S132 S290
and PR. Further research should be conducted on the inter-relation-
ship relationships of BF, AL, and PR in other geriatric syndromes.
Level of Evidence:
Level II
Poster 12:
Post-Traumatic Amnesia Duration, Glasgow Coma
Scale, and Intracranial Pressure Correlation:
Evidence for Acute Management of Traumatic Brain
Injury
Nhung Quach, MD (Santa Clara Valley Medical Center, San Jose, CA,
USA), Reza Ehsanian, MD, PhD, Jyodi Mohole, BS, Samantha Sechrist,
BS, Sarah Lavoie, MPH, Laura Jamison, MD, Stephen McKenna, MD,
Thao Duong, MD, Linda Isaac, PhD
Disclosures:
Nhung Quach, MD: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
Elucidate outcomes of individuals with extremely severe
post-traumatic amnesia (EsPTA) after Traumatic Brain Injury (TBI) and
determine correlating measures.
Design:
Retrospective cohort study.
Setting:
Academic Medical Center.
Participants:
Individuals (N
¼
565) with moderate-severe TBI from the
Northern California TBI Model System of Care admitted between 1988
and 2011; followed through 2016.
Interventions:
Not applicable.
Main Outcome Measures:
PTA duration, Intracranial Pressure (ICP),
Glasgow Coma Scale (GCS), Disability Rating Scale, Functional Inde-
pendence Measures, and productivity.
Results:
EsPTA (greater than 28 days) group had higher disability levels,
lower functional independence status, and reduced productivity vs. non-
EsPTA (less than or equal to 28 days) group. Individuals with GCS less than
or equal 8 were nearly four times more likely to develop EsPTA (P
<
.0001),
and were almost at three times higher risk to have intracranial hyper-
tension (ICH) compared with GCS 9-15 group (P
<
.01). The risk of devel-
oping EsPTA increased more than four times for individuals with ICH (ICP
greater thanor equalto 20mmHg) versusICPless than20mmHg (P
<
.0001).
Conclusions:
GCS correlates with ICH, a factor that may be treated to
shorten PTA duration and improve clinical outcomes in persons with
moderate to severe TBI.
Level of Evidence:
Level III
Poster 15:
Patient and Clinical Outcomes with a
Transformational Coaching Intervention After
Orthopedic Trauma
Heather K. Vincent, PhD, MS (Univ of Florida Dept of Orthopedics and
Rehabilitation, Gainesville, FL, United States), Laura Ann Zdziarski,
LAT, PhDc, MaryBeth Horodyski, EdD, LAT, ATC, FNATA,
Alexandra Dluzniewski, BA, MS, Jennifer Hagen, MD,
Terrie Vasilopoulos, PhD, Kalia K. Sadasivan, MD
Disclosures:
Heather Vincent: Research Grants - Foundation for
PM&R, Consulting fees or other remuneration (payment) - Medicine
and Science in Sports and Exercise
Objective:
To determine the comparative efficacy of a 10-step
transformational coaching intervention (INTVN) and usual care con-
trols (CON) on acute care and patient-centered outcomes after or-
thopedic trauma injury.
Design:
Randomized, single-blinded, controlled study (RCT).
Setting:
Inpatient and outpatient clinics, research laboratory.
Participants:
Patients admitted to acute care for long-bone or poly-
trauma injury (N
¼
82; 41.3% women, 29.6 7.7 kg/m
2
and 43.4 16.8
yr). The average patient had 3.7 3.9 bone fractures.
Interventions:
We administered a 10-Step intervention program dur-
ing the acute care stay (assigned a “coach”, provided supportive
materials, individualized facilitator attention time, phone call and
personal outpatient follow-up visits, goal setting and customized
resource provision) to help patients overcome psychological stressors,
engage in therapeutic activities and prepare them for discharge.
Follow-ups occurred at 2 week, 6 week and 3 months.
Main Outcome Measures:
Clinical outcomes (length of stay [LOS],
participation in therapy, discharge location, adverse readmissions) and
Patient Reported Outcome Measurement (PROMIS) measures (Physical
Function, Emotional Well-being [Psychosocial Illness Impact Positive,
Satisfaction With Social Roles and Activities].
Results:
LOS was not different between groups (7.0 5.2 d CON and
8.7 5.6 d INTVN). Participation in physical therapy was greater with
INTVN than CON (2.2 1.3 hr versus 1.9 1.6 h; p
<
.05). The proportion
of patients who were discharged to home did not differ between
groups (55.0-60.4% of the groups). INTVN had half the number of
adverse readmissions as CON (10.5% versus 20.4%). Both groups
improved similarly with PROMIS Function and Emotional Well-Being.
Three-month scores in PROMIS Function were improved by 35.3 25.0 %
and 52.3 45.3% in INTVN and CON, respectively. Positivity was
improved by 3.0 19.0% and 3.2 16.1% in INTVN and CON, respec-
tively, at month 3.
Conclusions:
While all patients made physical and emotional gains by
3 months, transformational coaching may help improve engagement in
rehabilitation activities and reduce the hospital readmissions.
Level of Evidence:
Level II
Saturday, October 14, 2017
10:00 AM
e
11:15 AM
Room 705, Meeting Room Level
LEADING IN RESEARCH: MSK & SPORTS MEDICINE PODIUM
SESSION
Poster 36:
Motion Features Related to Shoulder Pain in Lacrosse
Athletes: Implications for Prehabilitation
Heather K. Vincent, PhD, MS (Univ of Florida Dept of Orthopedics and
Rehabilitation, Gainesville, FL, United States), Joseph G. Wasser, BS,
Trevor Leavitt, BS, Cong Chen, MS, Kevin R. Vincent, MD, PhD, FAAPMR
Disclosures:
Heather Vincent: Research Grants - Foundation for
PM&R, Consulting fees or other remuneration (payment) - Medicine
and Science in Sports and Exercise
Objective:
To identify the kinematic features of throwing motion in
high school and collegiate lacrosse players reporting chronic mild-to-
moderate shoulder pain.
Design:
Observational, experimental study.
Setting:
Academic research laboratory affiliated with an orthopedics
and rehabilitation department.
Participants:
Participants were male and female lacrosse players
(N
¼
62; 18.0 3.6 yr, 31.1% female). The player position distribution was
as follows: 36.1% attack, 34.4 midfield, 23.0 defense and 6.6% goalie.
Participants underwent a comprehensive testing session and participants
were grouped by the presence or not of shoulder pain (pain, no pain).
Interventions:
Not applicable.
Main Outcome Measures:
Pain severity was scored using an 11-point
numerical pain rating scale (NRSpain). Three-dimensional motion
capture of overhead throws was used to collect data on knee, pelvis,
trunk and shoulder kinematics, and ball speed. One-repetition
maximum muscle strength and endurance of the shoulders was
captured using weight machines.
Results:
Average NRSpain rating was 2.2 points. Players with shoulder
pain threw with faster velocity (112 11 km/hr vs 97 24 km/hr;
p
<
.001), were all male and were predominantly offensive positions
(83.3% attack and midfield). Shoulder-to-pelvis crossover was greater
in players with pain after ball release (67 21 degrees versus
52.1 17.0 degrees; p
¼
.047). Hand distance on the lacrosse stick was
less in players with pain by 1 cm during the throw (p
<
.05) Shoulder
S132
Abstracts / PM R 9 (2017) S131-S290