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Hypogonadism is associated with lower functional performance during inpatient rehabilitation following hypoxic ischemic encephalopathy
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Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
ISPR8-2646
ISPR8-0346
Hypogonadism is associated with lower functional performance during inpatient rehabilitation following hypoxic ischemic encephalopathy
Dual task gait after moderate-to-severe traumatic brain injury: Characterization of troubles and consequences
D. Ripley 1,∗ , B. Ingraham 2 , M. Kocherginsky 3 , M. Maneyapanda 4 , K. Franzese 2 1 Shirley Ryan Ability Lab, Department of PM&R, Chicago, USA 2 Northwestern McGaw Medical Center/Shirley Ryan AbilityLab, Physical Medicine and Rehabilitation, Chicago, IL, USA 3 Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, Division of Biostatistics, Chicago, IL, USA 4 Bryn Mawr Rehabilitation Hospital, Brain Injury Program, Malvern, PA, USA ∗ Corresponding author. E-mail address: [email protected] (D. Ripley), [email protected] (B. Ingraham)
L. Abadie 1 , O. Kozlowski 1 , K. Youssef 2 , C. Rogeau 3 , W. Daveluy 1 , A. Benoit 1 , E. Allart 1,∗ 1 Lille University Medical Centre, Neurorehabilitation unit, Lille, France 2 Sainte Barbe rehabilitation centre, Neurorehabilitation Unit, Fouquières-les-Lens, France 3 MAS de Loos, Brain injuries department, Loos, France ∗ Corresponding author. E-mail address: [email protected] (L. Abadie), [email protected] (E. Allart)
Introduction/Background Neuroendocrine dysfunction, including hypogonadism, is a frequent complication after traumatic brain injury (TBI). Hypogonadism has been associated with worse functional performance after TBI. The prevalence of hypogonadism and its relationship to functional status after hypoxic ischemic encephalopathy (HIE) has not been previously reported. This study aimed to determine if hypogonadism is also negatively associated with functional performance during inpatient rehabilitation following HIE. Material and method Records were reviewed from male patients sequentially admitted for inpatient rehabilitation following HIE over a three-year period at an academic inpatient rehabilitation facility in the United States. Demographic, diagnostic, Functional Independence Measure (FIM) data, and serum endocrine results were collected. Linear regression analysis was performed to investigate the association between hormone values and functional status with a focus on Testosterone (T) function. Results Twenty-nine male subjects were admitted with HIE during the target time frame. Subjects had a mean age of 37.6 years. Twenty subjects had T levels drawn on admission to rehabilitation; of these, five (25%) had levels below the normal range (2.0–8.0 ng/mL). Lower T levels were associated with worse admission total FIM (P = 0.001), motor FIM (P = 0.004) and cognitive FIM scores (P = 0.003). Low T levels were also associated with worse discharge total FIM (P = 0.04) and cognitive FIM scores (P = 0.05) and a trend towards lower discharge motor FIM scores (P = 0.06). Conclusion The prevalence of hypogonadism in this population of HIE subjects was 25%, similar to that seen in studies of subjects with TBI. Hypogonadism was negatively associated with a lower functional status across domains. This relationship is similar to that seen in the traumatic brain injury population. Impaired hormone function should be considered clinically following HIE and warrants further investigation. Keywords Brain injury; Endocrine; Hypogonadism Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.517
Introduction/Background Patients suffering from traumatic brain injury (TBI) often present with cognitive but also posture and gait impairments. In this study, we aimed at evaluating the cost of the addition of 3 types of cognitive concurrent tasks on gait parameters, and studying the relationship between dual task cost and patientreported perception of their confidence in balance and gait in daily living. Material and method Spatiotemporal gait parameters were assessed using a GAITRITE mat in 22 moderate-to-severe TBI patients and 26 age-matched healthy controls. The addition of 3 cognitive tasks (letter back-task, substractions by 3, talking when walking) was studied during unobstructed walking and stepping over an obstacle. We also evaluated the relationship between dual task cost during gait and (1) cost in another motor task (Baddeley) and (2) patient perceived confidence in dynamic balance and gait in daily living (ABC scale). Results Dual task cost during gait was higher in TBI patients compared to healthy controls when walking unobstructed and in the subtraction and talking concurrent tasks. Alteration of gait speed was primarily due to a decrease of step length more than of gait cadence. TBI patients tended to prioritize the cognitive task. Dual task cost during gait was correlated with the Baddeley dual task performance (r = −0.420; P = 0.003) but not with the ABC scale score. Conclusion TBI patients exhibit difficulties in dual task gait conditions, which can be easily assessed and should be addressed in rehabilitation. The dual task cost could be not specific to locomotor activities. Finally, other factors seem to explain the alteration in confidence in gait and balance in daily living. Keywords Traumatic brain injury; Gait; Dual task gait Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.518 ISPR8-0846
A change of cerebral perfusion of patients with chronic neuropsychological impairments before and after a daytreatment group rehabilitation G. Uruma 1,∗ , K. Hashimoto 2 , N. Takashi 3 Kajiwara Hospital, Division of Rehabilitation Medicine, Tokyo, Japan 2 National Center for Child Health and Development, Devision of Rehabilitation Medicine, Tokyo, Japan 3 Kashiwa Ekimae Nakayama Mental Clinic, Division of psychiatry, Kashiwa, Japan ∗ Corresponding author. E-mail address: [email protected] (G. Uruma)
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Introduction/Background The objective of this study is to evaluate a change of cerebral perfusion of patients with chronic neuropsychological impairments (NPIs) before and after a daytreatment
Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
ISPR8-2646
ISPR8-0346
Hypogonadism is associated with lower functional performance during inpatient rehabilitation following hypoxic ischemic encephalopathy
Dual task gait after moderate-to-severe traumatic brain injury: Characterization of troubles and consequences
D. Ripley 1,∗ , B. Ingraham 2 , M. Kocherginsky 3 , M. Maneyapanda 4 , K. Franzese 2 1 Shirley Ryan Ability Lab, Department of PM&R, Chicago, USA 2 Northwestern McGaw Medical Center/Shirley Ryan AbilityLab, Physical Medicine and Rehabilitation, Chicago, IL, USA 3 Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, Division of Biostatistics, Chicago, IL, USA 4 Bryn Mawr Rehabilitation Hospital, Brain Injury Program, Malvern, PA, USA ∗ Corresponding author. E-mail address: [email protected] (D. Ripley), [email protected] (B. Ingraham)
L. Abadie 1 , O. Kozlowski 1 , K. Youssef 2 , C. Rogeau 3 , W. Daveluy 1 , A. Benoit 1 , E. Allart 1,∗ 1 Lille University Medical Centre, Neurorehabilitation unit, Lille, France 2 Sainte Barbe rehabilitation centre, Neurorehabilitation Unit, Fouquières-les-Lens, France 3 MAS de Loos, Brain injuries department, Loos, France ∗ Corresponding author. E-mail address: [email protected] (L. Abadie), [email protected] (E. Allart)
Introduction/Background Neuroendocrine dysfunction, including hypogonadism, is a frequent complication after traumatic brain injury (TBI). Hypogonadism has been associated with worse functional performance after TBI. The prevalence of hypogonadism and its relationship to functional status after hypoxic ischemic encephalopathy (HIE) has not been previously reported. This study aimed to determine if hypogonadism is also negatively associated with functional performance during inpatient rehabilitation following HIE. Material and method Records were reviewed from male patients sequentially admitted for inpatient rehabilitation following HIE over a three-year period at an academic inpatient rehabilitation facility in the United States. Demographic, diagnostic, Functional Independence Measure (FIM) data, and serum endocrine results were collected. Linear regression analysis was performed to investigate the association between hormone values and functional status with a focus on Testosterone (T) function. Results Twenty-nine male subjects were admitted with HIE during the target time frame. Subjects had a mean age of 37.6 years. Twenty subjects had T levels drawn on admission to rehabilitation; of these, five (25%) had levels below the normal range (2.0–8.0 ng/mL). Lower T levels were associated with worse admission total FIM (P = 0.001), motor FIM (P = 0.004) and cognitive FIM scores (P = 0.003). Low T levels were also associated with worse discharge total FIM (P = 0.04) and cognitive FIM scores (P = 0.05) and a trend towards lower discharge motor FIM scores (P = 0.06). Conclusion The prevalence of hypogonadism in this population of HIE subjects was 25%, similar to that seen in studies of subjects with TBI. Hypogonadism was negatively associated with a lower functional status across domains. This relationship is similar to that seen in the traumatic brain injury population. Impaired hormone function should be considered clinically following HIE and warrants further investigation. Keywords Brain injury; Endocrine; Hypogonadism Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.517
Introduction/Background Patients suffering from traumatic brain injury (TBI) often present with cognitive but also posture and gait impairments. In this study, we aimed at evaluating the cost of the addition of 3 types of cognitive concurrent tasks on gait parameters, and studying the relationship between dual task cost and patientreported perception of their confidence in balance and gait in daily living. Material and method Spatiotemporal gait parameters were assessed using a GAITRITE mat in 22 moderate-to-severe TBI patients and 26 age-matched healthy controls. The addition of 3 cognitive tasks (letter back-task, substractions by 3, talking when walking) was studied during unobstructed walking and stepping over an obstacle. We also evaluated the relationship between dual task cost during gait and (1) cost in another motor task (Baddeley) and (2) patient perceived confidence in dynamic balance and gait in daily living (ABC scale). Results Dual task cost during gait was higher in TBI patients compared to healthy controls when walking unobstructed and in the subtraction and talking concurrent tasks. Alteration of gait speed was primarily due to a decrease of step length more than of gait cadence. TBI patients tended to prioritize the cognitive task. Dual task cost during gait was correlated with the Baddeley dual task performance (r = −0.420; P = 0.003) but not with the ABC scale score. Conclusion TBI patients exhibit difficulties in dual task gait conditions, which can be easily assessed and should be addressed in rehabilitation. The dual task cost could be not specific to locomotor activities. Finally, other factors seem to explain the alteration in confidence in gait and balance in daily living. Keywords Traumatic brain injury; Gait; Dual task gait Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.518 ISPR8-0846
A change of cerebral perfusion of patients with chronic neuropsychological impairments before and after a daytreatment group rehabilitation G. Uruma 1,∗ , K. Hashimoto 2 , N. Takashi 3 Kajiwara Hospital, Division of Rehabilitation Medicine, Tokyo, Japan 2 National Center for Child Health and Development, Devision of Rehabilitation Medicine, Tokyo, Japan 3 Kashiwa Ekimae Nakayama Mental Clinic, Division of psychiatry, Kashiwa, Japan ∗ Corresponding author. E-mail address: [email protected] (G. Uruma)
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Introduction/Background The objective of this study is to evaluate a change of cerebral perfusion of patients with chronic neuropsychological impairments (NPIs) before and after a daytreatment