Document Type

Case Report

Department

Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2019

Advisor

Frey Law, Laura

Abstract

Background: Traumatic brain injury (TBI) is the number one cause of death and disabilities in the pediatric population. Various injury severity measures are used for patients with TBIs in order to predict expected outcomes. The purpose of this case report is to assess the stark differences in progression and functional outcomes of two children with TBIs who presented similarly at baseline using various severity measures. Case Descriptions: Both patients were admitted into inpatient rehabilitation on the same day and presented similarly at baseline: with Functional Independence Measure for Children (WeeFIM) scores of 19 and 18 for Patients A and B, respectively. Yet, they progressed differently during their time in rehab. Patient A was a 53-month-old female who suffered from a left-sided subdural hematoma with blown pupil on her left side and a right-sided skull fracture as a result of a non-accidental trauma. Patient B was a 45-month- old female who had a right-sided subdural hematoma, multifactorial intracranial hemorrhage, pneumocephalus with multiple skull fractures and facial fractures, small left pneumothorax, and a transverse process fracture of the second lumbar vertebrae as a result of a motor vehicle accident. Outcome Measure: The raw WeeFIM scores were used to calculate each patient’s WeeFIM developmental functional quotient (DFQ). At discharge, the WeeFIM DFQ score for Patient A was 71.87% but only 18.81% for Patient B. The severity measures outlined in this case report include the time from injury to admission into inpatient rehabilitation (TTA), the Glasgow Coma Scale (GCS), duration of post traumatic amnesia (PTA), total duration of impaired consciousness (TFC+PTA), and the time to follow command (TFC). Discussion: This case report highlights that the severity measures that were available for each patient would have helped create more accurate predictions for each patient’s functional outcomes than simply the WeeFIM score. These predictions are useful when creating treatment plans and educating families on expected outcomes.

Keywords

Pediatrics, Traumatic brain injury, WeeFIM, Severity measures, Rehabilitation, Physical Therapy

Pages

13 pages

Copyright

Copyright © 2019 Sabrina Casares

COinS
 

URL

https://ir.uiowa.edu/pt_casereports/79