- Email: [email protected]
Development of the Participation Activation Scale
Research Posters Results: 61% chose to focus on pain; 31% on physical activity and 8% on depression. Randomization was effective. Mixed-effects linear regression adjusting for stratification, and for sex and injury level as necessary (p<.10) revealed equivalent CC vs. UC outcomes on the WHOQOL-BREF. However, the CC group had greater improvement in pain interference (Adjusted Mean Difference [AMD]Z-1.02, p<.005) and depression (AMDZ-0.22, p<.05) than UC. In the pain-focused subgroup, CC outperformed UC on reducing pain interference (AMDZ-1.13, p<.01) and in the physical activity focused subgroup CC outperformed UC on improving QOL (AMDZ6.22, p<.05). Conclusions: Overall, CC demonstrates promise for improving pain, depression, and QOL in a SCI clinic population. While few individuals focused on mood specifically, intervening on pain and activity also led to reduction in depressive symptoms. Key Words: Spinal cord injury, pain, depression, physical activity, health services Disclosures: Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research grant H133N110009. Research Poster 506 Situated Communication Across Species: A Case Study of Animals in Therapy Martha Sherrill (University of Illinois at Urbana-Champaign), Julie Hengst Research Objectives: Animal Assisted Therapy (AAT), the use of trained therapy animals in rehabilitation sessions targeting discipline-specific goals, is currently utilized by multiple disciplines (OT, PT, RT) across settings (e.g., IPR, SNF). Although the research base for AAT is growing, very little attention has been given to the potential for AAT to target Speech-Language goals for adult neurogenic populations. This paper presents an ethnographic case study of a sub-acute IPR with an established AAT program using therapy dogs to examine: 1) patterns of communication visible during AAT sessions, and 2) patterns of patient engagement with/around the dog. Design: Ethnographic case study of an IPR with an established AAT program using therapy dogs. Data collection over 6 weeks included interviews, video-recorded observations of nine 30-minute AAT sessions, and collection of medical/institutional records. Setting: Sub-Acute Inpatient Rehabilitation Hospital. Participants: 34 total participants selected in collaboration with rehab staff: 6 IPR patients, 28 secondary participants (therapists, AAT handlers). Interventions: Not Applicable. Main Outcome Measure(s): 1) Transcription of audio/video, 2) analysis of the institutional context of the program, 3) identification/coding of language patterns (communicative modality by type and interactional discourse resources), and 4) interpretation of visible signs of engagement (eye gaze, non-verbal interaction). Results: Results: 1) the therapy dog was embedded into the context of the AAT session creating opportunities for rich communicative interactions and complex language use across diagnoses/deficits, and 2) visible signs of engagement were observed across all primary participants (eye gaze on the dog, attempts to interact physically with the dog, personal stories of impact) and point to future research on patient involvement in activity/goal selection. Conclusions: AAT is a viable option to engage IPR patients with complex and meaningful communication activities. Clinical implications for AAT in SLP include social/activity-based approaches to discipline-specific targets and correlates to evidence-based interventions. Key Words: Aphasia, Communication, Animal Assisted Therapy Disclosures: None disclosed. Research Poster 507
e79 investigated how dynamic stability is learned following repeated exposure to a novel destabilizing environment. Design: Repeated Measures. Setting: Biomechanics Laboratory. Participants: Five chronic individuals with incomplete spinal cord injury, AIS D, able to walk continuously for 300 steps. Interventions: Subjects performed five treadmill walking trials of 400 steps at their preferred speed. The first 100 steps established a Baseline of walking ability. The next 200 steps were either a Null condition (Trials 1, 5) with no external assistance or a Stabilizing condition (Trials 2-4) with lateral forces applied to the pelvis by a motor that reduced the requirements to actively maintain straight-ahead walking. After these 200 steps any applied forces were removed and subjects walked for another 100 steps to measure any After-Effects. Main Outcome Measure(s): We measured step width during each Baseline and After-Effects period and calculated how many steps were needed to return to steady-state during each After-Effects period. We quantified how performance changed with repeated exposure to the robotic force-field. Results: Step width narrowed in the stabilizing field. When the stabilizing field was removed, subjects’ initial step width during the after-effects period was narrower than baseline. This corresponded with a strong lateral instability. This effect was greatest during the first after-effects period and decreased with subsequent exposures. The number of steps to return step width to steady state was highly variable between subjects. Conclusions: Subjects rapidly learned to produce stable gait patterns following the induced instability that occurred during the after-effects periods. Individuals improved by actively regulating step width. Key Words: Gait, spinal cord injury, postural balance, locomotion, robotics Disclosures: None disclosed. Research Poster 508 Development of the Participation Activation Scale Danbi Lee (University of Illinois at Chicago), Joy Hammel Research Objectives: To conceptualize participation activation and develop items for the Participation Activation Scale. Design: Instrument development including conceptualization (literature review, focus groups, qualitative interviews), item writing, expert reviews, and cognitive interviewing. Setting: Community. Participants: Content area and outcome measurement experts participated in expert reviews (nZ7). Adults who had a stroke informed the development through focus groups and qualitative interviews (nZ13) and cognitive interviews (nZ5). Interventions: Not applicable. Main Outcome Measure(s): Not applicable. Results: The findings show that activated people with stroke are likely to have the knowledge and attitude and take actions that make them actively seek and maintain meaningful life activities and roles. Three domains included attitude, knowledge, and actions. A pool of 41 items was examined by experts, and 37 items were used for cognitive testing. Items were revised based on the feedback from cognitive interviews. Conclusions: The Participation Activation Scale is a new measure assessing traits that activate participation after stroke that can be used as a participation outcome measure in stroke rehabilitation. Field-testing with a larger sample is underway to evaluate reliability and validity. Key Words: Stroke, Patient outcome assessment, Social participation, Qualitative research Disclosures: None disclosed.
