Fred Murdock

Growth characteristics in cerebral palsy subtypes: a comparative assessment.

Children with quadriplegic cerebral palsy (CP) have been found to have growth rates that differ from those of children with typical development. Little research has been performed to distinguish whether growth patterns in hemiplegic, diplegic, and quadriplegic CP differ from one another. The purpose of this study was to compare growth of children with quadriplegic, hemiplegic, and diplegic CP.

Quality of Intrathecal Baclofen From Different Sources

To compare the quality of intrathecal baclofen obtained from a national compounding pharmacy (AnazaoHealth) with the manufactured product (Lioresal) with regard to accuracy and precision of baclofen concentration, and the content of the baclofen degradation product, 4‐(4‐chlorophenyl)‐2‐pyrrolidinone (PYR).

A Cross-Sectional Study of Pain Among U.S. College Music Students and Faculty

OBJECTIVES Studies over recent decades have demonstrated significant performance-related pain among professional musicians. However, there have been no largescale studies to evaluate pain among college musicians. The aim of this study was to determine the prevalence and anatomical locations of performance-related pain among students and faculty at the college level and learn what musicians do when they have pain. METHODS Cross-sectional data were collected using an online survey distributed to colleges across the United States. Data were analyzed using REDCap electronic data capture tools and Microsoft Excel. RESULTS We received 1,007 survey responses and found that 67% of musicians at colleges experienced performance-related pain. The highest prevalence of pain was in woodwind musicians, with 83% reporting performance-related pain. The most common locations of pain were upper back (27%), lower back (26%), and fingers of the right hand (25%). Many student musicians with pain seek help from their teacher, but almost as many do not seek help at all. Less than 25% see a medical professional. CONCLUSIONS Most musicians at colleges experience performance-related pain in a variety of anatomical locations depending upon instrument/voice. Performing arts health organizations can increase awareness of treatment options for musicians suffering from performance-related pain, which may lead to improved quality of life and increased career longevity for college musicians.

PW 0930 Evaluation of first impact—a missouri graduated driver license (GDL) traffic safety program for parents

Background First Impact is a 90 min evidence-based traffic safety program for parents of new drivers. The goal of the program is to reduce the number of motor vehicle fatalities, injuries and crashes among teen drivers by increasing parental awareness and enforcement of Missouri’s GDL law. The objectives of the program are to increase: 1) Awareness of teen driving risks, 2) Understanding of Missouri’s GDL law, 3) GDL monitoring and enforcement at home, and 4) Importance of being a positive role model. Trained facilitators who deliver the program statewide coach parents by presenting key facts and proven strategies to help parents lower their teens’ crash risk. First Impact is a program of ThinkFirst Missouri, an affiliate chapter of the ThinkFirst National Injury Prevention Foundation. Primary funding for First Impact is provided by the Missouri Department of Transportation, Highway Safety and Traffic Division. Purpose The purpose of this study was to evaluate the understanding of the Missouri GDL law before and after receiving the First Impact GDL parent program. Methods Pre-and post-test surveys were conducted during the pilot year of the First Impact intervention (12 month period, May 1, 2016-April 30, 2017). Participants included parents and teens attending the First Impact program (n=690). The majority (60%) of attendees were parents. A chi-square analysis was used to evaluate whether frequency of responses in the pre- and post-test groups were significantly different. Results There was a significant (p<0.01) increase in each of the three components measured (understanding of GDL law, nighttime restrictions, and passenger restrictions). Conclusion Based on the change in attendee responses, the First Impact intervention produced a highly significant improvement in understanding three vital components of the GDL law. Results of this study indicate that First Impact is a promising intervention to increase the understanding of Missouri’s GDL law.

Prevalence of Injuries during Brazilian Jiu-Jitsu Training

Brazilian jiu-jitsu (BJJ) is a martial art that focuses on groundwork, joint locks, and chokeholds. The purpose of this study is to determine the prevalence of injuries sustained during BJJ training. A 27-question research survey was e-mailed to 166 BJJ gyms in the United States. Demographic information, belt level, weight class, training hours, competition experience, and injury prevalence data were collected. The majority of respondents were Caucasian (n = 96) males (n = 121) with an average age of 30.3 years. Overall, the most common injury locations were to the hand and fingers (n = 70), foot and toes (n = 52), and arm and elbow (n = 51). The most common medically diagnosed conditions were skin infections (n = 38), injuries to the knee (n =26), and foot and toes (n = 19). The most common non-medically diagnosed injuries occurred to the hand and fingers (n = 56), arm and elbow (n = 40), and foot and toes (n = 33). In general, athletes were more likely to sustain distal rather than proximal injuries. Athletes reported more frequent medically diagnosed injuries to the lower extremity and more frequent self-diagnosed injuries to the upper extremity. Upper extremity injuries appear to be more frequent but less severe than lower extremity injuries with the opposite being true for lower extremity injuries.

