hospital with an American College of Surgeons Level I pediatric trauma designation were more likely to receive therapy evaluations. The median time until the first therapy evaluation was 5 (PT or OT) and 7 days (speech or swallow). Expected hospital evaluation rates were 25% to 54% (PT or OT) and 16% to 35% (speech or swallow), while observed hospital evaluation rates were 11% to 74% (PT or OT) and 4% to 55% (speech or swallow). Conclusions There is wide between-hospital variation in provision of rehabilitation therapies for children with TBI. Evidence-based criteria for initiation of routine therapy evaluations after TBI are needed.</description><subject>Adolescent</subject><subject>Brain Injuries - rehabilitation</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Craniocerebral trauma</subject><subject>Deglutition</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Occupational therapy</subject><subject>Occupational Therapy - statistics & numerical data</subject><subject>Pediatrics</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Physical Therapy Specialty - statistics & numerical data</subject><subject>Rehabilitation</subject><subject>Retrospective Studies</subject><subject>Speech therapy</subject><subject>Speech Therapy - statistics & numerical data</subject><subject>Time Factors</subject><subject>Trauma Severity Indices</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Ul2L1TAQDaK419U_4IP00Qd7nUn6CbKgFz8uLKywK_oW0nRqU3vTbtIu9N_4W_xlpt51UR-EgTCZc84kc4axpwhbBMxedls1HtyWA4ot8BB4j20wFTwuOH65zzYAIOKyLMUJe-R9F9IsFfiQnXCR5CKHZMPU3prJqMkMNhqa6GO7eKNV_yK60Hoef92vmbJ1dDkS6Ta6asmpcYmM_fF915q-dmSjz2YKFafmQ6Do6I1TxkZ7281uecweNKr39OT2PGWf3r292n2Izy_e73evz2OdIkxxkUJVJwLyBJNE11WGFRE2GfBEoyKAAuu0yZWueIVQlDolDGhUjcryrE7FKTs76o5zdaBak52c6uXozEG5RQ7KyL8r1rTy63AjkzSFtMQg8PxWwA3XM_lJHozX1PfK0jB7iSLnUITWIkD5Eard4L2j5q4Ngly9kZ1cvZGrNxJ4iFX_2Z8PvKP8NiMAXh0BFMZ0Y8hJrw1ZTbVxpCdZD-b_-mf_0HVv7OrmN1rId8PsgpfhH9IHgrxct2NdjjBG4BCEfgJy47bP</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Bennett, Tellen D., MD, MS</creator><creator>Niedzwecki, Christian M., DO, MS</creator><creator>Korgenski, E. Kent, MT, MS</creator><creator>Bratton, Susan L., MD, MPH</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20130701</creationdate><title>Initiation of Physical, Occupational, and Speech Therapy in Children With Traumatic Brain Injury</title><author>Bennett, Tellen D., MD, MS ; Niedzwecki, Christian M., DO, MS ; Korgenski, E. Kent, MT, MS ; Bratton, Susan L., MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-850bd43074144cdb61bee1f6024c1ae0081d5f7acb2b1089c5e13071afa676d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Brain Injuries - rehabilitation</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Craniocerebral trauma</topic><topic>Deglutition</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Occupational therapy</topic><topic>Occupational Therapy - statistics & numerical data</topic><topic>Pediatrics</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Physical Therapy Specialty - statistics & numerical data</topic><topic>Rehabilitation</topic><topic>Retrospective Studies</topic><topic>Speech therapy</topic><topic>Speech Therapy - statistics & numerical data</topic><topic>Time Factors</topic><topic>Trauma Severity Indices</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bennett, Tellen D., MD, MS</creatorcontrib><creatorcontrib>Niedzwecki, Christian M., DO, MS</creatorcontrib><creatorcontrib>Korgenski, E. Kent, MT, MS</creatorcontrib><creatorcontrib>Bratton, Susan L., MD, MPH</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bennett, Tellen D., MD, MS</au><au>Niedzwecki, Christian M., DO, MS</au><au>Korgenski, E. Kent, MT, MS</au><au>Bratton, Susan L., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Initiation of Physical, Occupational, and Speech Therapy in Children With Traumatic Brain Injury</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>94</volume><issue>7</issue><spage>1268</spage><epage>1276</epage><pages>1268-1276</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><abstract>Abstract Objectives (1) To determine factors associated with physical therapy (PT) or occupational therapy (OT) evaluation and speech or swallow therapy evaluation in hospitalized children with traumatic brain injury (TBI); (2) to describe when during the hospital stay the initial therapy evaluations typically occur; and (3) to quantify any between-hospital variation in therapy evaluation. Design Retrospective cohort study. Setting Children's hospitals participating in the Pediatric Health Information System database (January 2001–June 2011). Participants Children (age <18y) with TBI (N=21,399) who were admitted to the intensive care unit and survived to hospital discharge. Interventions Not applicable. Main Outcome Measures PT or OT evaluation and speech or swallow therapy evaluation. A propensity score was calculated to allow comparison of expected with observed rates of therapy evaluations by the hospital. Results The median hospital length of stay was 5 days (interquartile range, 3–10d). Overall, 8748 (41%) of 21,399 children received either a PT or OT evaluation, and 5490 (26%) out of 21,399 children received either a speech or swallow evaluation. Older children and those with higher energy injury mechanisms, more severe injuries, extremity fractures, more treatment with neuromuscular blocking agents or pentobarbital, and admission to a hospital with an American College of Surgeons Level I pediatric trauma designation were more likely to receive therapy evaluations. The median time until the first therapy evaluation was 5 (PT or OT) and 7 days (speech or swallow). Expected hospital evaluation rates were 25% to 54% (PT or OT) and 16% to 35% (speech or swallow), while observed hospital evaluation rates were 11% to 74% (PT or OT) and 4% to 55% (speech or swallow). Conclusions There is wide between-hospital variation in provision of rehabilitation therapies for children with TBI. Evidence-based criteria for initiation of routine therapy evaluations after TBI are needed.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23473704</pmid><doi>10.1016/j.apmr.2013.02.021</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Brain Injuries - rehabilitation Child Child, Preschool Craniocerebral trauma Deglutition Female Humans Infant Infant, Newborn Length of Stay Male Occupational therapy Occupational Therapy - statistics & numerical data Pediatrics Physical Medicine and Rehabilitation Physical Therapy Specialty - statistics & numerical data Rehabilitation Retrospective Studies Speech therapy Speech Therapy - statistics & numerical data Time Factors Trauma Severity Indices |
| title | Initiation of Physical, Occupational, and Speech Therapy in Children With Traumatic Brain Injury |
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