5 women). Interventions: None. Main Outcome Measures: Cir- cumference (CIRC) and anterior-posterior diameter of the chest at the level of the xiphoid process. Manual measurement of circum- ference was obtained with a Gulick anthropometric tape. Manual measurement of diameter was obtained using an anthropometer. 4 sets of images were obtained with the SP system. Anterior-posterior diameter and CIRC were each calculated using the system’s built-in measurement software. Spearman correlations and t tests were performed. Results: The correlations between manual and calcu- lated CIRC (r=0.964, P0.69910 –5) and anterior-posterior di- ameter (r=0.995, P0.17910 – 8) were high. However, there was a statistically significant difference between the measured (63.9cm16.1cm) and the calculated (67.1cm15.27cm) CIRC (P0.022). There was also a statistical difference between the measured (16.5cm3.65cm) and the calculated (17.8cm4.57cm) anterior-posterior diameter (P0.001). Conclusions: These results show that the SP system is able to generate consistent anatomical measurements that strongly correlate with those obtained by stan- dard manual techniques. The source of the differences between the manual and calculated methods may be a result of technical differ- ences in the 2 methods. One of the most notable distinctions is that pressure is applied on soft tissue by the anthropometer and the Gulick Anthropometric Tape, causing deformation. Since there is no direct physical contact between the subject and the SP system, soft tissue deformation is not included in the measurements ob- tained from SP images. Additional study will be done to further elucidate the sources of differences between SP and other tech- niques. We also plan to explore other appropriate clinical applica- tions for SP, including limb edema, skin lesions, skeletal deformi- ties, and obesity. Key Words: Disability, Rehabilitation; Stereophotogrammetry. Poster 282 Stereophotogrammetry Imaging of Nominal Features of Torso Anatomy in Osteogenesis Imperfecta: Comparison With Clinical Observation. Scott M. Paul, MD (National Institutes of Health, Bethesda, MD); Andrew P. Chamberlin, BS; Jerome V. Danoff, PT, PhD; Ellen Levy, PT; Monique B. Perry, MD. Disclosure: A.P. Chamberlin, none; J.V. Danoff, none; E. Levy, none; S.M. Paul, none; M.B. Perry, none. Objective: To determine the usability of stereophotogrammetry (SP) as a technique to accurately obtain anatomical data from the torso in people with osteogenesis imperfecta (OI). We compared physical observations of pelvic alignment, rib, and sternal anomalies, scoliosis, and abdominal girth made during clinical visits with observations made using the images created by SP. Design: Validation study. Setting: Rehabilitation department in government research hospital. Participants: 10 subjects with OI type III or type IV between 4 and 27 years of age (5 males, 5 females). Interventions: None. Main Out- come Measures: Nominal observations of pelvic symmetry, presence of pectus carinatum/excavatum (PC/PE), infraxiphoid and supraxi- phoid (SX) depression, abdominal (AP) and thoracic protrusion and scoliosis. A physiatrist and physical therapist collaborated on clinical observation made during the patients’ visits. A different physiatrist and physical therapist, blinded to the clinical observation, scored the 3-dimensional images created contemporaneously by SP. The data were compared using Cohen’s  correlation. Significant agreement was defined as a  greater than or equal to 0.4. Results: There was significant agreement between clinical observation and both SP raters for thoracic scoliosis ( physical therapist [PT]=0.460.08,  physi- atrist=0.720.12) and agreement approaching significance for lumbar scoliosis ( PT)=0.260.17,  physiatrist=0.380.18). In addition, there was significant overall agreement within raters using SP (=0.390.01). There was also significant agreement between raters for the identification of SX (=0.740.22), AP (=0.740.22), thoracolumbar scoliosis (=0.640.10), and PE (=0.400.22). Conclusions: The agreement between SP and clinical observation for scoliosis suggests that SP may be a good technique for assessing the presence and vector of scoliosis in OI. The agreement between each of the SP raters for most of the measures indicates that there is reasonable inter-rater reliability of the SP system for nominal measures of the torso. Further study will be performed to try to explain the lack of significant agreement between SP and clinical observation for the nominal measures other than scoliosis. Possible causes include limits of the SP field of vision and differences between visualization of a model on a computer monitor and direct observation and palpation of a patient. Key Words: Disability; Rehabilitation; Stereophotogram- metry. Poster 283: Paper presentation. Poster 284 The Use of Botulinum Toxin in Facial Muscles for Improved Speech Clarity and Facial Appearance in a Teenager With Cere- bral Palsy: A Case Report. Maureen R. Nelson, MD (Carolinas Rehabilitation, Charlotte, NC); Andrea P. Toomer, MD. Disclosure: M.R. Nelson, none; A.P. Toomer, none. Setting: Outpatient pediatric rehabilitation clinic. Patient: A 16- year-old girl with cerebral palsy. Case Description: Botulinum toxin injections were placed into the levator labii superioris muscles bilat- erally due to patient and parent complaints of oral appearance and difficulty with speech production. Assessment/Results: The patient and her mother reported improvements in speech production and facial appearance. The patient reported that her speech was more easily understood by classmates and teachers at school. Pretreatment and posttreatment photographs were taken to demonstrate the improve- ments in facial movements during expression and speech. Conclu- sions: Botulinum toxin injections can be utilized into the facial mus- culature for enhancement of appearance and production of comprehensible speech in patients with cerebral palsy. Key Words: Cerebral palsy; Botulinum toxin; Rehabilitation. Poster 285 The Use of Caffeine as a Neurostimulant in Pediatric Brain In- jury: A Case Series. Ellen K. Casey, MD (Rehabilitation Institute of Chicago, Chicago, IL); Deborah J. Gaebler-Spira, MD; Melanie Rak, MD. Disclosure: E.K. Casey, none; D.J. Gaebler-Spira, Allergan speakers bureau, Medtronics speakers bureau; M. Rak, none. Setting: Acute, inpatient rehabilitation facility. Patients: 2 pediatric patients with brain injury. Case Descriptions: Case 1: A 16-year-old patient with a traumatic brain injury secondary to assault. His partic- ipation in inpatient rehabilitation was extremely limited by decreased arousal, attention, and concentration, despite being on Ritalin for several weeks. After the addition of caffeine, he had marked improve- ment in his level of participation, particularly with orientation, swal- lowing, and ambulation. Case 2: A 16-year-old patient with multiple intracranial hemorrhages secondary to arteriovenous malformation. Her participation in rehabilitation was severely limited by her de- creased arousal. She was not a candidate for Ritalin due a risk of subsequent stroke from hypertension, so she was also placed on caffeine. Her level of arousal and interaction improved enough for her to begin communicating with thumb movements and eye gaze. As- sessment/Results: Caffeine has been used as a therapeutic agent in a variety of settings, including migraines and apnea of prematurity. E111 ACADEMY ANNUAL ASSEMBLY ABSTRACTS Arch Phys Med Rehabil Vol 89, November 2008