Poster 54

E19 41% of vignettes were allowed. Kappa statistics for individual physicians ranged from .55 to .91 (average, .70). Conclusions: Agreement was somewhat better than in previous studies of other SCI pain taxonomies, possibly resulting from the use of vignettes rather than more extensive but also more ambiguous clinical material. Categorization needs to attain a ␬ level of at least .90 before the BR-SCI-PT (or any other SCI pain classification) becomes truly useful in research and clinical applications. Key Words: Rehabilitation; Pain; Spinal cord injuries. Poster 52 Proprioceptive Acuity and Multijoint Coordination in Hemiplegic Cerebral Palsy. Colleen Lewis (University of Michigan, Ann Arbor, MI), Daniel Goble, Edward Hurvitz, Susan Brown. Disclosure: None declared. Objective: To determine if children with hemiplegic cerebral palsy (CP) have impaired position sense in addition to motor coordination deficits. Design: Descriptive measurement study. Setting: University motor control laboratory. Participants: 8 control participants and 8 children with mild hemiplegic CP. Interventions: Not applicable. Main Outcome Measures: Accuracy of proprioceptively guided movements about the elbow was measured by using instrumented levers. Movement time (MT) and reach hand path trajectory length (HPTL) were measured by using a 3-dimensional motion capture system. Results: In proprioceptive tasks, matching error was greater in CP subjects than controls (P⫽.003). During unilateral reaching, MT was slower in the affected arm (P⬍.001). Coupled, bilateral movements led to increased MT in both arms (P⫽.002), and HPTL was significantly longer in the affected compared with the less affected arm (P⬍.001). Conclusions: Proprioceptive ability is impaired in the affected arm of children with hemiplegic CP, which may, in turn, impact movements made by the less affected arm. The lack of improvement in spatiotemporal characteristics, as indicated by increased hand path length when both arms move together, argues against a bilateral facilitation of movement as has been reported for stroke. Key Words: Proprioception; Coordination impairment; Rehabilitation. Poster 53 Occurrence of Transverse Myelitis in a Pediatric Rehabilitation Hospital Setting. Rajashree Srinivasan (Baylor College of Medicine, Houston, TX), Deborah Fisher. Disclosure: None declared. Objective: To determine the occurrence of transverse myelitis in a rehabilitation hospital setting. Design: Retrospective chart review. Setting: A free-standing rehabilitation hospital with pediatric patients. Participants: Children aged 9 months to 16 years. Interventions: We evaluated the levels of injury, motor sensory loss, presenting symptoms, medical management, and associated findings. Main Outcome Measures: We evaluated FIM scores at the time of admission and discharge with respect to transfers, eating, grooming, and upper- and lower-extremity dressing. Results: 100% (13/13) of patients were dependent in transfers at admission. 46% (6/13) became independent at discharge. 77% (10/13) were dependent in moving from a supine to a sitting position at admission. 69% (9/13) became independent at discharge. 31% (4/13) were dependent with eating at admission, and 77% (10/13) became independent by discharge. 85% (11/13) were dependent with grooming at admission, and 54% (7/13) became independent by discharge. 92% (12/13) of patients were dependent with bathing at admission, and 23% (3/13) were independent at discharge. 92% (12/13) were dependent with upper- and lower-extremity dressing at admission, and 54% (7/13) were independent by discharge. Conclusions: There was an improvement in the patients’ mobility and

activities of daily living from dependent to independent from admission to discharge. Key Words: Rehabilitation; Transverse myelitis.

Poster 54 Diaries as an Indirect Measure of Compliance With “Return to Activity”: Guidelines Given to Children Who Sustain a Mild Head Injury. Isabelle Gagnon (Montreal Children’s Hospital, Montreal, QC, Canada), Robert Forget, Bonnie Swaine. Disclosure: None declared. Objectives: To use diaries to examine whether children who sustain a mild head injury comply with “return to activity” guidelines received on hospital discharge and to compare their postinjury level of activity with that of noninjured children matched for age, sex, and premorbid level of physical activities. Design: Cohort study. Setting: Pediatric trauma center. Participants: 34 children aged 8 to 16 (mean, 12.3⫾2.6) years were in each group. Children had mild head injury (mean Glasgow Coma Scale score, 14.9) and were told to resume regular physical activity 4 weeks postinjury. Interventions: Not applicable. Main Outcome Measures: 3-day activity diary documenting intensity and duration of activities (energy expenditure, in kCal) during the first, fourth, and twelfth week after mild head injury and at corresponding time intervals for control children. Results: Only 15 pairs of children (mild head injury ⫹ controls) completed the diaries for all assessment times. Although 20% to 30% of children engaged in some restricted activities before the end of the 4-week restriction period, the majority followed the guidelines. Children with mild head injury maintained lower levels of energy expenditure at 1 and 4 weeks (P⬍.01) compared with noninjured children but not at 12 weeks (P⫽.39). Conclusions: Most children complied with activity restrictions they received at discharge from hospital. Key Words: Brain injuries; Pediatrics; Rehabilitation.

Poster 55 Stroke Consequences on Movement Control of the Unaffected Upper Limb. Clare Giuffrida (Rush University Medical Center, Chicago, IL), Lisa Newton, Kim O’Neill, Cristina Posse, Sangbum Kim, James Cauraugh. Disclosure: None declared. Objective: To examine the role of vision in movement control of the unaffected limb in patients with stroke with motor planning deficits by using the Fitts paradigm. Design: A between-group, multifactorial design. Setting: Motor control laboratory. Participants: 12 right-hand dominant adults matched for age and sex with and without a stroke were recruited. Interventions: Each participant performed 6 trials of simple and reciprocal tapping with and without vision using the unaffected limb. Main Outcome Measures: Spatial and temporal measures of limb movements across conditions were obtained. Results: Each group showed an increase in movement time with increasing task complexity, but there were no significant differences between the groups. In the control group, reaction time increased in the vision conditions with increasing task complexity but decreased in the patient groups, suggesting less use of vision in the preplanning of movements. Patients with stroke showed more movement abnormalities. Conclusions: The movement speed and the movement profiles of patients with stroke differ significantly from the typical person. Rehabilitation of movement control may be enhanced by learning strategies focused on speed and smoothness of movement. Key Words: Rehabilitation; Stroke. Arch Phys Med Rehabil Vol 86, October 2005