S178 S290
Objective:
Previous studies by other researchers have shown promise
for robotic rehabilitation to improve ankle mobility and strength in
patients with cerebral palsy. We plan to build on this work and develop
a low-cost robotic system for rehabilitation for children with cerebral
palsy. Our long-term goal is to enable rehabilitation in the home with
quantitative data sent to a central server that is monitored by the
clinical team.
Design:
We built a three degree of freedom robot along with an
associated control system. An airplane video game was constructed
using the open source gaming software Unity and connected to the
robotic system. The range of motion is configurable and the foot of the
user becomes the “joystick” that is responsible for controlling the
plane to fly through a series of hoops. We present the clinical feasi-
bility study for the use of the robot as a therapeutic tool.
Setting:
Pediatric outpatient clinic.
Participants:
5 children with cerebral palsy, ages 4-13 years.
Interventions:
Children were positioned in a Rifton Activity Chair so
that one affected foot could be strapped into the robot to be used as
the controller for the video game. Limits to the robot were set by the
PT to make use of the controller possible to fly the plane through the
hoops in the videogame. The game was made progressively more
difficult, encouraging the patient to increase use and range of motion
of the affected foot.
Main Outcome Measures:
Tolerance, enjoyment, ability to play the
videogame.
Results:
All participants were enthusiastic users of the robot as a
“joystick” to play the video game. They participated eagerly in ther-
apy sessions and were happy to “get to the game time.” There were no
incidents or accidents that caused us to stop the trials.
Conclusions:
PedBOT can be tolerated by children as an adjunct to
therapy for cerebral palsy.
Level of Evidence:
Level IV
Poster 141:
Pilot use of the Social Skills Rating System in Children
with Traumatic Brain Injury
Mi Ran Shin, MD (Johns Hopkins University School of Med),
Stacy J. Suskauer, MD
Disclosures:
Mi Ran Shin: I Have No Relevant Financial Relationships
To Disclose
Objective:
Use of the Social Skills Rating System (SSRS) has not
been reported in traumatic brain injury (TBI). Our goal was to
examine how youth with TBI scored on this measure in comparison
to published norms and scores of children with attention deficit
hyperactivity disorder (ADHD) and the relationship between SSRS
scores and parent-report measures of executive function and
quality of life (QOL).
Design:
Longitudinal observational study.
Setting:
Pediatric rehabilitation research center.
Participants:
Children aged 10-17 at injury with mild (53%) or
moderate-severe (47%) TBI; 15 children were evaluated 2 and 12
months post-TBI.
Interventions:
Not applicable.
Main Outcome Measures:
SSRS: standardized scores for social skills
(SS) and problem behaviors (PB) and raw subscale scores for cooper-
ation, assertion, responsibility, and self-control. Behavior Rating In-
ventory of Executive Function (BRIEF): Global Executive
Composite(GEC) t-score. Pediatric Quality of Life Inventory (PedsQL)
(12 month visit only): General Health score
Results:
SSRS scores fell within the normal range at 2 and 12
months post-injury. Lowest scores/greatest range were seen in the
cooperation subscale at 2 months. For the cooperation subscale, TBI
cohort scores were between the norms and scores for children with
ADHD; for other scores the TBI cohort was similar to norms. SS was
negatively correlated with GEC at 2 months (r
¼
-0.628) and 12
months (r
¼
-0.632); better social skills was associated with fewer
executive function concerns. SS was positively correlated with
PedsQL (r
¼
0.817, p
<
.01); stronger social skills were associated with
better quality of life.
Conclusions:
This is the first report of use of the SSRS in TBI. In this
small pilot sample, the group as a whole performed well, though
some children had lower scores, particularly on the cooperation
subscale. SSRS scores were associated with other parent-report
measures. Future work should examine the utility of this measure in
larger groups of children with TBI including those with more severe
injuries.
Level of Evidence:
Level II
PRACTICE MANAGEMENT & LEADERSHIP POSTER HALL:
ORIGINAL RESEARCH
Poster 142:
Correlates of Participation in Patient Experience
Survey Among Patients with Orthopedic Conditions in
an Inpatient Rehabilitation Facility
Sharon Bushi (East Brunswick, NJ, USA), Mooyeon Oh-Park, MD
Disclosures:
Sharon Bushi: I Have No Relevant Financial Relationships
To Disclose
Objective:
Patient experience has been increasingly emphasized as
an important parameter of quality care in various healthcare settings.
Although healthcare providers use patient experience surveys (PES) as
tools to capture the voice of patients, the results may vary depending
on which patients respond to the survey. The objective of this study
was to identify the correlates of participation in patient experience
survey (PES) among patients with orthopedic conditions in inpatient
rehabilitation facility (IRF).
Design:
Retrospective data analysis.
Setting:
Free standing IRF.
Participants:
Patients admitted with orthopedic diagnoses (arthro-
plasty, fractures without neurological injuries) for a 12 month period.
Interventions:
Not applicable.
Main Outcome Measures:
Participation in patient experience surveys
(34 multiple choice questions) which were offered to all the patients
upon discharge.
Results:
A total of 2,631 patients (65% female) with orthopedic
diagnoses were included in the analysis. Of these patients, 1,399
(53%) participated in the PES. These participants were found to be
younger [(mean age standard deviation (SD), 70.91.x 11.9 vs
72.3 12.8), with higher cognitive functional independence mea-
sure (FIM) scores at discharge (31.5 3.6 vs 29.8 4.9) compared
to non-participants. Also, a higher proportion of participants
were married (56% vs 48%) and discharged home (91% vs 83%)
than nonparticipants. There was no difference in gender and
ethnicity between participants and nonparticipants. In multivar-
iate logistic regression analysis, independent correlates of
participation in PES include younger age [odds ratio (OR), 95%
confidence interval (CI), 1.01, 1.00-1.02], marital status (OR, 95%
CI, 1.29, 1.09-1.51), and cognitive FIM scores at discharge (OR,
95% CI, 1.06, 1.04-1.09).
Conclusions:
This study showed that older patients with lower
cognitive function, or those with limited family support may be un-
derrepresented in the PES results. Patient experience has tremendous
implications for resource allocation and medical administration.
Systematic efforts to capture the voices of this underrepresented
population, therefore, are desired to provide ideal patient centered
care.
Level of Evidence:
Level III
S178
Abstracts / PM R 9 (2017) S131-S290