Functional Changes During Inpatient Rehabilitation for Children with Musculoskeletal Diagnoses

Abstract

The purpose of this study was to describe functional self-care and mobility changes of children with musculoskeletal diagnoses during inpatient rehabilitation. A retrospective record review was completed for 50 children and youth aged three to 20 years admitted to inpatient rehabilitation after a traumatic musculoskeletal injury or after orthopedic surgery because of a preexisting musculoskeletal or neuromuscular disorder. Admission to discharge changes in summary scaled scores on the Pediatric Evaluation of Disability Inventory's (PEDI) Functional Skills and Caregiver Assistance Self-Care and Mobility scales for the total group and two diagnostic subgroups were examined using paired t tests and effect-size coefficients. Independent t tests were used to determine differences between change scores for the subgroups. Mean PEDI Functional Skills Self-Care and Mobility scaled scores were significantly higher at discharge for the total group. For the subgroups, both Functional Skills and Caregiver Mobility scaled scores were significantly higher at discharge, but only the trauma group made a significant change in Self-Care, on the Caregiver Assistance scale. Effect-size coefficients ranged from 0.23 to 1.76. The trauma group demonstrated significantly greater changes than the postsurgical group on both scales in both domains. During inpatient rehabilitation, children with musculoskeletal diagnoses demonstrated significant functional improvements. Children with traumatic injuries made greater gains than children with preexisting conditions after orthopedic surgery. These results support the PEDI as a responsive measure of change during inpatient rehabilitation for children with musculoskeletal diagnoses.