scholarly journals Measuring Functional Change in Children With Acquired Brain Injury (ABI): Comparison of Generic and ABI-Specific Scales Using the Pediatric Evaluation of Disability Inventory (PEDI)

2003 ◽  
Vol 83 (9) ◽  
pp. 776-785 ◽  
Author(s):  
Dhara H Kothari ◽  
Stephen M Haley ◽  
Kathleen M Gill-Body ◽  
Helene M Dumas
Keyword(s):  
Chart Review ◽  
Brain Injuries ◽  
Self Care ◽  
Retrospective Chart Review ◽  
Inpatient Rehabilitation ◽  
Functional Change ◽  
Functional Changes ◽  
Measuring Change ◽  
General Order ◽  
Future Work

Background and Purpose. The Pediatric Evaluation of Disability Inventory (PEDI) subscales are hierarchic in nature, with item placements within each subscale reflecting the general order of skill attainment in children without disabilities. The purpose of this study was to determine whether a hierarchical subscale developed in this study for children with acquired brain injuries (ABIs) corresponds to the generic PEDI subscales, and, if not, whether condition-specific (ABI-specific) PEDI subscales are more sensitive for measuring change. Subjects. Eighty-seven children and adolescents (mean age=9.2 years, SD=5.2, range=1–20) with ABI during inpatient rehabilitation admissions were included. Methods. Data were collected by retrospective chart review. Rasch one-parameter analyses were conducted to construct the ABI-specific PEDI scale focusing on the Mobility and Self-care domains (content areas) only. Each domain consists of a Functional Skills subscale and a Caregiver Assistance subscale. Thus, in all, 4 scales were constructed within the ABI-specific PEDI scale. Differences in item hierarchies and sensitivity between generic and ABI-specific PEDI subscales for each domain were then examined. Results. Both generic and ABI-specific PEDI scales were sensitive for measuring functional changes during inpatient rehabilitation hospitalization. Even though the generic and ABI-specific item hierarchies differed substantially, only one of the 4 ABI-specific PEDI subscales (Caregiver Assistance Self-care subscale) was more sensitive for measuring change than the generic PEDI scale. Discussion and Conclusion. The ABI-specific scales added relatively little improvement in sensitivity compared with the generic PEDI scales of the Mobility and Self-care domains. Thus, for group analyses, the authors recommend use of the generic PEDI subscales for children with ABI. Future work with ABI-specific subscales may improve the physical therapist's ability to describe an individual's pattern of functional recovery.

EVALUATION OF A TEN-YEAR EXPERIENCE IN A COMPREHENSIVE CARE PROGRAM FOR HANDICAPPED CHILDREN

PEDIATRICS ◽  
1972 ◽  
Vol 50 (5) ◽  
pp. 793-800
Author(s):  
Jane C. S. Perrin ◽  
Edna L. Rusch ◽  
Janet L. Pray ◽  
Gregg F. Wright ◽  
Glen S. Bartlett
Keyword(s):  
Social Worker ◽  
Chart Review ◽  
Correlation Coefficients ◽  
Retrospective Chart Review ◽  
Care Program ◽  
Zero Order ◽  
Handicapped Children ◽  
Functional Changes ◽  
Disabled Patients ◽  
Input Time

Chronically disabled patients under care of a multidisciplinary hospital program were scored for functional changes by retrospective chart review. Family functions were also assessed. Professional input time was measured as the number of clinic visits (physician) or years of social worker involvement. Correlation coefficients calculated between a number of variables did not show significant zero-order correlations between professional quantitative input and improvement of patient-family functions.

