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Poster 32 Is It Important to Stretch Accessory Inspiratory Muscles? A Case Series
PM&R
Poster 32 Is It Important to Stretch Accessory Inspiratory Muscles? A Case Series. Eulogio Pleguezuelos (Mataró Hospital, Mataró, Spain); Mirta Bobadilla, Maria Costea, MD, Lluis Guirao, Gemma Llorensi, Maria Engracia Perez, Beatriz Samitier. Disclosures: E. Pleguezuelos, none. Objective: To determine if a stretching program of accessory inspiratory muscles in patients with chronic obstructive pulmonary disease (COPD) was capable of increasing respiratory function measured by spirometry and functional capacity measured by 6-minute walking distance (6MWD). Design: Prospective matched pairs intervention. Setting: Ambulatory care. Participants: Twenty-four stable patients with COPD. Interventions: A 3-week stretching program, including pectoralis major, pectoralis minor, and sternocleidomastoid (SCM), was designed for the study. The variables were collected by following a protocol designed for the study. A spirometry and a 6MWD were at the beginning and at the end of every week. Main Outcome Measures: Meters in 6MWD, Borg scale score, oxygen desaturation, FVC, FEV1, FEV1/FVC, MMEF 25%75%. Results: There were significant statistical differences in meters in 6MWD and Borg scale score between the beginning and the end in the first and second week (⬍.001 and ⬍.001, respectively, for the first week, and .022 and .002 , respectively, for the second week). There were significant statistical differences between meters in 6MWD and Borg scale score from the beginning to the end of the study. Conclusions: Our findings indicate that stretching of the pectoral major, pectoral minor, and SCM in COPD increases functional capacity and reduces the subjective dyspnea sensation as measured with the Borg scale. Stretching of inspiratory muscles does not modify the respiratory function parameters measured by spirometry. Poster 33 Inpatient Rehabilitation in Patients Receiving Left Ventricular Assist Device Therapy. Osama Alsara, MD (Mayo Clinic, Rochester, MN, United States); Engen Deborah, OT, Soon J. Park, Mary D. Pyfferoen, PT, MA, Carmen M. Terzic, MD, PhD, Randal J. Thomas, MD, Tamra Trenary, OTD, Merri L. Vitse, OTA. Disclosures: O. Alsara, none. Objective: To evaluate the role of inpatient rehabilitation programs in the management of patients with left ventricular assist device (LVAD). Design: A retrospective study. Setting: Comprehensive inpatient rehabilitation settings. Participants: 47 patients who were referred to the inpatient rehabilitation program after receiving LVAD therapy at Mayo Clinic, Rochester, MN between January 2008 and June 2010. Interventions: Not applicable. Main Outcome Measures: All patients admitted to inpatient rehabilitation program underwent a functional and cognitive analysis by using the Functional Independence Measurement Scale (FIM) at the moment of admission and after dismissal.
Vol. 3, Iss. 10S1, 2011
S187
Results: Patients with an LVAD stayed in an inpatient rehabilitation program for 6.62⫾3.87 days. At the time of the discharge, a significant improvement in FIM scores was noted compared with the scores at the time of admission. Significant changes occurred in eating (5.76 vs. 6.43; P⫽.01), grooming (5.02 vs. 6.13; P⫽.0001), bathing (3.10 vs. 4.36; P⫽.0008), dressing upper body (3.93 vs. 5.10; P⫽.0009), dressing lower body (3.30 vs. 4.78; P⫽.0001), toileting (3.71 vs. 5.17; P⫽.0003), bladder control (4.08 vs. 4.76; P⫽.0001), toilet transfer (3.73 vs. 4.97, P⫽.0002 ), bed/chair/ wheelchair transfer (3.41 vs. 5; P⫽.0001), tub/shower transfer (3.17 vs. 4.47; P⫽.007), walk/wheelchair transfer (3.10 vs. 5.26; P⫽.0001), stairs (2.1 vs. 3.69; P⫽.0001), comprehension (5.54 vs. 6.17; P⫽.02), expression (5.93 vs. 6.43; P⫽.01), social interaction (5.89 vs. 6.19; P⫽.048), problem solving (4.86 vs. 5.63, P⫽.001), and memory (5.10 vs. 5.86, P⫽.004). Although bowel control also improved at the time of discharge, this improvement was not statically significant (5.08 vs. 5.28; P⫽.6). The total FIM score at admission was 77.5, whereas the score was 95.8 at discharge (P⬍.0001). Conclusions: A significant improvement in the functional and cognitive status of patients with an LVAD is achieved upon participating in an inpatient rehabilitation program, which emphasizes the important role of this approach in the care of patients receiving LVAD therapy.
