Poster 76

E25 stay for the nonanemic group and the anemic group was 11 and 10.5 days, respectively. 53% of the subjects were anemic. The anemic group had more patients with orthopedic disorder (16%), whereas the other group had more stroke patients (27%). The nonanemic group had significant improvements in their FIM discharge scores (21%, P⫽.03) compared with the anemic group (16%). Improvement in FIM scores in the group with Hgb ⬎11.5g/dL (21%) was significant compared with the group with Hgb ⬍10.0g/dL (15%, P⫽.03), after adjusting for associated admission impairments and age. Conclusions: Anemia (Hgb ⬍11.5g/dL) in this study sample was a significant independent predictor of functional outcomes during rehabilitation stay after adjusting for various admission impairments. There was a trend toward improvement in the functional outcome as the Hgb improved from below 10.0g/dL to ⬎11.5g/dL. No further improvement was seen once the Hgb was ⬎13g/dL. It remains to be determined if anemia correction will lead to improvement in rehabilitation outcomes. Key Words: Hemoglobin; Rehabilitation. Poster 75 Low Vision Rehabilitation Consensus Project. Robert Massof (Johns Hopkins University School of Medicine, Baltimore, MD), William Park. Disclosure: Supported by the National Eye Institute, National Institutes of Health (grant no. EY015889). Objective: To develop a Bayesian decision model for the estimation of rehabilitation potential. Design: Rehabilitation potential, defined as the joint conditional probability that the outcome of rehabilitation will exceed a criterion outcome, is conditioned on the patient state and plan of intervention. To specify parameters in the model, we conducted a consensus project using nominal group and Delphi methods with low vision rehabilitation experts and opinion leaders. Setting: The consensus project was conducted over the Internet. Participants: The 22-member panel consisted of influential low vision experts in optometry, ophthalmology, vision rehabilitation, orientation and mobility, occupational therapy, psychology, social work, and technology. Intervention: The expert panel had moderated discussions online in synchronous sessions using both voice over the Internet and chat boards. Main Outcome Measures: Transcripts of the discussions were coded using grounded theory methods. Panelists were then polled in iterative rounds of asynchronous sessions with feedback to build a consensus on the network of relationships among coded concepts. Results: Patient state, interventions, and outcomes are represented by hierarchical networks of codes. These become the parameters in the Bayesian model. Conclusions: Experts differ in their preferences for level of detail and for areas of emphasis, but not in the hierarchical structure of the network. Key Words: Rehabilitation; Vision. Poster 76 Places of Treatment and Medical Specialists Seen Surrounding Children’s Visits to an Emergency Department for a Head Injury. Alla Kostylova (Universite´ de Montre´al, Montreal, QC, Canada), Bonnie Swaine, Debbie Feldman. Disclosure: None declared. Objectives: To describe places of treatment and medical specialists seen by children who visited an emergency department (ED) for head injury according to child’s age, sex, and household income and to compare the results with children who sought care for a musculoskeletal injury. Design: Cohort study. Setting: Urban. Participants: 3049 children visited the ED for injury at 1 of 2 tertiary care pediatric hospitals (mean age, 8y; 61% boys; average household income, $40,462); 1147 for a head injury and 1902 for a musculoskeletal

injury. Interventions: Not applicable. Main Outcome Measures: Place of treatment and type of physicians seen within 24 hours surrounding the ED visit. Results: Besides their ED visit, 8% of children with head injury visited a physician’s office. They received treatment from 1 to 6 (mean, 1.2) different physicians and had fewer claims than those with musculoskeletal injury (1.5 per child vs 2.2; P⬍.001). Children with a head injury aged 5 to 9 years and those from families with higher household incomes tended to see the most specialists. Conclusions: Prevention strategies aimed at reducing subsequent head injury should consider that children with head injury receive care from several specialists in different facilities. Key Words: Head injury; Rehabilitation; Medical specialty. Poster 77 Complex Regional Pain Syndrome and Functional Rehabilitation. Alexander Krakovsky (Galileo Medical Center, San Luis Obispo, CA). Disclosure: None declared. Objective: To develop an interdisciplinary clinical pathway for complex regional pain syndrome (CRPS) using 3 simultaneous treatment elements: pain management, rehabilitation, and psychotherapy. Design: 3 different treatment strategies for CRPS: pain management, rehabilitation, and psychotherapy. Setting: Ambulatory medicalsurgical center. Participants: 27 patients with clinical signs and symptoms of CRPS were supplemented with 3-phase bone scan, thermography, and diagnostic blocks to confirm the diagnosis. 1 patient was in stage 4, 3 patients were in stage 3, 9 in stage 2, and 14 in stage 1. Interventions: Not applicable. Main Outcome Measures: Not applicable. Results: 25 patients in stages 1 and 2 were treated with interventional pain management including regional analgesia, neuronal blockades, aggressive medical treatment, and extensive physical therapy (PT). Average registered numeric pain score (NPS) was 4. All patients remained active, and 7 patients returned to work. 2 patients in stage 3 were treated with a spinal cord stimulator, aggressive medical therapy, and extensive physical rehabilitation. The average registered NPS was 5, and they were able to maintain normal lifestyles. 1 patient in stage 3 was permanently totally disabled. 1 patient in stage 4 had intrathecal infusion pump implanted. This patient used a wheelchair for years but remained active secondary to aggressive PT treatment. Conclusions: Rehabilitation is the mainstay of CRPS treatment. The implementation of aggressive pain management and psychologic therapy dramatically improve the outcome of CRPS. In the early stages of CRPS treatment, PT and occupational therapy are crucial to a patient’s progression through clinical pathways and core on the development of an effective therapeutic alliance. Adequate analgesia, reassurance, and education are essential for the successful application of physical modalities. Successive steps in this pathway are active ROM, stress loading, isotonic strengthening, recreation therapy, and vocational rehabilitation. Key Words: Complex regional pain syndrome; Rehabilitation. Poster 78 The Impact of Personalized Information Provision on Traumatic Brain Injury Rehabilitation Outcomes. Ronald Seel (Shepherd Center, Atlanta, GA), Phillip Pegg, Stephen Auerbach, Luis Buenaver, Donald Kiesler, Laura Plybon. Disclosure: None declared. Objective: To evaluate providing personalized information to patients with acute traumatic brain injury (TBI). Design: Randomized, blinded, controlled trial. Setting: Single-center, acute TBI rehabilitation unit. Participants: 28 active duty military personnel and veterans who sustained severe TBI. Interventions: The experimental group Arch Phys Med Rehabil Vol 86, October 2005