S177 S290
Results:
Children with mild group had significant higher DQs in language
(receptive, expressive and total language), motor (gross, fine and total
motor), social and total domains than severe groups (p
<
.05). Children
withmild group also had higher DQs in the self-help domain (p
¼
.092) than
severe group, but it did not achieve the significant differences.
Conclusions:
The cognitive impairment in children with ASD was
associated with developmental outcomes in most domains. These
findings may allow clinicians early identifying the development out-
comes and planning the therapeutic strategies in children with ASD.
Level of Evidence:
Level II
Poster 136:
30 Year Outcomes After Severe Traumatic Brain
Injury in a Pediatric Population
Kathleen Vonderhaar, MD (Univ of Minnesota, St. Paul, MN,
United States), Molly E. Hubbard, MD, Gabrielle Meyer, DO,
Gaylan L. Rockswold, MD, Uzma Samadani, MD
Disclosures:
Kathleen Vonderhaar: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
Interruption of normal developmental capabilities may
occur in a pediatric TBI patient as they age, which is not appreciated
in the adult TBI patient. However, long term follow up of pediatric
samples has been limited. The question remains whether these deficits
continue to be more pronounced and persistent years after the injury.
The purpose of this study is to describe the functional outcomes of
subjects less than or equal to 18 years old at the time of severe TBI
(pediatric-onset) relative to those subjects greater than 18 years old
at time of severe TBI (adult-onset) approximately 30 years after injury.
Design:
Observational, Cross Sectional, Long Term Outcomes Study.
Setting:
Level One Trauma Center.
Participants:
Thirty-two patients with severe traumatic brain injury
(GCS 9) previously enrolled in a study during the 1980s.
Interventions:
Not applicable.
Main Outcome Measures:
TICS-m, educational level, work status,
ability to walk 1 flight of stairs and manage finances.
Results:
Fifty-three percent of the population had abnormal cognitive
status (TICS-m score 32) with the mean TICS-m score for the pedi-
atric-onset group being 29 and the adult-onset group being 34
(p
¼
.0852). 62% of pediatric-onset participants had completed at least
some college, 50% reported working either full or part-time, 64%
handled their own finances (vs 83% of adult-onset), and 79% could
climb one flight of stairs (vs 94% of adult-onset). However, patients
with adult-onset TBI were more likely to report at least one arrest
compared to pediatric TBI patients (p
¼
.048, 66% vs 31%).
Conclusions:
This study provides functional outcomes of severe pe-
diatric TBI patients 30 years after injury and compares them to their
adult counterparts. Of the two groups, pediatric-onset TBI patients
reported more severe functional outcomes. Though within the margin
of error, the overall trend suggests there may be a difference between
pediatric-onset TBI patients and adult-onset TBI patients 30 years
after injury.
Level of Evidence:
Level IV
Poster 137:
Incidence and Safety of Botulinum Toxin Type A
Injections for Pediatric Patient with Cerebral Palsy
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 the incidence of hospitalizations in pediatric
patients with cerebral palsy (CP) who received Botulinum toxin type A
(BoNT-A) compared to inpatient hospitalization rates in pediatric
patients with CP who had not received BoNT-A injections in the last 6
months of the most recent rehabilitation clinic visit.
Design:
Retrospective cohort study.
Setting:
Tertiary care pediatric rehabilitation outpatient clinic.
Participants:
494 participants were analyzed within a three year
period who were seen in a pediatric rehabilitation clinic.
Interventions:
Participants who received BoNT-A were followed for 6
months after injection and patients who did not receive BoNT-A were
followed for the same duration after the most recent rehabilitation
clinic visit for any inpatient hospitalization.
Main Outcome Measures:
Time from injection or rehabilitation clinic
visit to inpatient admission.
Results:
Of the 494 participants in the study, 40 subjects had an
inpatient admission within 6 months of a clinic follow up or a botuli-
num injection. Of those admissions, 23/40 patients received BoNT-A
injections while 17/40 patients had not received BoNT-A treatment
(p
<
.495).
Conclusions:
There does not appear to be an increased incidence of
admission for patients who had received BoNT-A injections compared
to treatment of patients without BoNT-A during the 6-months follow-
up period for each cohort.
Level of Evidence:
Level III
Poster 138:
The Use and Safety of Intramuscular Midazolam
During In-Office Neurolysis/Botox Injection
Procedures for Pediatric Patients
Mariam Mian, DO (Tufts Medical Cntr, Boston, MA, United States),
Nadia O. Alwasiah, MD
Disclosures:
Mariam Mian: I Have No Relevant Financial Relationships
To Disclose
Objective:
This study was conducted to determine whether the use of
intramuscular midazolam is a reasonable and safe anxiolytic medica-
tion option for pediatric patients undergoing neurolysis /Botox in-
jections, in lieu of performing the procedure in the Operating Room
under general anesthesia or in the office without the use of anxiolytic
medications.
Design:
Retrospective chart review.
Setting:
Tertiary Pediatric Hospital, Outpatient Clinic.
Participants:
121 Children with Spasticity, ages 2 -18 years.
Interventions:
Not applicable.
Main Outcome Measures:
Post-recovery anesthesia scale REACT
(Respiration, Energy, Alertness, Circulation, Temperature), scaled
from 1-10. Frequency of side effects after midazolam dosing including
prolonged sedation, breakthrough crying and respiratory compromise.
Results:
We found that 38% of the patients had prolonged sedation (
>
30 minutes after medication administration), 15% had breakthrough
crying, and 0% had any respiratory concerns requiring oxygen or an ER
visit. The average time of sedation was 29 minutes. None of the sub-
jects required reversal of midazolam or transfer to the emergency
room.
Conclusions:
Overall, intramuscular midazolam has been a safe
anxiolytic medication choice for performing in-office neurolysis/Botox
injection procedures for appropriately selected pediatric patients.
Level of Evidence:
Level IV
Poster 139:
PedBOT: Robotically Assisted Rehabilitation for
Children with Cerebral Palsy
Sarah H. Evans (Children’s National Health System, Washington, DC,
USA), Kevin Cleary, PhD, Catherine L. Coley, PT DPT PCS
Disclosures:
Sarah Evans: I Have No Relevant Financial Relationships
To Disclose
S177
Abstracts / PM R 9 (2017) S131-S290