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Titre : | Initiation of Physical, Occupational, and Speech Therapy in Children With Traumatic Brain Injury (2013) |
Auteurs : | Tellen Bennett ; Christian Niedzwecki ; Kent Korgenski ; et al. |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2013/7, 2013) |
Article en page(s) : | pp. 1268-1276 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Ergothérapie ; Orthophonie ; Pédiatrie ; Rééducation et réadaptation ; Traumatismes cranioencéphaliques |
Mots-clés: | Craniocerebral trauma ; Occupational therapy ; Pediatrics ; Speech therapy |
Résumé : |
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 2001June 2011). Participants Children (age 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, 310d). 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. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/archives-of-physical-medicine-and-rehabilitation |