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does not fully describe PCS in this sample. PCS after blast may becharacterized by distinctive visual and vestibular clusters that are notwell explained by traumatic stress symptoms. Subsets of individualswith PCS may benefit from in-depth assessments and rehabilitation forvisual and vestibular disorders. Key Words: Brain injury; Function;Impairment-independent; Research methods; Rehabilitation.

Poster 58Psychometric Properties of the Multidimensional Assessment ofFatigue Among Individuals With Traumatic Brain Inj-ury. Anthony Lequerica (Kessler Foundation Research Center,West Orange, NJ), Jerry Wright, Tamara Bushnik, Flora Ham-mond, Joshua Cantor

Disclosure: None disclosed.Objectives: To examine the psychometric properties of the Multi-

dimensional Assessment of Fatigue (MAF) scale in a sample ofindividuals with Traumatic Brain Injury (TBI). Design: Cross-sec-tional sample from a larger prospective longitudinal cohort study.Setting: Enrollment in acute inpatient TBI rehabilitation with fol-low-up at one or two years post-injury. Participants: 167 persons withTBI enrolled in the TBI Model Systems National Database. Interven-tions: Not applicable. Main Outcome Measures: The Multidimen-sional Assessment of Fatigue at one or two years post-injury. Results:A Rasch Analysis showed the measure to be unidimensional with oneitem not fitting the overall construct. In addition, the 10-point ratingscale was shown to be disordered. Rasch measurement properties ofthe rating scale were improved by collapsing categories down to afour-point scale. Conclusions: The results suggest that the “walking”tem on the MAF may not fit with the other scale items to measure theonstruct of fatigue within the population of individuals with TBI. Thisay be explained by the fact that the scale was developed as a measure

f fatigue for individuals with rheumatoid arthritis. It is possible thathe experience of fatigue may be more of a cognitive or mental fatigueor individuals with TBI. This study highlights the importance ofxamining the psychometric properties of outcome measures, espe-ially if a given measure was developed and used primarily within aifferent clinical population. Ways to improve the properties of theAF among TBI survivors are discussed. Key Words: Brain injury;

Mental health; Research methods; Rehabilitation.

Poster 59The Relationship Between Medical Comorbidities and MortalityAfter Traumatic Brain Injury. Chari I. Hirshson (Mount SinaiSchool of Medicine, New York, NY), Wayne A. Gordon, AyushiSingh.

Disclosure: None disclosed.Objective: The purpose of this study was to explore the relationship

between medical comorbidities present at the time of rehab admissionand cause of death in a sample of older adults who sustained aTraumatic Brain Injury (TBI) and died one to five years after theirinjury. Design: Retrospective descriptive analysis of medical andesearch records of participants enrolled in TBI Model SystemsTBIMS). Setting: Urban medical research center. Participants: Re-ords and death certificates of 30 individuals with TBI enrolled in theount Sinai TBIMS, whose data were collected between 2003 and

011 and who died one to five years post-injury (age at injury �77.910.8) women�46.7%, white 56.7%). Intervention: Not applicable.

ain Outcome Measures: Presence of 18 pre-specified medicalomorbidities (e.g., cardiac disease, diabetes) and injury informationere obtained through medical record extraction. Cause of death

COD) was determined through review of death certificates and codedsing ICD-10. Results: Descriptive statistics were used to describenformation abstracted from medical records to link to COD. Commonedical comorbidities present at time of admission associated withOD included cardiac disease, psychological illness, presence of re-

piratory disease and diabetes. There were a total of 11 individualshose COD could be directly linked back to a medical comorbidity

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rch Phys Med Rehabil Vol 93, October 2012

hat was present at time of rehab admission. Conclusions: The inter-lay between TBI and pre-existing medical problems warrants furthernvestigation. The findings from this study could inform future re-earch, which in turn may lead to the development of appropriatereatment and intervention at the primary care level. Key Words:rain injury; Lifespan issues; Research methods; Rehabilitation.

oster 60valuation of a Virtual Dialogue Method for Acquired Brain

njury Education: A Pilot Study. James F. Malec (PM&R, Indi-na University Medical School/Rehabilitation Hospital of Indiana,ndianapolis, IN), Elena Gillespie, William G. Harless, Monikanapp, Marcia A. Zier.

isclosure: James F. Malec is an Inventive Software Solutions grantubcontractor. William G. Harless is the Interactive Drama, Inc. Pres-dent & CEO. Marcia A. Zier is the Interactive Drama, Inc. Executiveice-President. Other authors have no disclosures.Objective: To assess the benefit of virtual dialogues with experts asmethod for educating family members and caregivers of patientsith an acquired brain injury (ABI). Methods: Seven single partici-ants and one couple interacted with a virtual dialogue computerrogram (Virtual Conversations®). The virtual dialogue technologyllows a computer user to have a meaningful, in-depth conversationith the pre-stored video images of a real person—usually a notable

xpert. Seated face-to-face, the user speaks and image of the personesponds in real time. The careful organization and seamless flow ofhe dialogue session ensure that the user actually feels in the presencef the expert and, almost always, has the experience of being involvedn a personal conversation. Participants could interact with a well-nown neuropsychologist and a survivor of severe brain injury.nowledge of ABI was assessed by questionnaire prior to and after theirtual dialogue session. Participants also completed an attitude surveyegarding their perceived value of the experience. Results: Perfor-ance on the Knowledge Questionnaire improved significantly from

efore to after participation in the virtual dialogue (Wilcoxon Signed-ank Test (Z � �1.97; p. Conclusion: The virtual dialogue method

s an effective and efficient way to increase knowledge of brain injuryor most family caregivers in a short period of time at their own pace.urther evaluation of this method is indicated. Key Words: Brain

njury; Community integration; Community participation; Technol-gy; Rehabilitation.

oster 61sing Inertial Sensor Based Novel System to Assess Upper Limbovement in Brain Injury. Mohamed Sakel (East Kent University

oundation Hospitals NHS Trust, Canterbury, Kent, United King-om), Lu Bai, Matthew Pepper, Y. Yan, S.K. Spurgeon.

isclosure: None disclosed.Objective: To use inertial motion sensors to develop a novel, precise,

on-invasive and objective assessment tool to detect the trajectory of thepper limb movement of patients with brain injury. Design: Initially highuality commercial sensors (Xsens MTx) which are the gold standard fornertial measurements are used. These provided 3-axis acceleration data,-axis angular rate (angular velocity) data and 3-axis orientation data. Theeasibility of utilizing low cost inertial sensors used in gaming (e.g., Wii)as evaluated on volunteers as per Ethics committee agreement. Subse-uently, the system was used with the patients with brain injury. Setting:n-patient neuro-rehabilitation unit of a regional UK teaching hospital.articipants/ Intervention: Four volunteers and four patients with brain

njury. Main Outcome Measures: Nine Hole Peg Test, Kinematics data.esults: It is possible to monitor the motion of upper limb joints with arift no greater than 0.5cm and segment rotation angles to within oneegree over a measurement period of 25 seconds. Sensor data alsorovided timing information. Conclusions: Utilizing the kinematicsodel and inertial sensors has enabled the measurement of acceleration,

elocity and movement profiles of the shoulder, elbow and wrist joints/

egments. The information profile was richer than usual clinical test. Theiming data from nine-hole peg tests on volunteers has already identified