Bolger Ashlee, Collins Andrew, Michels Michelle, Pruitt David
Departments of Pediatrics and Neurology & Rehabilitation Medicine, University of Cincinnati College of Medicine; Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLD 4009, Cincinnati, OH 45229-3039(∗).
Departments of Pediatrics and Neurology & Rehabilitation Medicine, University of Cincinnati College of Medicine(†).
PM R. 2018 Sep;10(9):910-916. doi: 10.1016/j.pmrj.2018.03.004. Epub 2018 Mar 14.
Conversion disorder (CD) can lead to impaired functioning. Few studies present demographic and outcome data for pediatric patients. Many have had success with rehabilitation; however, further details are not known.
To identify characteristics and outcomes of children admitted to a pediatric inpatient rehabilitation program with CD symptoms.
Retrospective study.
Inpatient rehabilitation unit within a large children's hospital.
All patients with diagnosis of CD or functional gait disorder (FGD) during designated time period.
Data were obtained from chart review and United Data Systems for Medical Rehabilitation. Descriptive statistics and Wilcoxon signed rank tests were used to analyze data. A P value of <.05 was statistically significant.
Average length of stay, Functional Independence Measure for Children (WeeFIM) scores, WeeFIM change, WeeFIM efficiency, recommended therapies, number of repeat admissions to the same hospital for conversion disorder symptoms in the 12 months following discharge, and school reentry characteristics.
Thirty admissions were identified that met criteria. Before diagnosis, duration of symptoms was 58 ± 145 days, physician visits averaged 1.9 ± 2.1, hospital admissions to the same hospital averaged 0.7 ± 0.9, and absence from school was 6 ± 12 weeks. Overall, 83% exhibited mixed symptoms. Length of inpatient rehabilitation stay was 8.4 ± 4.2 days with WeeFIM score change of 30 ± 11.9 (P <.001). WeeFIM efficiency was 4.8 ± 4.1 points/d. For patients with documented WeeFIM scores at 3 months, all were improved or maintained. More than three-fourths (80%) had no documented readmission to the same hospital for CD symptoms for 1 year after discharge from inpatient rehabilitation. Close to half (47%) returned to school within 1 week of discharge from inpatient rehabilitation (when school was in session).
This study suggests that a multidisciplinary inpatient rehabilitation approach is a potentially effective and efficient treatment for children and adolescents with conversion disorder and leads to sustained functional improvement and return to school after discharge.
III.
转换障碍（CD）可导致功能受损。很少有研究提供儿科患者的人口统计学和预后数据。许多康复治疗已取得成功；然而，更多细节尚不清楚。
确定因转换障碍症状入住儿科住院康复项目的儿童的特征和预后。
回顾性研究。
一家大型儿童医院的住院康复科。
在指定时间段内诊断为转换障碍或功能性步态障碍（FGD）的所有患者。
数据来自病历审查和联合医疗康复数据系统。使用描述性统计和Wilcoxon符号秩检验分析数据。P值<.05具有统计学意义。
平均住院时间、儿童功能独立性测量量表（WeeFIM）评分、WeeFIM评分变化、WeeFIM效率、推荐治疗方法、出院后12个月内因转换障碍症状再次入住同一家医院的次数以及复学特征。
确定了30例符合标准的入院病例。诊断前，症状持续时间为58±145天，平均看诊次数为1.9±2.1次，同一家医院的平均住院次数为0.7±0.9次，缺课时间为6±12周。总体而言，83%的患者表现出混合症状。住院康复时间为8.4±4.2天，WeeFIM评分变化为30±11.9（P<.001）。WeeFIM效率为4.8±4.1分/天。对于出院3个月时有记录的WeeFIM评分的患者，所有患者的评分均有所改善或维持。超过四分之三（80%）的患者在住院康复出院后一年内没有因转换障碍症状再次入住同一家医院的记录。近一半（47%）的患者在住院康复出院后1周内（学校上课期间）复学。
本研究表明，多学科住院康复方法对于患有转换障碍的儿童和青少年是一种潜在有效且高效的治疗方法，可导致功能持续改善并在出院后复学。
III级。
