Neurological rehabilitation in children and adolescents.

Abstract

We report about 38 patients aged between 1 and 19 years (36.8% female, 63.2% male; mean age 7.8 years) admitted as inpatients for further neurorehabilitation mostly 4 weeks after severe acquired brain injury (ABI) of different aetiology. Of the patients, 73.7% were in a state of minimal responsiveness (vigilance score < 7 WVS) on admission. We evaluate the course of rehabilitation and the outcome 6 months after the end of the inpatient-period. The average stay of 15.5 weeks is strikingly low. The average intensity of therapy comes to about 16 units per week including strategies of rehabilitative education. The incidence of good rehabilitation was 21%, whereas almost 45% of patients displayed severe impairment. Although further improvements were found in almost 40% of patients 6 months later, these only slightly changed the overall picture of the GOS values. More than 3/4 returned to their families after rehabilitation, often despite great functional impairment. A return to the former environment outside the family (kindergarten, school) was, however, possible in 2/3 of the subjects. The proportion of minimally responsive patients fell from 73.7% to 18.4% during the stationary rehabilitation phase. After a further 6 months (follow up), 36.4% of the originally minimally responsive patients achieved a GOS value of > 5.