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No. 163 Management Response in Post-Traumatic Pseudarthrosis Scaphoid With Extracorporeal Shock Wave Therapy. A Case Report
PM&R
Age effect differences; 3. Effect of standing versus sitting in elderly adults. Setting: Geriatric rehabilitation center. Methods: The tasks involved reaching to virtual balls appearing in random order on the left and right side of TV screen connected to a computer. In the simple movement time (SMT) task, subjects were asked to touch each ball as soon as it appeared. In the go\no-go task the participants were asked to touch only the smooth looking balls and avoid balls with spines. Total duration of each task was one minute. For the reliability study 19 young healthy male and female subjects performed the tasks twice. To determine age effect, 18 young female subjects and 16 older female subjects performed the same tasks as in the previous study. In the third study a group of 22 elderly participants performed both the SMT and go\no-go tasks while sitting and standing in a comfortable stance. Results: The interclass correlation coefficient (ICC) for the SMT and the go\no-go were 0.717 and 0.564, respectively. ANOVA resulted in significant age task and interaction effects. No differences were noted in old subjects between performance while sitting or standing. Conclusions: The studied VR environment demonstrates moderate to high test retest reliability. Older adults respond more slowly particularly when faced with a go\no-go reaction. The need to maintain upward posture while maintaining a comfortable stance position does not challenge the older subjects sufficiently to effect movement time during stance. No. 162 Role of a Foreign Non-Profit Rehabilitation Association in a Large-Scale Natural Disaster: The Papa Experience in Typhoon Haiyan a Program Report. Rochelle Dymd; Ernesto Cruz, MD; Filipinas Ganchoon; Charles De Mesa, DO. Setting: Tent city for displaced persons and a rural community in the typhoon-affected area. Program: A relief/medical mission co-sponsored by the Philippine American Physiatrist Association (PAPA). Program Description: PAPA, a small group of US-based physiatrists of Filipino heritage/descent partnered with the Philippine Academy of Rehabilitation Medicine (PARM) a national rehabilitation society in conducting a relief and medical mission to a tent city in San Jose Tacloban and the rural community of Burauen, Leyte, Philippines three months after typhoon Haiyan February 17-18, 2014. The group comprised of 8 physiatrists. Assessment/Results: 1200 and 300 hygiene kits were distributed at San Jose and Burauen, respectively. A basic need/medical screening survey was administered which identified basic needs as well as medical conditions including disabilities. Free medical-rehabilitation consultations with limited medications were provided to residents in Burauen. Nearly half (46%) of the 283 patients served were pediatrics and 94 were males. Infections were the most common diagnoses (143; 42%) followed by musculoskeletal conditions (62; 18%) of which 80% were degenerative joint disease. Seventeen neurological cases (5%) were evaluated. Discussion (relevance): At 3 months post-disaster primary care diagnoses including secondary injuries sustained during acquisition of basic provisions, relocation, and clean-up efforts were common in these two community populations. Physiatrists can effectively treat this range of conditions with specialized focus on musculoskeletal and neurological injuries as well as on persons with disabilities. Medical follow-up of mission patients is a concern due to social, economical, and financial limitations. Conclusions: Physiatrists can play a significant role after a natural disaster. Through collaborations, a foreign non-profit rehabilitation association and its members can provide valuable direct support of local efforts in a large-scale natural disaster. No. 163 Management Response in Post-Traumatic Pseudarthrosis Scaphoid With Extracorporeal Shock Wave Therapy. A Case Report. Esquivia Carmen C., MD (Hospital Militar Central Bogotá, D.C., Colombia); Pira Jo; Esquivia Pajaro Carmen; Pira Paredes Jose. Disclosure: None. Setting: Tertiary care military hospital. Patient: A 17-year-old male with scaphoid pseudarthrosis before surgical management. Case Description: The initial management performed was osteosynthesis
Vol. 6, Iss. 8S2, 2014
S127
on the scaphoid bone and a pelvic graft of the nonunion focus. The procedure was described as unremarkable. However in subsequent outpatient controls after two months patient reported persistent pain. Radiographic examination showed an altered consolidation. After which he was referred to our service. In our perspective patient had preserved muscle strength in both upper limbs. Sensitivity was preserved without signs of active synovitis levels in the right carpal region. Patient is then considered a candidate for shock wave therapy. The patient received 5 sessions of shock waves at a frequency of 14 beats per second with an intensity of 2 air pressure at 5 bar for a total of 6000 shots. Assessment/Results: After 5 sessions a new x-ray is taken where improvement was evident in consolidation level. The nonunion of the left hand also had a decrease of 4 points on the subjective pain scale. Physical examination did not indicate a decrease in range of motion. Finally there was an improvement indicator on the score of quick functional scale. Discussion: Treatment with extracorporeal shock waves has proven effective to accelerate bone healing. However to our knowledge this is one of the first