Examining the Effectiveness of OT in the Treatment of Patients Recovering From COVID-19 in the Rehabilitation Setting

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512505157p1-7512505157p1
Author(s):  
Nelle Hannah Ouellette ◽  
Leah Bellinger ◽  
Julie Leonard
Keyword(s):  
Pilot Study ◽  
Daily Living ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Inpatient Rehabilitation ◽  
Assessment Instrument ◽  
Patient Assessment ◽  
Rehabilitation Facility ◽  
Inpatient Rehabilitation Facility ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. A pilot study was completed to examine the effectiveness of OT in helping individuals regain independence in activities of daily living after COVID-19. In a retrospective chart review, statistically significant results (p < .05) on the Inpatient Rehabilitation Facility Patient Assessment Instrument and the Modified Barthel Index demonstrated that OT is effective in the rehabilitation setting to increase individuals' independence following a COVID-19 diagnosis. Primary Author and Speaker: Nelle Hannah Ouellette Additional Authors and Speakers: Leah Bellinger, Julie Leonard Contributing Authors: Leah Bellinger, Julie Leonard

scholarly journals Delivering Telerehabilitation to COVID-19 Inpatients:A Retrospective Chart Review Suggests It Is a Viable Option

2020 ◽  
Vol 16 (S1) ◽  
pp. 64-70
Author(s):  
Kelsey Rosen ◽  
Monika Patel ◽  
Cecelia Lawrence ◽  
Brianne Mooney
Keyword(s):  
Physical Therapy ◽  
Chart Review ◽  
Vital Signs ◽  
Retrospective Chart Review ◽  
Inpatient Rehabilitation ◽  
Supplemental Oxygen ◽  
Hospitalized Patients ◽  
Home Exercise ◽  
Viable Option ◽  
Therapeutic Exercises

Abstract Background Guidelines for physical therapy management of patients hospitalized with COVID-19 recommend limiting physical therapists’ contact with patients when possible. Telehealth has been viewed as “electronic personal protective equipment” during the COVID-19 pandemic; although telerehabilitation has been shown to be effective with outpatients, it is unknown whether it is a viable option for hospitalized patients. Purpose Our facility developed an algorithm for the use of a physical therapy telerehabilitation program for inpatients with COVID-19. We sought to investigate the safety and viability of the program. Methods We conducted a retrospective chart review of patients admitted with a diagnosis of COVID-19 who received either telerehabilitation only or a combination of telerehabilitation and in-person rehabilitation. Based on the algorithm, COVID-19 inpatients were selected to receive telerehabilitation if they could ambulate independently, could use technology, had stable vital signs, required minimal supplemental oxygen, and were cognitively intact. We analyzed data of inpatients who received telerehabilitation only, which included patient education, therapeutic exercises, and breathing techniques. Results Of 33 COVID-19 inpatients who received telerehabilitation, in-person rehabilitation, or a combination of the two, 12 patients received telerehabilitation only (age range, 33 to 65 years; all but one male). They demonstrated independence with their individualized home exercise programs in one to two sessions, did not require an in-person rehabilitation consultation, did not require increased oxygen, experienced no exacerbation of symptoms, and were discharged home. Conclusions Inpatient telerehabilitation appears to be a viable option for selected hospitalized patients with COVID-19 and may be a safe way of delivering inpatient rehabilitation to isolated or at-risk populations. At our hospital, the use of inpatient telerehabilitation reduced staff exposure while providing important education and services to patients. To our knowledge, no studies have investigated the use of telerehabilitation for hospitalized patients, including those with COVID-19. Our findings suggest that this innovative approach warrants further study.

Cholinesterase Inhibitor Use in Patients With Dementia Admitted to a Palliative Care Unit

2021 ◽  
pp. 104990912098511
Author(s):  
Giulia-Anna Perri ◽  
Jessica Wilson ◽  
Sandra Gardner ◽  
Anna Berall ◽  
Anne Kirstein ◽  
...  
Keyword(s):  
Palliative Care ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Palliative Care Unit ◽  
Dose Frequency ◽  
Severe Dementia ◽  
Comorbid Diagnosis ◽  
Diagnosis Of Dementia ◽  
Future Work ◽  
Current Guidelines

