ArticleJournal of pediatric rehabilitation medicine2026
Assessing and categorizing health-related quality of life outcomes in children and youth with acquired brain injury in outpatient rehabilitation.
Article in Journal of pediatric rehabilitation medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionYoung patients with acquired brain injury (ABI) often report diminished health-related quality of life (HRQoL) compared to healthy peers. Yet, this has not been investigated in a large multicenter outpatient-rehabilitation based cohort. Furthermore, a clear way to categorize HRQoL to better interpret scores is lacking, though this could be valuable for clinical use (i.e., for comparison with other populations).
methodsThis cross-sectional study used the PedsQL™ Generic Core Scales 4.0 questionnaire with 23 items to assess patients' HRQoL, where lower scores mean a more diminished HRQoL. Children (8-12 years), adolescents (13-17 years), and young adults (18-25 years) with ABI, referred to a Dutch rehabilitation center, were included. Patient characteristics were analyzed using descriptive statistics and mean (standard deviation [SD]). HRQoL scores were calculated per age group and subsequently categorized using reference data(means, SDs) from healthy peers. HRQoL was categorized as 1 ('better HRQoL than healthy peers', > + 1SD), 2 ('comparable HRQoL', -1SD to +1SD), 3 ('moderately diminished HRQoL', -1SD to -2SD), or 4 ('severely diminished HRQoL', < -2SD).
resultsFour hundred twenty-six young patients (aged 8-25 years) with ABI participated in the study; 233 were female (54.7%), and 334 had a diagnosis of traumatic brain injury (78.4%). Children, adolescents, and young adults had mean (SD) HRQoL total scores below age-specific Dutch healthy peer normative means (62.98 [14.39], 62.86 [16.82], and 59.34 [18.46], respectively). Based on the SD-based categorization using healthy peer reference data, 59% of children (55/93), 52% of adolescents (147/282), and 61% of young adults (31/51) were categorized in Category 4 ('severely diminished HRQoL' < -2SD relative to age-specific Dutch healthy peer norms).
conclusionMeasuring and categorizing HRQoL in outpatient rehabilitation may facilitate clinically meaningful interpretation of PedsQL scores by benchmarking to healthy peers, supporting shared decision-making at referral in young patients with ABI.
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