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E48 2012 ACRM–ASNR Annual Conference Abstracts

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per month after 16 months. Conclusion: The Medical Home model ofrimary care delivery has been successful in reducing hospitalizationates and avoidable hospitalizations within a medically complicatedatient population. The clinic has saved an estimated $3 million perear on hospitalization costs for the state of Minnesota. Key Words:rain injury; Spinal cord injury; Health and wellness; Epidemiology;utcomes Research; Rehabilitation.

oster 115ositive Psychology and Resilience in Rehabilitationedicine. Hilary Bertisch (NYU Rusk Institute of Rehabilitationedicine, New York, NY), Coralynn Long.

isclosure: None disclosed.Background: Positive attributes of human nature and their role in

uality of life have become a rapidly growing field in psychology, ledy the pioneering efforts of Martin Seligman. The last decade has seenremendous advancement in studying positive psychology, includingpplication to clinical populations. Within rehabilitation, studies thatave examined the topics of positivity and resilience and their effectsn treatment outcome remain preliminary. The few available reportsuggest that resilience is a characteristic that positively affects treat-ent outcomes and quality of life post-discharge. In fact, within the

ast year there have been joint efforts between the US Department ofefense and the National Institute of Mental Health to establish

esiliency programs for military personnel to improve outcomes forhose most susceptible to traumatic brain injury. Design: The dataeported in this presentation describe relationships between self-reporteasures of positive traits, resilience, mood, perception of functional

bility post-injury, and responses to psychological therapies at treat-ent initiation and six-month follow-up. Participants: Thirty-six

utpatients with heterogeneous brain injury diagnoses participating inlarge, urban, outpatient neurorehabilitation program completed the

uestionnaires. Results: Preliminary analyses suggest correlations be-ween stable positive traits and both mood states and resiliency post-njury (r � .59 to .67, p r � �.57 to �.64, p r� �.54, p.). Conclusion:ositive traits and resiliency are important to consider in treatmentonceptualization within neurorehabilitation settings. Key Words:rain injury; Stroke; Neurodegenerative disorder; Mental health; Clin-

cal practice; Rehabilitation.

oster 116rimary Care: Two Year Outcomes From a Medical Home forersons With Disabilities. Nancy A. Flinn (Courage Center, Min-eapolis, MN).

isclosure: None disclosed.Objective: Identify benefits and cost savings associated with a

edical home for persons with physical disabilities. Design: Cohortanalysis of 225 clients who enrolled in Courage Center’s medicalhome in the first two years of operation. Setting: A community-basedrehabilitation and resource center which established a medical homefor persons with disabilities, providing disability knowledgeable pri-mary care. Participants: Two hundred twenty-five individuals withdisabilities seeking primary care focused on managing both the med-ical and social determinants of health. Thirty-five percent of clientshad a brain injury, 25% had a spinal cord injury, along with a varietyof other conditions. Thirty-eight percent of the patients live below thepoverty level, and 28% are dually eligible for Medicaid and Medicare.Main Outcome Measures: Three year retrospective and ongoinghospitalization data was collected on patients through the state ofMinnesota. Results: 133 patients on medical assistance had a hospi-talization rate of 11.16 days per year in the period prior to enrollmentand 2.4 days per year after enrolling in the clinic. Initially, clientsreported 10.9 healthy days per month on enrollment which increasedto an average of 15.9 days per month after 16 month. Conclusion: The

edical Home model of primary care delivery has been successful ineducing hospitalizations days and avoidable hospitalizations within a

edically complicated patient population. The clinic has saved an

stimated $3 million per year on hospitalization costs for the state of

rch Phys Med Rehabil Vol 93, October 2012

innesota. Key Words: Brain injury; Spinal cord injury; Functionnd impairment-independent; Epidemiology; Rehabilitation.

oster 117uantified Neurorecovery: A Pilot Feasibility Study of Rehabili-

ation Inpatients With Movement Disorders. Marcia BockbraderWexner Medical Center at the Ohio State University, Dept ofM&R, Columbus, OH), Lise Worthen-Chaudhari, W. Jerryysiw.

isclosure: None disclosed.The objective of this pilot feasibility study was to provide proof of

oncept that digital technologies can be used during acute inpatientehabilitation to augment and quantify movement therapies. We pres-nt a subset of results from six individuals with concomitant move-ent disorders and cognitive impairments. Patients used digital tech-

ologies (Embedded Arts Program) in conjunction with standardovement therapy (Worthen-Chaudhari, 2011). Initial analysis of thembedded Arts sensor data supported our ability to identify “off-task”eriods, or segments of time that patients were not actively engaged inhe prescribed activity-based therapy, during treatment sessions. Ourheoretical algorithm had 92% concordance with therapist-identifiedff-task periods of greater than five seconds, was particularly good atetecting onset and offset of therapy breaks, and had adjustable sen-itivity thresholds (i.e., could detect shorter off-task periods as de-ired). In summary, this emerging technology was found to be feasibleor use in an acute inpatient rehabilitation hospital setting and datanalytic techniques successfully provided clinically-relevant informa-ion to the care team. Implementation of simple digital motion captureechnologies in rehabilitative care can serve to support therapists byroviding feedback to patients and therapists about the quality anduantity of movement performance. They are also promising as alatform to facilitate translation between neuroscience models ofovement recovery and clinical care, allowing these theoretical and

pplied disciplines to mutually inform each other. Key Words: Brainnjury; Stroke; Motor function; Clinical practice; Rehabilitation.

Acknowledgment: We thank Sarah Haserodt for data collectionssistance.

oster 118ouble-Blind, Placebo-Controlled, Crossover Trial of Amantadinen Arousal in Patients with Disorders of Consciousness. Marciaockbrader (Wexner Medical Center at the Ohio State University,epartment of Physical Medicine and Rehabilitation, Columbus,H), Sharon McDowell.

isclosure: None disclosed.Amantadine is frequently prescribed to improve cognition in indi-

iduals in persistent vegetative state (PVS) or minimally conscioustate (MCS) due to acquired Brain Injury, despite limited evidence forts efficacy. We enrolled 13 participants with severe hypoxic or trau-atic brain injury and subsequent chronic PVS or MCS in a prospec-

ive, randomized, double-blind, placebo-controlled, crossover study ofmantadine’s effect on arousal. The study was designed with twoedication periods, each followed by a medication washout period.edications were placebo and an amantadine titration up to 400g/day; patients were randomized for order of medications. Outcomeeasures which included visual attention and command following

sing paradigms developed by Whyte, Glasgow coma scale, andubjective caregiver impressions of arousal were collected on subjectst baseline as well as at the completion of each two week medicationeriod, and three week washout period. We found that: (1) Amanta-ine significantly improved visual attention (F 4,40) � 3.504,�0.015, power � 0.82), regardless of crossover order; (2) Amanta-

dine significantly improved command following relative to placeboduring verbal cue and verbal plus tactile cue conditions (F(1,12) �7.789, p� 0.016, power � 0.73), regardless of crossover order; (3)Caregiver reports of improved arousal were 92% congruent with

timing of amandatine administration. Despite the statistical signifi-cance, the effect on both tasks was small for some subjects: less than