Objectives: Current guidelines suggest that patients with severe dementia on cholinesterase inhibitors (CHEIs) should discontinue their CHEIs by taper. This study aims to define the prevalence of patients admitted to a palliative care unit (PCU) with dementia on a CHEI and to determine whether these patients were tapered off their CHEIs according to current deprescribing guidelines. Design: This is a descriptive retrospective chart review that examined patients admitted to a PCU with dementia on a CHEI from January 2015 to June 2019. Methods: Individuals admitted to the PCU with a primary or comorbid diagnosis of dementia were identified. Their corresponding CHEI dose, frequency and discontinuation pattern were identified. Data were analyzed using descriptive statistics. Results: A total of 36 patients were admitted to the PCU with dementia on a CHEI (prevalence of 2.3%). The median length of stay was 21 days. For 31 of these patients, their CHEI was discontinued, only 9 of which had a taper. Of the 24 patients who discontinued their CHEI suddenly, 10 patients had an order to discontinue their CHEI in the last 2 days before their date of death. Conclusion: This study suggests that although patients admitted to a PCU with dementia have their CHEI discontinued, the discontinuation was done without a taper. In many cases the CHEIs were continued through the active stage of dying. Future work should explore reasons why PCU physicians are mostly late to taper CHEIs for patients admitted with dementia.

scholarly journals 0987 Characterizing Scratch And Limb Movements In Atopic Dermatitis During Sleep

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A375-A375
Author(s):  
G M Gillow ◽  
C Robins ◽  
R Palomo ◽  
S S Sheldon ◽  
A B Fishbein
Keyword(s):  
Atopic Dermatitis ◽  
Chart Review ◽  
Sleep Stage ◽  
Retrospective Chart Review ◽  
Movement Analysis ◽  
Sleep Stages ◽  
Limb Movements ◽  
Video Footage ◽  
And Gender ◽  
Future Work

Abstract Introduction Children with atopic dermatitis (AD) experience significant sleep disruption due to nocturnal scratching. Our group has found distinct patterns of limb movements in contrast to control and PLMD patients. To expand on previous findings, our objective was to characterize timing and duration of scratch v. non-scratch movement in children with AD coincidentally undergoing polysomnography (PSG). Methods Retrospective chart review of PSG, video footage was synchronized with the EEG and limb electrode readings using a time/date generator and was then operationally classified as either scratching or non-scratching movement. Analysis of data was done using SPSS and groups were compared using an ANOVA. Results We analyzed four previously completed sleep studies in children with atopic dermatitis (1 female and 3 males), mean age years±SD 11.3±1.0, mean BMI±SD 21.9±7.1, mean AHI±SD 2.3±0.8. Average scratch duration was not significantly different by sleep stage, N1v.N2v.N3v.REM (mean scratch duration in seconds±SD= 9.0±1.5 v 6.3±3.2 v. 11.9±11.8 v. 6.3±7.3, respectively p=0.65). However, frequency of scratching events were more common during N2v.N1v.N3v.REM (mean scratching events±SD= 9.3±3.9 v 3.8±1.7 v. 4.3±4.3 v. 1.3±1.9, respectively p=0.02). Yet, given the duration of total time spent in sleep stages, minutes of scratching events occupied the largest percentage of N1v.N2v.N3v.REM (mean% ±SD= 3.9±0.9 v. 0.6±0.4 v. 0.4±0.2 v. 0.3±0.5, respectively, p&lt0.01). Interestingly, non-scratch related movements were not significantly different between sleep stages (p=0.2). However, non-scratch related movements trended to occupy the largest percentage of N1v.N2v.N3v.REM (mean% ±SD= 9.3±7.7 v. 2.1±1.6 v. 1.5±0.8 v. 1.9±1.4, respectively, p=0.05). Conclusion Our results suggest that scratching episodes in children with AD occur most commonly during N2 sleep, but occupy the largest % of N1 sleep. Future work will include comparing these limb movements to age and gender-matched allergic rhinitis patients. Support This study was unfunded.

