Research Reports - Fatigue following traumatic brain injury in children and adolescents

J Head Trauma Rehabil. 2017 Sep 18. doi: 10.1097/HTR.0000000000000330. [Epub
ahead of print]

Crichton A(1), Anderson V, Oakley E, Greenham M, Hearps S, Delzoppo C, Beauchamp
MH, Hutchison JS, Guerguerian AM, Boutis K, Babl FE; Biomarker and Quality of
Life in Children with Traumatic Brain Injury group.

BACKGROUND: Longitudinal fatigue data in children suffering from traumatic brain
injury (TBI) are lacking.
OBJECTIVES: To examine the effects of time postinjury (6-12 months) and injury
severity on fatigue after childhood TBI. Secondarily, we compared fatigue 12
months postinjury against published control data.
SETTING: Three tertiary children's hospitals across Australia (n = 1) and Canada
(n = 2).
PARTICIPANTS: Parents (n = 109) of children (mean [M] = 9.9 years at injury;
range, 1.0-16.9 years) admitted to one of 3 participating hospitals with mild (n
= 69) or moderate/severe (n = 37) TBI.
DESIGN: Longitudinal prospective study.
MEASURES: Primary: Pediatric Quality of Life Multidimensional Fatigue Scale
(total, general, sleep/rest, and cognitive), rated by parents 6 and 12 months
postinjury. Secondary: Pediatric Injury Functional Outcome Scale (fatigue and
sleep items, rated on recruitment and 6 and 12 months postinjury). Demographic
and children data were collected at recruitment.
RESULTS: Mixed-models analysis demonstrated nonsignificant effects of time (6 vs
12 months postinjury) on multidimensional fatigue scores. Cognitive fatigue
worsened over time. Moderate/severe TBI was associated with worse fatigue 12
months postinjury (general, P = .03; cognitive, P = .02). Across all severities,
fatigue 12 months postinjury was significantly worse compared with control data
(total fatigue, P < .001; all domains, all Ps < .025).
CONCLUSION: Fatigue remains significant at 12 months since injury, particularly
for those with moderate/severe TBI. 

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