CLINICAL OUTCOMES Poster 34 Improvement in Health-related Quality of Life After Treatment With OnabotulinumtoxinA in Patients With Urinary Incontinence Due to Neurogenic Detrusor Overactivity. Michael Chancellor, MD (William Beaumont School of Medicine, Royal Oak, MI, United States); Chris R. Chapple, MD, Giulio Del Popolo, Denise Globe, PhD, Wayne Lam, PhD, Peter J. Pommerville, BA, MD, FRCS(C), Patrick J. Shenot, MD, David Sussman. Disclosures: M. Chancellor, Allergan, Inc, research grants. Allergan, Inc, consulting fees or other remuneration. Objective: To evaluate the impact of onabotulinumtoxinA on health-related quality of life (HRQoL) in patients with urinary incontinence (UI) due to neurogenic detrusor overactivity (NDO). Design: Two international, multicenter, double-blind, randomized, placebo-controlled studies. Setting: Urology, urogynecology, and rehabilitation clinics or hospitals. Participants: Patients aged ⬎18 years with UI (ⱖ14 episodes/ wk) due to NDO that results from multiple sclerosis (MS) or spinal cord injury (SCI), inadequately managed with anticholinergics. Interventions: Placebo (n⫽241), onabotulinumtoxinA 200 U (n⫽227) or onabotulinumtoxinA 300 U (n⫽223). Main Outcome Measures: The primary end point was change from baseline in UI episodes/wk (week 6). HRQoL assessments (administered every 6 weeks) included the 22-item incontinence quality of life (I-QOL) (with 1 overall score and 3 subscale scores) and the 16-item modified OAB Patient Satisfaction with Treatment Questionnaire (OAB-PSTQ), which consisted of the original 12 items (which comprised the total score), and 4 additional items that were added to assess satisfaction, goal attainment, treatment expectations, and adverse effects. Data from 2 phase III trials were pooled for analysis. Results: At week 6, significant improvements in mean I-QOL total
Poster 32 Is It Important to Stretch Accessory Inspiratory Muscles? A Case Series. Eulogio Pleguezuelos (Mataró Hospital, Mataró, Spain); Mirta Bobadilla, Maria Costea, MD, Lluis Guirao, Gemma Llorensi, Maria Engracia Perez, Beatriz Samitier. Disclosures: E. Pleguezuelos, none. Objective: To determine if a stretching program of accessory inspiratory muscles in patients with chronic obstructive pulmonary disease (COPD) was capable of increasing respiratory function measured by spirometry and functional capacity measured by 6-minute walking distance (6MWD). Design: Prospective matched pairs intervention. Setting: Ambulatory care. Participants: Twenty-four stable patients with COPD. Interventions: A 3-week stretching program, including pectoralis major, pectoralis minor, and sternocleidomastoid (SCM), was designed for the study. The variables were collected by following a protocol designed for the study. A spirometry and a 6MWD were at the beginning and at the end of every week. Main Outcome Measures: Meters in 6MWD, Borg scale score, oxygen desaturation, FVC, FEV1, FEV1/FVC, MMEF 25%75%. Results: There were significant statistical differences in meters in 6MWD and Borg scale score between the beginning and the end in the first and second week (⬍.001 and ⬍.001, respectively, for the first week, and .022 and .002 , respectively, for the second week). There were significant statistical differences between meters in 6MWD and Borg scale score from the beginning to the end of the study. Conclusions: Our findings indicate