reported cases of improved results with shock wave therapy. Conclusion: Scaphoid pseudarthrosis refers to the failure to consolidate a fracture at a navicular bone level. Several types of treatments have been used to improve this union alteration one being extracorporeal shockwave therapy as described in this case presentation which showed excellent results. No. 164 Randomized Controlled Trial: Decreased Pain and Improved Functionality By Using Intraarticular Injection of Botulinum Toxin Type A Vs Intraarticular Injection With Methylprednisolone in Knee Osteoarthrosis. Ethel Fluchaire; María Del Carmen Mora. Objective: To prove that knee intraarticular injection with botulinum toxin type A (TBA) in patients with knee osteoarthrosis (KOA) is more effective than those with knee intraarticular injection with methylprednisolone (MP) for decreased pain and improvement in functionality. Design: Prospective randomized controlled study. Setting: Rehabilitation center. Third attention level. Participants: 35 subjects randomly assigned to TBA (n¼17) or MP (n¼ 18) groups; with a total of 53 knees TBA group (n¼22) and MP group (n¼31). Interventions: Intraarticular injection was performed in symptomatic knees of patients with KOA with subsequent follow-up in 1, 2, 3, and 6 months after application. Descriptive statistical analysis was made by using t Student and linear regression analysis. Main Outcome Measures: Visual analog scale (VAS) for pain intensity, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functionality. Level of Evidence: 2. Results: A significant difference with a p value¼0.01 was found for TBA group in decreased pain (VAS) and improvement in functionality (WOMAC) in the categories of pain and function. With a longer duration of therapeutic effect in the group of TBA. Conclusions: The use of the intraarticular injection of botulinum toxin type A provides more effective therapeutic option for pain reduction and improved function in patients with knee osteoarthrosis with a longer duration of effect compared with the use of methylprednisolone. No. 166 Does Sugar-Sweetened Beverage Consumption Determine Metabolic Health Status in Adults: An Observational Study. Katherine González-Ruíz; Robinson Ramírez-Vélez; Jorge Enrique Correa-Bautista. Disclosure: None. Objective: The influence of sugar-sweetened beverages (SSBs) on metabolic health and body fatness has been extensively researched and debated in the last few years. However this association has not been reported in Latin-American population. The aim was to examine the relationships between the consumption of SSBs and metabolic health definitions in adults. Setting: All subjects were from Bogota (Colombia) and belong to different universities (public and private). Participants: A total of 280 healthy men and women (age 23.32.3 years; weight 61.211.3 kg; BMI 22.53.6 kgm-1) were invited to participate in the
Age effect differences; 3. Effect of standing versus sitting in elderly adults. Setting: Geriatric rehabilitation center. Methods: The tasks involved reaching to virtual balls appearing in random order on the left and right side of TV screen connected to a computer. In the simple movement time (SMT) task, subjects were asked to touch each ball as soon as it appeared. In the go\no-go task the participants were asked to touch only the smooth looking balls and avoid balls with spines. Total duration of each task was one minute. For the reliability study 19 young healthy male and female subjects performed the tasks twice. To determine age effect, 18 young female subjects and 16 older female subjects performed the same tasks as in the previous study. In the third study a group of 22 elderly participants performed both the SMT and go\no-go tasks while sitting and standing in a comfortable stance. Results: The interclass correlation coefficient (ICC) for the SMT and the go\no-go were 0.717 and 0.564, respectively. ANOVA resulted in significant age task and interaction effects. No differences were noted in old subjects between performance while sitting or standing. Conclusions: The studied VR environment demonstrates moderate to high test retest reliability. Older adults respond more slowly particularly when faced with a go\no-go reaction. The need to maintain upward posture while maintaining a comfortable stance position does not challenge the older subjects sufficiently to effect movement time during stance. No. 162 Role of a Foreign Non-Profit Rehabilitation Association in a Large-Scale Natural Disaster: The Papa Experience in Typhoon Haiyan a Program Report. Rochelle Dymd; Ernesto Cruz, MD; Filipinas Ganchoon; Charles De Mesa, DO. Setting: Tent city for displaced persons and a rural community in the typhoon-affected area. Program: A relief/medical mission co-sponsored by the Philippine American Physiatrist Association (PAPA). Program Description: PAPA, a small group of US-based physiatrists of Filipino heritage/descent partnered with the Philippine Academy of Rehabilitation Medicine (PARM) a national rehabilitation society in conducting a relief and medical mission to a tent city in San Jose Tacloban and the rural community of Burauen, Leyte, Philippines three months after typhoon Haiyan February 17-18, 2014. The group comprised of 8 physiatrists. Assessment/Results: 1200 and 300 hygiene kits were distributed at San Jose and Burauen, respectively. A basic need/medical screening survey was administered which identified basic needs as well as medical conditions including disabilities. Free medical-rehabilitation consultations with limited medications were provided to residents in Burauen. Nearly