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Assessing Needs for Medical Rehabilitation: Associations with ADLs in Older Individuals with or without Dementia
e48 unemployment. Findings in our study highlight the unique perspectives of Veterans with PTSD within the VHA health care system. Currently, there are limited measures of HRQOL and employment in Veterans with DRPTSD. Study findings may contribute to the future development of a more sensitive measure of DR-PTSD HRQOL building on the PROMIS/NeuroQol framework. Key Words: Veterans, Employment, Stress-Disorders, Post-Traumatic, Quality of Life, Health Disclosure(s): The development of this manuscript was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Service (IIR 10-169) and the Center of Innovation for Disability and Rehabilitation Research at the James A. Haley Veterans Hospital, Tampa FL. The contents of this manuscript do not represent the views of the Department of Veterans Affairs or the United States Government. Research Poster 3602 Motor Imagery Training on Muscle Strength and Gait Performance in Ambulant Stroke Subjects: A Randomized Clinical Trial Vijaya Kumar (Manipal University) Objective(s): 50%-65% of stroke survivors have residual motor deficits; principal among them is hemi paretic gait that limits mobility, increases the risk of falls and promoting sedentary life style. Increased strength in the lower extremity muscles has been shown to be associated with improvements in walking performance. Recently Motor Imagery training (MIT) are enhancing motor learning, neural reorganization and cortical activation in stroke patients. However, efficacy MIT involving lower extremity mobility tasks are limited in stroke rehabilitation. To investigate the effect of combining mental practice with physical practice paretic Lower Extremity Muscles strength and Gait performance in ambulant stroke subjects. Design: Randomized Clinical Trial. Setting: Department of Physical therapy, Tertiary Care Hospitals, Mangalore, India. Participants: 76 hemi paretic patients(>3 months post-stroke) who can able to walk 10 m with good imagery ability in KVIQ-20 60 and Time dependent motor imagery screening test were recruited and randomly allocated into physical practice group(nZ38)and physical+ mental practice group(nZ38). Interventions: Subjects in both groups underwent task orientated training for lower extremity 45-60 minutes, 4 days a week for 3 weeks. In addition, the experimental group received 15 minutes of audio-based lower extremity mobility tasks for MI practice. Main Outcome Measure(s): Isometric muscle strength of Hip, Knee and Ankle using a hand-held dynamometer and self-selected 10 m gait speed were assessed before and after 3 weeks. Results: Our results showed significant improvements in the experimental group hip flexors strength 98% compared to 80% in the control group, knee flexors 112% compared to 85% in control group and ankle dorsiflexors 140% compared to 80% in control group. A significant improvement in gait speed was noted in the experimental group (from .52 to .80) compared with the control group (from .56 to .78) with 15% change between them. Conclusions: Additional task specific MI training improves paretic muscle strength and gait performance in ambulant stroke patients. Key Words: Motor imagery, Task specific training, Hemiplegic gait Disclosure(s): None Disclosed. Research Poster 3603 Assessing Needs for Medical Rehabilitation: Associations with ADLs in Older Individuals with or without Dementia Hiroyuki Hashidate (Kyorin University), Kazuhiro Harada Objective(s): To describe needs for medical rehabilitation (NMR) assessing by rehabilitation staff, and relationship between the NMR and
Research Posters basic activities of daily living (ADLs) in community-dwelling older individuals with or without dementia. Design: Cross-sectional study. Setting: Day care service center. Participants: Community-dwelling older individuals with diagnosis of dementia (nZ24), and those without dementia (nZ23). Interventions: N/A. Main Outcome Measure(s): The NMR was evaluated using a questionnaire that provides about needs score (NS) for medical rehabilitation, comprised of 7-items (NS-7), 3 about affirmative (NS-affirmative), 2 about impairments (NS-impairment), and 2 about circumstance (NS-circumstance). Each item has a 4-point scale (0 Z not at all applicable, 4 Z extremely applicable). The NMR were rated by occupational therapist, and the sum score of respective components of NMR was calculated with respect to each raters. We characterized ADLs using Barthel index (BI) and care burden for ADLs using 8 items of BI excepted for bladder and bowels (burden BI). Results: There was no significant differences in BI and burden BI between groups, whereas the dementia group showed significantly lower NS-affirmative, NS-impairment, NS-circumstance, and NS-7 than the non-dementia group. The NS-7 and NS-impairment showed moderate correlations with BI and burden BI in both groups. Conclusions: The NMR correlates with basic ADLs and care burden for ADLs regardless of the presence of dementia in community-dwelling older individuals with dementia. However, needs for medical rehabilitation may be estimated lower in those with dementia. Key Words: Needs assessment, Activities of daily living, Dementia Disclosure(s): None Disclosed.
