S140 S290
neurological levels of injury and worse functional outcomes during
inpatient rehabilitation compared with adult patients.
Level of Evidence:
Level IV
Poster 132:
Location of Involvement in Pediatric Patients with
Cerebral Palsy and the Relationship to Development
of Scoliosis: A Retrospective Cross-Sectional Analysis
Denesh Ratnasingam, BA (University of Missouri - Kansas City, Kansas
City, Missouri, United States), Emily McGhee, MD, Ashley K. Sherman,
MA, Matthew J. McLaughlin, MD, MS, FAAPMR
Disclosures:
Denesh Ratnasingam: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
To determine if pediatric patients with cerebral palsy (CP)
with a quadriplegic type of CP have a stronger correlation of devel-
oping scoliosis compared to other types of CP.
Design:
Retrospective cross-sectional study.
Setting:
Tertiary pediatric rehabilitation outpatient clinic.
Participants:
494 participants were analyzed to determine factors
associated with increased radiographic Cobb angle measurements.
Interventions:
Not applicable.
Main Outcome Measures:
Cobb angle measurement analysis by
radiographic imaging of spine and orthopedic surgery evaluation,
location of CP involvement, age, weight, and Gross Motor Functional
Classification System (GMFCS) scores were collection.
Results:
Using an analysis of variance, a statistically significant dif-
ference in Cobb angle (p
<
.0001) was found between quadriplegic
patients (mean 42.7*, standard deviation 32.9*) compared to hemi-
plegic (9.1*, 3.9*), diplegic (13.5*, 6.9*), and triplegic (17.7*,
16.2*) patients after controlling for both weight and age. Individu-
ally, there is a moderately strong correlation observed (p
<
.001,
r
¼
0.40) between increasing age and increased Cobb angle; however,
no statistically significant correlation related to weight. Patients with
GMFCS level V had greater Cobb angles compared to all other GMFCS
levels (p
<
.05).
Conclusions:
In comparing patients with CP, those with quadriplegic
involvement or GMFCS level V patients had an increased amount of
scoliosis compared to those with different locations of involvement or
improved functional mobility.
Level of Evidence:
Level III
Poster 133:
Intensive Inpatient Pain Rehabilitation Program for
Adolescents and Young Adults (Age 18-21)
Katherine Bentley, MD, FAAPMR (Childrens Specialized Hospital,
Mountainside, NJ, United States), Urma Jalil, BS, Sharon Bushi, MD
Disclosures:
Katherine Bentley: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
Chronic amplified pain syndromes are common in children
and adolescents. Amplified musculoskeletal pain syndrome (AMPS) and
Complex Regional Pain Syndrome (CRPS) can be treated with an
intensive interdisciplinary rehabilitation program. The purpose of this
study is to examine the effect of an intensive pain rehabilitation on
older adolescents and young adults age 18-21.
Design:
This is a retrospective study.
Setting:
An intensive inpatient pain rehabilitation program in an acute
pediatric rehabilitation hospital.
Participants:
Thirty-one patients participated in the program. There
were 22: 18-year-old patients, 6: 19-year-old patients, 2: 20-year-old
patients and 1: 21-year-old patient.
Interventions:
All patients participated in therapy. They received an
average of 2 hrs of physical therapy, 2 hrs of aquatherapy, 1 hr of
aqua-therapy 5 days a week. They also received a minimum of 2hrs
weekly of psychotherapy in addition to group.
Main Outcome Measures:
Functional disability inventory (FDI), Brui-
ninks Oseretsky Test of Motor Performance, Second Edition (BOT-2),
Lower Extremity Functional Scale (LEFS)2 and Upper Extremity Func-
tional Scale (UEFS) and pain scale.
Results:
Among 31 patients aged 18-21 years who completed the
program, functional improvements and improvements in pain level
were observed. Pain level was significantly lower at discharge as
compared to admission (2.2 2.04, vs. 7.1 1.66). Both LEFS and UEFS
were significantly higher at discharge as compared to admission (68.54
14.5 vs. 34.5 11.8 and 72.2 8.8 vs. 50.1 14.8, respectively).
Improvements were also measured in child and parent FDI.
Conclusions:
Inpatient pain rehabilitation programs are beneficial for
older adolescents and young adults in improving function and pain.
Specific modifications of these programs may be beneficial for this age
group to prepare them for independent living and adulthood.
Level of Evidence:
Level III
Poster 140:
Descriptive Cohort Study of Children Sustaining Mild
or Complicated Mild TBI
Colby R. Hansen, MD, FAAPMR (Univ of Utah, Salt Lake City, UT,
United States), Maya Battikha, MD, Connor M. Peck, BS, Marcus Hunt,
Medical Student, Mary Pautler, MPH, Masa Teramoto, PhD
Disclosures:
Colby Hansen: I Have No Relevant Financial Relationships
To Disclose
Objective:
A complicated mild Traumatic Brain Injury (TBI) is differ-
entiated from a mild TBI by the presence of a skull fracture, or a
trauma related intracranial abnormality such as hemorrhage, contu-
sion, or edema. We compared three groups of children: 1) mild TBI
(mTBI); 2) mild TBI with skull fracture only (SF-mTBI), and 3) compli-
cated mild TBI (C-mTBI). Our objective was to describe the charac-
teristics and outcomes in children with these three classifications of
mTBI.
Design:
Eligibility was based on hospital database queries of children
presenting with all forms of mTBI from 2010-2013. Group assignments
were made based on chart reviews. Questionnaires were mailed to
parents that addressed pre- and post-injury health characteristics and
activity patterns.
Setting:
Academic Medical Center.
Participants:
Parents of eligible study subjects.
Interventions:
Not applicable.
Main Outcome Measures:
Characteristics and outcomes in children
with mTBI by mTBI classification were analyzed using Pearson’s chi-
square test.
Results:
Of 1777 children, 1319 had mTBI (74.2%), 127 had SF-mTBI
(7.1%), and 331 had C-mTBI (18.6%). The complete survey was returned
from 285 (16.0%) parents. Of these, 175 (61.4%), 33 (11.6%), and 77
(27.0%) were classified as mTBI, SF-mTBI, and C-mTBI respectively.
There was a significant association between prior concussion and mTBI
classification [p
¼
.011; significantly higher than expected among
those with mTBI (adjusted standardized residual
¼
2.992) and signifi-
cantly lower than expected among those with C-mTBI (adjusted
standardized residual
¼
-2.110)]. The association of repeated con-
cussions to mTBI classification was also significant [p
¼
.020; signifi-
cantly higher than expected among children with mTBI (adjusted
standardized residual
¼
2.311) and significantly lower than expected
among those with C-mTBI (adjusted standardized residual
¼
-2.781)].
Conclusions:
A significant proportion of children with mTBI presenting
to a children’s hospital have C-mTBI. Interestingly, it is patients with
mTBI and not C-mTBI who are more likely to have had prior concussion
and sustain repeat concussion.
Level of Evidence:
Level II
S140
Abstracts / PM R 9 (2017) S131-S290