half (46%) of the 283 patients served were pediatrics and 94 were males. Infections were the most common diagnoses (143; 42%) followed by musculoskeletal conditions (62; 18%) of which 80% were degenerative joint disease. Seventeen neurological cases (5%) were evaluated. Discussion (relevance): At 3 months post-disaster primary care diagnoses including secondary injuries sustained during acquisition of basic provisions, relocation, and clean-up efforts were common in these two community populations. Physiatrists can effectively treat this range of conditions with specialized focus on musculoskeletal and neurological injuries as well as on persons with disabilities. Medical follow-up of mission patients is a concern due to social, economical, and financial limitations. Conclusions: Physiatrists can play a significant role after a natural disaster. Through collaborations, a foreign non-profit rehabilitation association and its members can provide valuable direct support of local efforts in a large-scale natural disaster. No. 163 Management Response in Post-Traumatic Pseudarthrosis Scaphoid With Extracorporeal Shock Wave Therapy. A Case Report. Esquivia Carmen C., MD (Hospital Militar Central Bogotá, D.C., Colombia); Pira Jo; Esquivia Pajaro Carmen; Pira Paredes Jose. Disclosure: None. Setting: Tertiary care military hospital. Patient: A 17-year-old male with scaphoid pseudarthrosis before surgical management. Case Description: The initial management performed was osteosynthesis
Vol. 6, Iss. 8S2, 2014
S127
on the scaphoid bone and a pelvic graft of the nonunion focus. The procedure was described as unremarkable. However in subsequent outpatient controls after two months patient reported persistent pain. Radiographic examination showed an altered consolidation. After which he was referred to our service. In our perspective patient had preserved muscle strength in both upper limbs. Sensitivity was preserved without signs of active synovitis levels in the right carpal region. Patient is then considered a candidate for shock wave therapy. The patient received 5 sessions of shock waves at a frequency of 14 beats per second with an intensity of 2 air pressure at 5 bar for a total of 6000 shots. Assessment/Results: After 5 sessions a new x-ray is taken where improvement was evident in consolidation level. The nonunion of the left hand also had a decrease of 4 points on the subjective pain scale. Physical examination did not indicate a decrease in range of motion. Finally there was an improvement indicator on the score of quick functional scale. Discussion: Treatment with extracorporeal shock waves has proven effective to accelerate bone healing. However to our knowledge this is one of the first reported cases of improved results with shock wave therapy. Conclusion: Scaphoid pseudarthrosis refers to the failure to consolidate a fracture at a navicular bone level. Several types of treatments have been used to improve this union alteration one being extracorporeal shockwave therapy as described in this case presentation which showed excellent results. No. 164 Randomized Controlled Trial: Decreased Pain and Improved Functionality By Using Intraarticular Injection of Botulinum Toxin Type A Vs Intraarticular Injection With Methylprednisolone in Knee Osteoarthrosis. Ethel Fluchaire; María Del Carmen Mora. Objective: To prove that knee intraarticular injection with botulinum toxin type A (TBA) in patients with knee osteoarthrosis (KOA) is more effective than those with knee intraarticular injection with methylprednisolone (MP) for decreased pain and improvement in functionality. Design: Prospective randomized controlled study. Setting: Rehabilitation center. Third attention level. Participants: 35 subjects randomly assigned to TBA (n¼17) or MP (n¼ 18) groups; with a total of 53 knees TBA group (n¼22) and MP group (n¼31). Interventions: Intraarticular injection was performed in symptomatic knees of patients with KOA with subsequent follow-up in 1, 2, 3, and 6 months after application. Descriptive statistical analysis was made by using t Student and linear regression analysis. Main Outcome Measures: Visual analog scale (VAS) for pain intensity, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functionality. Level of Evidence: 2. Results: A significant difference with a p value¼0.01 was found for TBA group in decreased pain (VAS) and improvement in functionality (WOMAC) in the categories of pain and function. With a longer duration of therapeutic effect in the group of TBA. Conclusions: The use of the intraarticular injection of botulinum toxin type A provides more effective therapeutic option for pain reduction and improved function in patients with knee osteoarthrosis with a longer duration of effect compared with the use of methylprednisolone. No. 166 Does Sugar-Sweetened Beverage Consumption Determine Metabolic Health Status in Adults: An Observational Study. Katherine González-Ruíz; Robinson Ramírez-Vélez; Jorge Enrique Correa-Bautista. Disclosure: None. Objective: The influence of sugar-sweetened beverages (SSBs) on metabolic health and body fatness has been extensively researched and debated in the last few years. However this association has not been reported in Latin-American population. The aim was to examine the relationships between the consumption of SSBs and metabolic health definitions in adults. Setting: All subjects were from Bogota (Colombia) and belong to different universities (public and private). Participants: A total of 280 healthy men and women (age 23.32.3 years; weight 61.211.3 kg; BMI 22.53.6 kgm-1) were invited to participate in the