Poster 443 Prevalence of Tracheostomy and Gastrostomy Tube Utilization in Acute Traumatic Brain Injury in the Pediatric Population

responsive a short time later. Patient was transported to an outside hospital, had a tonic-clonic seizure, was intubated, and then transferred to Children’s Hospital of Wisconsin. Computed tomography (CT) of head revealed a left frontotemporal skull fracture and large heterogeneous left frontal mass with calcification and hemorrhagic transformation. Subsequent magnetic resonance imaging (MRI) of brain revealed a large (8.3x7 cm), lobulated, avidly enhancing, extra-axial heterogeneous mass that appeared consistent with a meningioma. Within 10 hours of admission, intravenous epinephrine was initiated to maintain cerebral perfusion and blood pressures. Setting: Pediatric hospital. Results or Clinical Course: Patient extubated on hospital day 3 and progressed well in physical and occupational therapy. She was discharged home on hospital day 5 without significant cognitive or functional deficits. She returned 2 months later, once fully recovered, for tumor resection, with pathology consistent with meningioma. Discussion: This is the first reported case, to our knowledge, of a meningioma bleed secondary to a traumatic brain injury. The patient’s underlying brain pathology may have predisposed her to hemorrhage and led to a more significant degree of brain injury. Conclusions: The mass effect from brain tumors like meningiomas are known to cause cognitive and functional deficits. Although meningiomas are slow growing and considered relatively benign, this case illustrates the potential acute complications of trauma in a patient with meningiomas.

Poster 322 Underutilization of Inpatient Rehabilitation Facilities for ThinkFirst Traumatic Injury Prevention Programs: A Case Study

Disclosures: H. Kim, No Disclosures. Objective: To develop and evaluate the reliability and validity of a modified version of the Naturalistic Action Test (m-NAT) for Korean patients with cognitive impairment. The NAT was originally designed to assess everyday action impairment associated with higher cortical dysfunctions. Design: We developed the m-NAT to adapt to the Korean cultural background. Inter-rater reliability was assessed between two raters. Validity was evaluated by comparing the m-NAT score with various measures of daily life, attention, and executive functions. Setting: University-affiliated hospital. Participants: 30 patients receiving neurorehabilitation (23 with stroke, 5 with traumatic brain injury, and 2 with dementia) and 20 healthy matched controls. Interventions: Not applicable. Main Outcome Measures: m-NAT; (2) Korean Instrumental activity of daily living (K-IADL); (3) significant other and self-report of daily life function, Executive Behavior Scale(EBS), Korean version of the Cognitive Failure Questionnaire(K-CFQ); (4) neuropsychological tests of attention and executive functions such as the Sustained Attention to Response Task(SART), Stroop test, and Trail making test A&B. Results: Performance on the m-NAT in terms of the total score was significantly different between patients and controls (P .01). Patients made significantly more errors than controls (P .01). Omission error was the most frequent type of error in patient group. Intraclass correlation coefficient (ICC) for total m-NAT score was 0.98 (95% confidence interval, 0.96-0.99; P .00); total error was 0.91 (95% confidence interval, 0.89-0.92, P .00). Total score of the m-NAT showed moderate to strong correlations with K-IADL (rs 0.58; P .05), EBS (rs .60; P .01), K-CFQ (rs .51; P .01), SART commission error (rs .44; P .01), Stroop interference rate (rs .73; P .01), and Trail making test A&B (rs .55/ 0.65; P .01). Conclusions: The m-NAT showed very good reliability and adequate validity. The m-NAT adjusted to Korean cultural background would be useful in performance-based assessment of naturalistic action for clinical and research purposes.

Poster 346: The Impact of Body Mass Index on Achievement of Functional Changes During Inpatient Rehabilitation for Lower Limb Amputees

Disclosures: N. Olafsen, None. Objective: To evaluate the impact of body mass index (BMI) on functional outcomes during inpatient rehabilitation for patients with lower limb amputations. Design: A retrospective chart review was conducted by using a computerized medical record database. Setting: Inpatient rehabilitation facility. Participants: Records of 124 patients with lower limb amputations admitted for inpatient rehabilitation from 2002 to 2009 were reviewed. The most recent admission data were used for each patient because of the heterogeneous nature of such factors as number of admissions and cause of admission. Interventions: Not applicable. Main Outcome Measures: Functional independence measure (FIM), length of stay (LOS), height, weight, age, gender, reason for inpatient admission, and etiology and location of amputation were obtained from medical records. FIM change ( FIM discharge FIM admission) and FIM efficiency ( FIM change/LOS) were calculated for each patient. Patients were grouped based on BMI category: underweight (BMI 18.5), normal weight (BMI, 18.5-24.9), overweight (BMI, 25.0-29.9), and obese (BMI 30.0). Group means and 95% confidence intervals were calculated. Results: Based on calculation of the 95% confidence interval for the difference among means, there was no significant difference among any BMI group for any variable. No statistically significant differences were seen for FIMchange (total, motor, and cognitive), LOS, FIM efficiency, or age among BMI categories. There was no difference observed in gender, etiology of amputation and admission, and location of amputation among BMI categories. Conclusions: Patients with lower limb amputations in the underweight, overweight, and obese BMI categories achieved comparable functional gains to those in the normal BMI category. This study supports the benefits of inpatient rehabilitation for all amputees regardless of BMI.