Learning Locomotor Stability After Incomplete Spinal Cord Injury
Research Poster 509
Keith Gordon (Feinberg School of Medicine, Northwestern University), Mengnan (Mary) Wu, Geoffery Brown
Assessing the Impact of Executive Dysfunction in the Home Environment Using the Multiple Errands Test Home Version (MET-Home): Preliminary Results
Research Objectives: We investigated the mechanisms individuals with incomplete spinal cord injury use to stabilize gait. Specifically, we
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Suzanne Perea Burns (Texas Woman’s University)
e79 investigated how dynamic stability is learned following repeated exposure to a novel destabilizing environment. Design: Repeated Measures. Setting: Biomechanics Laboratory. Participants: Five chronic individuals with incomplete spinal cord injury, AIS D, able to walk continuously for 300 steps. Interventions: Subjects performed five treadmill walking trials of 400 steps at their preferred speed. The first 100 steps established a Baseline of walking ability. The next 200 steps were either a Null condition (Trials 1, 5) with no external assistance or a Stabilizing condition (Trials 2-4) with lateral forces applied to the pelvis by a motor that reduced the requirements to actively maintain straight-ahead walking. After these 200 steps any applied forces were removed and subjects walked for another 100 steps to measure any After-Effects. Main Outcome Measure(s): We measured step width during each Baseline and After-Effects period and calculated how many steps were needed to return to steady-state during each After-Effects period. We quantified how performance changed with repeated exposure to the robotic force-field. Results: Step width narrowed in the stabilizing field. When the stabilizing field was removed, subjects’ initial step width during the after-effects period was narrower than baseline. This corresponded with a strong lateral instability. This effect was greatest during the first after-effects period and decreased with subsequent exposures. The number of steps to return step width to steady state was highly variable between subjects. Conclusions: Subjects rapidly learned to produce stable gait patterns following the induced instability that occurred during the after-effects periods. Individuals improved by actively regulating step width. Key Words: Gait, spinal cord injury, postural balance, locomotion, robotics Disclosures: None disclosed. Research Poster 508 Development of the Participation Activation Scale Danbi Lee (University of Illinois at Chicago), Joy Hammel Research Objectives: To conceptualize participation activation and develop items for the Participation Activation Scale. Design: Instrument development including conceptualization (literature review, focus groups, qualitative interviews), item writing, expert reviews, and cognitive interviewing. Setting: Community. Participants: Content area and outcome measurement experts participated in expert reviews (nZ7). Adults who had a stroke informed the development through focus groups and qualitative interviews (nZ13) and cognitive interviews (nZ5). Interventions: Not applicable. Main Outcome Measure(s): Not applicable. Results: The findings show that activated people with stroke are likely to have the knowledge and attitude and take actions that make them actively seek and maintain meaningful life activities and roles. Three domains included attitude, knowledge, and actions. A pool of 41 items was examined by experts, and 37 items were used for cognitive testing. Items were revised based on the feedback from cognitive interviews. Conclusions: The Participation Activation Scale is a new measure assessing traits that activate participation after stroke that can be used as a participation outcome measure in stroke rehabilitation. Field-testing with a larger sample is underway to evaluate reliability and validity. Key Words: Stroke, Patient outcome assessment, Social participation, Qualitative research Disclosures: None disclosed.
Learning Locomotor Stability After Incomplete Spinal Cord Injury
Research Poster 509
Keith Gordon (Feinberg School of Medicine, Northwestern University), Mengnan (Mary) Wu, Geoffery Brown
Assessing the Impact of Executive Dysfunction in the Home Environment Using the Multiple Errands Test Home Version (MET-Home): Preliminary Results
Research Objectives: We investigated the mechanisms individuals with incomplete spinal cord injury use to stabilize gait. Specifically, we
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Suzanne Perea Burns (Texas Woman’s University)