Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Dev Med Child Neurol. 2022 Sep;64(9):1168-1175. doi: 10.1111/dmcn.15199. Epub 2022 Mar 9.
To describe cross-sectional and longitudinal variation in neurorehabilitation content provided to young people after severe paediatric acquired brain injury (pABI) and to relate this to observed functional recovery.
This was an observational study in a cohort of admissions to a residential neurorehabilitation centre. Recovery was described using the Pediatric Evaluation of Disability - Computer Adaptive Testing instrument. Rehabilitation content was measured using the recently described Paediatric Rehabilitation Ingredients Measure (PRISM) and examined using multidimensional scaling.
The PRISM reveals wide variation in rehabilitation content between and during admissions primarily reflecting proportions of child active practice, child emotional support, and other management of body structure and function. Rehabilitation content is predicted by pre-admission recovery, suggesting therapist decisions in designing rehabilitation programmes are shaped by their initial expectations of recovery. However, significant correlations persist between plausibly-related aspects of delivered therapy and observed post-admission recovery after adjusting for such effects.
The PRISM approach to the analysis of rehabilitation content shows promise in that it demonstrates significant correlations between plausibly-related aspects of delivered therapy and observed recovery that have been hard to identify with other approaches. However, rigorous, causal analysis will be required to truly understand the contributions of rehabilitation to recovery after pABI.
Rehabilitation content varies widely between, and during, admissions for neurorehabilitation after paediatric acquire brain injury. Strong correlations are seen between plausibly-related aspects of rehabilitation content and observed recovery, though careful interpretation is necessary.
描述严重儿童获得性脑损伤（pABI）后青少年接受神经康复的横断面和纵向变化，并将其与观察到的功能恢复相关联。
这是一项对居住在神经康复中心的患者队列进行的观察性研究。使用小儿残疾评估-计算机自适应测试工具（ Pediatric Evaluation of Disability - Computer Adaptive Testing instrument）描述康复情况。使用最近描述的儿科康复成分量表（ Paediatric Rehabilitation Ingredients Measure，PRISM）测量康复内容，并使用多维标度进行检查。
PRISM 揭示了住院期间和住院期间康复内容的广泛差异，主要反映了儿童主动练习、儿童情感支持以及其他身体结构和功能管理的比例。康复内容由入院前的恢复情况预测，这表明治疗师在设计康复计划时的决策是由他们对恢复的初始期望所决定的。然而，在调整了这些影响因素后，治疗中明显相关的方面与入院后观察到的恢复之间仍然存在显著相关性。
PRISM 分析康复内容的方法具有很大的潜力，因为它表明治疗中明显相关的方面与观察到的恢复之间存在显著相关性，而这些相关性很难用其他方法来识别。然而，需要进行严格的因果分析，才能真正理解康复对 pABI 后康复的贡献。
在儿童获得性脑损伤后的神经康复期间，康复内容在住院期间和住院期间差异很大。康复内容中明显相关的方面与观察到的恢复之间存在强烈的相关性，但需要谨慎解释。