The Physical Abilities and Mobility Scale as a New Measure of Functional Progress in the PICU

2021 ◽  
Author(s):  
Allison J. Weatherly ◽  
Li Wang ◽  
Christopher J. Lindsell ◽  
Elizabeth N. Martin ◽  
Katherine Hedden ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Functional Status ◽  
Logistic Regression Model ◽  
Pediatric Intensive Care ◽  
Retrospective Chart Review ◽  
Inpatient Rehabilitation ◽  
Functional Changes ◽  
Physical Abilities ◽  
Relationship Of

AbstractAssessing functional motor changes and their relationship to discharge needs in the pediatric intensive care unit (PICU) population is difficult given challenges quantifying small functional gains with current tools. Therefore, we compared the Physical Abilities and Mobility Scale (PAMS) to the Functional Status Scale (FSS) in PICU patients to assess correlation and differences and association with discharge needs. This study was a retrospective chart review of all patients (2–18 years old) admitted to the PICU and cardiac PICU for over 9 months who received early mobility services, including PAMS and FSS scoring. Correlation between scales, relationship of scores to disposition, and logistic regression model of changes in PAMS in relation to disposition were determined. Data were obtained for 122 patients. PAMS and FSS scores strongly negatively correlated (Spearman's ρ =  − 0.85), but with a nonlinear relationship, as the PAMS more readily differentiated among patients with higher functional status. The median FSS at discharge was 12.5 for those recommended an inpatient rehabilitation facility (IRF) (n = 24), versus 9 for those recommended discharge home (n = 83, Δ 3.5, 95% confidence interval [CI]: 1–6, around one-tenth of FSS scale). The corresponding median PAMS were 42 and 66 (Δ 24, 95% CI: 10–30, one-fourth of PAMS scale). Although not statistically significant, a logistic regression model was consistent with patients who showed modest change in PAMS across hospitalization but persistent deficits (PAMS < 60) were more likely to be recommended an IRF. The PAMS correlates to the FSS, but appears more sensitive to small functional changes, especially in higher functioning patients. It may be useful in prognosticating discharge needs.

scholarly journals Clival fractures in a Level I trauma center

2015 ◽  
Vol 122 (1) ◽  
pp. 227-235 ◽  
Author(s):  
Alexander Winkler-Schwartz ◽  
José A. Correa ◽  
Judith Marcoux
Keyword(s):  
Skull Base ◽  
Chart Review ◽  
Brain Injuries ◽  
Trauma Registry ◽  
Clinical Presentation ◽  
Retrospective Chart Review ◽  
Radiological Data ◽  
Level I

OBJECT Clival fracture (CF) is rare among head traumas. The aim of this study was to explore how radiological features observed in CF reflect the clinical picture and mechanism of injury in such cases. METHODS Radiological data for patients with skull base fracture admitted to the Montreal General Hospital between February 2002 and October 2012 were obtained from the Quebec Trauma Registry and reviewed for CF. Identified CF was categorized by orientation and quality. Injury mechanism, clinical presentation, and follow-up outcome were obtained through retrospective chart review. RESULTS Of the 1738 patients with skull base fractures, 65 exhibited CF, representing 1.2% of the 5416 patients with traumatic brain injuries admitted during the period studied. Thirty-nine (60%) of the 65 CFs were obliquely oriented, 17 (26.2%) were longitudinal, and 9 (14%) were transverse. Twenty-nine (45%) of the 65 patients demonstrated linear fracture, 17 (26%) hairline, 10 (15%) diastatic, and 9 (14%) displaced. Cranial nerve deficits and vascular injury occurred in 13.8% and 7.7% of cases, respectively. Twenty-five patients (38.5%) died in hospital. The long-term Extended Glasgow Outcome Scale score was significantly lower in transverse compared with longitudinal and oblique fractures (p = 0.03 and 0.03, respectively) and lower in diastatic compared with displaced fractures (p = 0.05). CONCLUSIONS This study provides information on the largest CF population studied to date, expands the current CF classification to include fracture quality as well as orientation, and underscores the existence of significant differences in pathogenesis and clinical presentation of CF subtypes.

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