Predicting the Trajectories of Social Participation After Traumatic Brain Injury: A Longitudinal Analysis

e16 Key Words: Balance, Biomechanics, Falls prevention Disclosures: LWC acts as scientific consultant to Rekovo, a small business commercializing the EA technology. Research Poster 919 Predicting the Trajectories of Social Participation After Traumatic Brain Injury: A Longitudinal Analysis Kimberly Erler (Spaulding Rehabilitation Hospital), Joseph Locascio, Gale Whiteneck, Jennifer Bogner, Shannon Juengst, Jamie Kaminski, Joseph Giacino Research Objectives: To determine the predictors of the trajectories of participation over the first 5 years after moderate to severe traumatic brain injury (TBI). Design: Prospective, longitudinal, observational study. Setting: Traumatic Brain Injury Model Systems (TBIMS) centers. Participants: Individuals 16 years of age and older with moderate or severe TBI enrolled in the TBIMS National Database with complete participation data at 1, 2, and 5 years post TBI (nZ2015). Interventions: N/A. Main Outcome Measure(s): Participation Assessment with Recombined Tools-Objective. Results: There were main effects of FIM Cognitive, Race, and Depression on participation. An interaction of the quadratic component of time since injury occurred with Living Setting, and interactions of the linear term occurred with Age at Injury, Years of Education, and FIM Motor. The summative effect of these interactions was such that higher FIM Motor and more years of education tended to raise participation slightly across time, and that older age at injury lowered the trajectory of change, changing the slope from positive to negative across the span of age studied. The effect of Living Setting reflected an association of institutional living with lowered participation across time overall. Conclusions: Understanding the predictors of the trajectories of participation after TBI, allows rehabilitation professionals to identify those who are at risk for poor participation and to develop specific interventions for these individuals. Further research is needed to determine whether the statistically significant predictors produce clinically meaningful change in participation. Key Words: Brain injury, Social Participation, Rehabilitation Disclosures: None disclosed. Research Poster 922 A Preliminary Examination of Post-traumatic Growth, Empathy, Grief and Spirituality in Longterm Recovery in Traumatic Brian Injury (TBI) Elena Gillespie (Rehabilitation Hospital of Indiana) Research Objectives: To assess post-traumatic growth, empathy, grief and spirituality in adults with moderate to severe TBI. Few studies have addressed these factors in long-term recovery in TBI. The hypothesis is exploratory, to examine the potential relationship of these factors in TBI. Design: A one-time observational, mixed method pilot study. Setting: Subjects were out-patients and former in-patients of a TBI rehabilitation hospital in the Midwest. Participants: A convenience sample of 10 adults with severe TBIs were surveyed and asked an open-text question about their spirituality. The mean age was 43.8 years, average time from injury, 10.4 years. Six were males, and four were females. Nine were Caucasian and one was African-American. Interventions: N/A. Main Outcome Measure(s): Measures were the Balanced Emotional Empathy Scale, the Self-Compassion Scale, the Brain Injury Grief Inventory, and the Post-Traumatic Growth Inventory. The Hospital Anxiety and Depression Scale was given to obtain a baseline measure for depression. An open-text question was asked, “Has your spirituality been

Research Posters impacted by your TBI, and if so, please describe,” recorded and transcribed for thematic analysis. Results: 60% of subjects showed low to moderately low empathy, agreeing with other studies of empathy in TBI. 30% exhibited low self-compassion, and 100% demonstrated very low post-traumatic growth, although men reported better adjustment over long-term recovery post-injury than women. 60% exhibited great or very great spiritual impact on their belief systems as a result of their TBI. Conclusions: Further investigation of these relationships is warranted, and this study is continuing enrollment to assess these data with greater statistical power. Key Words: Post-traumatic growth, empathy, Self-compassion, Grief, Spirituality Disclosures: None disclosed. Research Poster 923 Effectiveness of Using Prism Adaptation to Treat Motor Function and Spatial Neglect in Stroke Survivors With Multiple Lesions Kimberly Hreha (Kessler Institution for Rehabilitation), Glen Gillen, Peii Chen Research Objectives: (1) To investigate whether PAT more effective than standard care in improving motor function and/or spatial function. (2) To investigate whether PAT is feasible to use with multi-lesion stroke survivors. (3) To investigate the use of an accelerometer to evaluate spontaneous movement of the affected limb. Design: Single blind non-randomized controlled, pre/post design. Setting: Inpatient rehabilitation. Participants: The inclusion criteria included: new right brain stroke with past medical history of stroke, spatial neglect, impaired left upper extremity, cognitively intact.13 in treatment group, 13 in comparison group. Interventions: Prism Adaptation Treatment versus standard occupational therapy. Main Outcome Measure(s): Functional Independence Measure (FIM), Kessler Foundation Neglect Assessment Process (KF-NAP). Results: One way repeated 2 x2 ANOVA was performed. There was no effect of prisms on motor FIM at discharge, nor an effect on motor FIM change. Both the treatment and comparison group improved the same amount (17 points). There was an effect on the interaction term (time and treatment condition, KF-NAP as DV): F(1,22)Z 5.44, pZ .029. After controlling for age and LOS, the effect still held. Accelerometer data was averaged, reported 18% to 26% “activity time” after treatment. Conclusions: PAT did not have an effect on the total motor FIM at discharge. However, PAT did improve spatial neglect, even though the treatment group had greater severity in neglect symptoms, they improved to the same level of severity as the control group at the end of the study. PAT is feasible to use in a group of stroke survivors with multiple strokes, even despite the cognitive deficits and medical complexities. The accelerometer is clinically usable and did report increased activity time after the treatment, however further analysis to determine if this increase is specifically spontaneous arm movement. Key Words: Prism adaptation treatment, spatial neglect, motor neglect Disclosures: None Disclosed. Research Poster 925 Carotid Artery Thrombus Caused by Severe Iron Deficiency Anemia Induced Reactive Thrombocytosis, Leading to Stroke in a Young Patient Ayesha Khan (Montefiore Medical Center), Maria Jouvin Castro, Gary N. Inwald Research Objectives: We report a case of a 42 year old female with history of iron deficiency anemia (IDA),fibroid uterus, menorrhagia, thrombocytosis and cerebrovascular accident (CVA) in 2012 with no

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