Responsiveness of the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test in measuring functional outcomes for inpatient pediatric rehabilitation

Issue title: Children with Medical Complexity Offer Challenges and Opportunities for the Healthcare System

Guest editors: Richard Segal

Article type: Research Article

Authors: Fragala-Pinkham, Maria A.^{a; *} | Dumas, Helene M.^a | Lombard, Kelly A.^{a; b} | O'Brien, Jane E.^a

Affiliations: [a] Research Center, Franciscan Hospital for Children, Brighton, MA, USA | [b] Physical Therapy Department, Boston Children's Hospital, Boston, MA, USA

Correspondence: [*] Corresponding author: Maria A. Fragala-Pinkham, MS Research Center, Franciscan Hospital for Children, 30 Warren Street, Brighton, MA 02135, USA. Tel.: +1 617 254 3800 x2280; Fax: +1 617 779 1361; E-mail:mfragala@fhfc.org

Abstract: PURPOSE: Responsiveness of the PEDI-CAT Mobility, Daily Activities, and Social/Cognitive domains and Wheelchair subdomain was evaluated for youth admitted to a pediatric post-acute care hospital. METHODS: Inpatients ages 2-21 years, with a length of stay of ≥ 5 days and with both admission and discharge scores were included. The difference between mean admission and discharge PEDI-CAT scaled scores were analyzed using paired t-tests. Effect sizes, standard response means (SRMs), and minimal detectable change values were calculated. Score comparison between diagnostic subgroups (Traumatic Brain Injury, Neurological, Orthopedic, Medical) and age groups ( ≤ 5, > 5 but < 13, ≥ 13 years) were evaluated for the Mobility domain. RESULTS: Sample size differed by domain with 66 Mobility, 30 Daily Activities, 19 Social/Cognitive and 9 Wheelchair subdomain pairs. Significant differences were found for all domains when mean admission and discharge scaled scores were compared. Moderate to large effect sizes and SRMs were found for the Mobility and Daily Activities domains and Wheelchair subdomain. Small effect size but large SRM was found for the Social/Cognitive domain. The Mobility domain was also responsive to changes in all diagnostic and age groups. CONCLUSION: The PEDI-CAT was responsive to functional changes for youth discharged from an inpatient pediatric rehabilitation hospital.

Keywords: Functional outcomes, pediatric post-acute care, inpatient pediatric rehabilitation, PEDI-CAT

DOI: 10.3233/PRM-160382

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 9, no. 3, pp. 215-222, 2016