Main Outcome Measures: Swallow movements orbiomechanics.Results: Patients demonstrated the ability to participate inintensive repetitive swallow training. Patients’ swallow bio-mechanics and endogenous secretion management were im-proved by training.Conclusions: We found that intensive swallow trainingprovided with cervical accelerometry enhances swallowingrehabilitation for persons with acquired brain injury. Basedon our experience, this noninvasive method is practical foruse with patients in various rehabilitation settings. The estab-lished safety and noninvasive nature of the general treatmenttechnique suggests that the use of swallow training usingaccelerometry technology is a promising treatment modalityfor patients with acquired brain injury and swallowing im-pairments. More research is forthcoming and will shed morelight on the mechanisms underlying improvement, the clin-ical benefits of treatment and the most cost-effective protocols.

Poster 18Predictors of Extended Rehabilitation Lengthof Stay After TBI.Camilo Castillo, MD (Virginia CommonwealthUniversity, Richmond, VA); Juan Carlos Arango,PhD; David X. Cifu, MD; Flora M. Hammond, MD;Jessica M. Ketchum, PhD; Anthony H. Lequerica,PhD; Thomas K. Watanabe, MD.

Disclosures: C. Castillo, Information not available at timeof print.Objective: To build a model for predicting extendedrehabilitation length of stay (LOS) for traumatic brain injury(TBI) survivors using demographic, injury, and hospitalcharacteristics.Design: Retrospective cohort study. Logistic regressionwas used to model the probability of extended LOS as afunction of demographic, injury, and hospital predictor vari-ables. The model was initially built with all significant uni-variate predictors and then reduced using backward selec-tion methods. A threshold in the predicted probability ofextended LOS was chosen to maximize sensitivity (SE) whilemaintaining at least 75% specificity (SP).Setting: Traumatic Brain Injury Model Systems.Participants: A sample of 7284 TBI survivors with injuriesoccurring between 1999 and 2009.Interventions: Not applicable.Main Outcome Measures: Extended LOS was definedas �67 days.Results: Approximately 5.1% of the sample had extendedLOS. Model building strategies using 75% of the sampleresulted in a final model containing FIM total at admission,level of education at injury, PTA, cause of injury, punctate/petechial hemorrhage, and primary payor source (all P-val-ues �.05). The model had good calibration (Hosmer andLemeshow goodness of fit test P-value �.3592) and excellent

discrimination (AUC�0.871). A threshold in the predictedprobability of 0.050 was associated with a SE of 84.1% and aSP of 75.1%. The validation sample indicated the model hadgood calibration (Hosmer and Lemeshow goodness of fitP value �.1160) and excellent discrimination capabilities(AUC � 0.836) and the cut-point of 0.05 yielded a SE of78.8% and a SP of 74.1%.Conclusions: The current predictor model for TBI survi-vors who require extended inpatient rehabilitation may allowfor enhanced rehabilitation team planning, improved patientand family education, and better utilization of health careresources. Cross validation of this model on other popula-tions of individuals with TBI is recommended.

Poster 19Psychometric Evaluation of the Arm ActivityMeasure (ArmA)—A Measure of Active andPassive Function in the Hemiparetic Arm.Lynne Turner-Stokes, DM FRCP (King's CollegeLondon—School of Medicine, London, UnitedKingdom); Stephen Ashford, BSc (Hons), MSc,PGCE; Mike Slade.

Disclosures: L. Turner-Stokes, Ipsen Ltd, Consulting feesor other remuneration.Objective: To evaluate the psychometric properties of theArm Activity Measure (ArmA) for evaluation of active andpassive function in the paretic upper limb.Design: Psychometric evaluation undertaken according tothe Medical Outcomes Trust Standards in the context of aprospective cohort study with multiple baseline and 8-weekfollow-up.Setting: A 2-center specialist spasticity management program.Participants: Patients (n�92) presenting for treatment ofupper limb spasticity. Mean age 44.5(SD 16.7); M:F 54:38,Diagnosis: stroke 48 (52%); other brain injury 28(31%);other neurologic condition 16 (17%).Interventions: A multidisciplinary spasticity managementprogram, including botulinum toxin-A (Dysport 150-1000or Botox 50-200 units) and physical therapy directed byclinical need.Main Outcome Measures: Reliability (internal consis-tency and test-retest); homogeneity; convergent and diver-gent validity; responsiveness to change and feasibility of theArmA for use in clinical practice.Results: Principal components analysis confirmed that ac-tive and passive function formed 2 separate constructs withinthe measure. Reliability: Cronbach’s alpha was �0.85 forboth active and passive subscales. Quadratic-weighted kappacoefficients for test-retest agreement were �0.70 for all indi-vidual items and �0.90 for both subscales. Mokken analysisdemonstrated homogeneity within each subscale (Item H�0.5 for all items). Expected convergent and divergent rela-tionships were seen with comparison measures (Spearmanrho 0.5-0.63). The passive function scale was sensitive to

S15PM&R Vol. 2, Iss. 9S, 2010