0985 Utility Of A Rest-activity Ratio In A Pediatric Brain Injury Rehabilitation Sample: A Pilot Study

Abstract

Abstract Introduction Sleep is an important element of health that can impact daytime performance in brain injury rehabilitation. Actigraphy in a pediatric inpatient setting can pose challenges when there are increased amounts of time spent in a hospital bed. A rest-activity ratio (Duclos et al., 2013) has demonstrated utility in adult brain injury populations, showing sensitivity to improved regulation of the sleep-wake cycle as individuals recover during their hospitalization. The present study sought to examine the utility of this ratio in differentiating children with and without acquired brain injury (ABI). Methods Sixteen individuals, ages 8-16 (M=12.6, SD=2.4) admitted to an inpatient pediatric rehabilitation hospital wore an actigraph over a 7-day period. Eight inpatients were being treated for ABI whereas another 8 inpatients treated for other, non-neurological conditions served as a control. Raw activity counts across the 24-hour period were analyzed to derive a rest-activity ratio. Results Those with ABI had lower average ratios (0.73) compared with patients without ABI (0.84), F(1,14)=4.3, p=0.058. Individuals with ratios of 0.85 or higher were rated by their physical therapists as being more alert during therapy using a 5-point Likert scale, F(1,14)=4.1, p=0.061. While these results were marginally significant, this pilot sample was small, and the effect sizes were large (eta squared = 0.234 and 0.229 respectively). Conclusion The rest-activity ratio successfully distinguished those with ABI from a non-ABI sample. This preliminary evidence in a pediatric sample suggests that this ratio, shown to be sensitive to the effects of brain injury on sleep-wake regulation, may be a useful metric in the inpatient pediatric rehabilitation setting when sleep diaries may be difficult to obtain and patients may be spending more time in bed while awake. Future studies with larger sample sizes are needed to explore the correlates of this ratio with other aspects of rehabilitation after pediatric brain injury. Support This study was funded in part through a generous grant from the Church & Dwight Employee Giving Fund