Research Poster 3604 Computerized Training of Working Memory for Patients with Acquired Brain Injury Lovisa Hellgren (Dep. of Rehabilitation Medicine, County Hospital Ryhov), Kersti Samuelsson, Anna Lundqvist, Bjorn Borsbo Objective(s): To investigate the effects of computerized WM training on WM skills, cognitive tests, activity performance and estimated health and whether the effects of computerized WM training can be attributed to sex or time since injury. Design: Before-after trial. Setting: A clinical rehabilitation program at a Rehabilitation Medicine department in Sweden. Participants: Forty-eight consecutive patients with non-progressive acquired brain injury met the clinical criteria for inclusion in WM training and chose to participate. Interventions: The patients underwent computerized WM training (Cogmed QM), for 25 training sessions, with 4-5 sessions/week. Patients were tested by a neuropsychologist and interviewed by an occupational therapist just prior and 20 weeks after completion of training. Main Outcome Measure(s): Paced Auditory Serial Attention Test. Forward and backward block repetition. Listening Span Task. Canadian Occupational Performance Measure. EuroQol. Results: Patients significantly improved their WM skills shown in WM index (p <0.001), their neuropsychological test scores (p <0.001), and their self-estimated health scores (p <0.001). They also significantly improved their performance of individually defined WM-related everyday activities and their satisfaction with the performance of these activities (p <0.001). No gender differences were found, but there was a significant difference in terms of WM index, WM-related daily activity performance, and satisfaction with respect to time since injury. All patients completed the training. Difference between groups and results before versus after training were analyzed using the Mann-Whitney U-test, the Chi-square test, and Wilcoxon sign rank test. For correlation analyses, Spearman’s rank correlation test was used. Conclusions: Computerized WM training can improve cognitive and everyday performance for patients with acquired brain injury. Patients can improve their
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Research Posters basic activities of daily living (ADLs) in community-dwelling older individuals with or without dementia. Design: Cross-sectional study. Setting: Day care service center. Participants: Community-dwelling older individuals with diagnosis of dementia (nZ24), and those without dementia (nZ23). Interventions: N/A. Main Outcome Measure(s): The NMR was evaluated using a questionnaire that provides about needs score (NS) for medical rehabilitation, comprised of 7-items (NS-7), 3 about affirmative (NS-affirmative), 2 about impairments (NS-impairment), and 2 about circumstance (NS-circumstance). Each item has a 4-point scale (0 Z not at all applicable, 4 Z extremely applicable). The NMR were rated by occupational therapist, and the sum score of respective components of NMR was calculated with respect to each raters. We characterized ADLs using Barthel index (BI) and care burden for ADLs using 8 items of BI excepted for bladder and bowels (burden BI). Results: There was no significant differences in BI and burden BI between groups, whereas the dementia group showed significantly lower NS-affirmative, NS-impairment, NS-circumstance, and NS-7 than the non-dementia group. The NS-7 and NS-impairment showed moderate correlations with BI and burden BI in both groups. Conclusions: The NMR correlates with basic ADLs and care burden for ADLs regardless of the presence of dementia in community-dwelling older individuals with dementia. However, needs for medical rehabilitation may be estimated lower in those with dementia. Key Words: Needs assessment, Activities of daily living, Dementia Disclosure(s): None Disclosed.
Research Poster 3604 Computerized Training of Working Memory for Patients with Acquired Brain Injury Lovisa Hellgren (Dep. of Rehabilitation Medicine, County Hospital Ryhov), Kersti Samuelsson, Anna Lundqvist, Bjorn Borsbo Objective(s): To investigate the effects of computerized WM training on WM skills, cognitive tests, activity performance and estimated health and whether the effects of computerized WM training can be attributed to sex or time since injury. Design: Before-after trial. Setting: A clinical rehabilitation program at a Rehabilitation Medicine department in Sweden. Participants: Forty-eight consecutive patients with non-progressive acquired brain injury met the clinical criteria for inclusion in WM training and chose to participate. Interventions: The patients underwent computerized WM training (Cogmed QM), for 25 training sessions, with 4-5 sessions/week. Patients were tested by a neuropsychologist and interviewed by an occupational therapist just prior and 20 weeks after completion of training. Main Outcome Measure(s): Paced Auditory Serial Attention Test. Forward and backward block repetition. Listening Span Task. Canadian Occupational Performance Measure. EuroQol. Results: Patients significantly improved their WM skills shown in WM index (p <0.001), their neuropsychological test scores (p <0.001), and their self-estimated health scores (p <0.001). They also significantly improved their performance of individually defined WM-related everyday activities and their satisfaction with the performance of these activities (p <0.001). No gender differences were found, but there was a significant difference in terms of WM index, WM-related daily activity performance, and satisfaction with respect to time since injury. All patients completed the training. Difference between groups and results before versus after training were analyzed using the Mann-Whitney U-test, the Chi-square test, and Wilcoxon sign rank test. For correlation analyses, Spearman’s rank correlation test was used. Conclusions: Computerized WM training can improve cognitive and everyday performance for patients with acquired brain injury. Patients can improve their
www.archives-pmr.org