that stretching of the pectoral major, pectoral minor, and SCM in COPD increases functional capacity and reduces the subjective dyspnea sensation as measured with the Borg scale. Stretching of inspiratory muscles does not modify the respiratory function parameters measured by spirometry. Poster 33 Inpatient Rehabilitation in Patients Receiving Left Ventricular Assist Device Therapy. Osama Alsara, MD (Mayo Clinic, Rochester, MN, United States); Engen Deborah, OT, Soon J. Park, Mary D. Pyfferoen, PT, MA, Carmen M. Terzic, MD, PhD, Randal J. Thomas, MD, Tamra Trenary, OTD, Merri L. Vitse, OTA. Disclosures: O. Alsara, none. Objective: To evaluate the role of inpatient rehabilitation programs in the management of patients with left ventricular assist device (LVAD). Design: A retrospective study. Setting: Comprehensive inpatient rehabilitation settings. Participants: 47 patients who were referred to the inpatient rehabilitation program after receiving LVAD therapy at Mayo Clinic, Rochester, MN between January 2008 and June 2010. Interventions: Not applicable. Main Outcome Measures: All patients admitted to inpatient rehabilitation program underwent a functional and cognitive analysis by using the Functional Independence Measurement Scale (FIM) at the moment of admission and after dismissal.
Vol. 3, Iss. 10S1, 2011
S187
Results: Patients with an LVAD stayed in an inpatient rehabilitation program for 6.62⫾3.87 days. At the time of the discharge, a significant improvement in FIM scores was noted compared with the scores at the time of admission. Significant changes occurred in eating (5.76 vs. 6.43; P⫽.01), grooming (5.02 vs. 6.13; P⫽.0001), bathing (3.10 vs. 4.36; P⫽.0008), dressing upper body (3.93 vs. 5.10; P⫽.0009), dressing lower body (3.30 vs. 4.78; P⫽.0001), toileting (3.71 vs. 5.17; P⫽.0003), bladder control (4.08 vs. 4.76; P⫽.0001), toilet transfer (3.73 vs. 4.97, P⫽.0002 ), bed/chair/ wheelchair transfer (3.41 vs. 5; P⫽.0001), tub/shower transfer (3.17 vs. 4.47; P⫽.007), walk/wheelchair transfer (3.10 vs. 5.26; P⫽.0001), stairs (2.1 vs. 3.69; P⫽.0001), comprehension (5.54 vs. 6.17; P⫽.02), expression (5.93 vs. 6.43; P⫽.01), social interaction (5.89 vs. 6.19; P⫽.048), problem solving (4.86 vs. 5.63, P⫽.001), and memory (5.10 vs. 5.86, P⫽.004). Although bowel control also improved at the time of discharge, this improvement was not statically significant (5.08 vs. 5.28; P⫽.6). The total FIM score at admission was 77.5, whereas the score was 95.8 at discharge (P⬍.0001). Conclusions: A significant improvement in the functional and cognitive status of patients with an LVAD is achieved upon participating in an inpatient rehabilitation program, which emphasizes the important role of this approach in the care of patients receiving LVAD therapy.
CLINICAL OUTCOMES Poster 34 Improvement in Health-related Quality of Life After Treatment With OnabotulinumtoxinA in Patients With Urinary Incontinence Due to Neurogenic Detrusor Overactivity. Michael Chancellor, MD (William Beaumont School of Medicine, Royal Oak, MI, United States); Chris R. Chapple, MD, Giulio Del Popolo, Denise Globe, PhD, Wayne Lam, PhD, Peter J. Pommerville, BA, MD, FRCS(C), Patrick J. Shenot, MD, David Sussman. Disclosures: M. Chancellor, Allergan, Inc, research grants. Allergan, Inc, consulting fees or other remuneration. Objective: To evaluate the impact of onabotulinumtoxinA on health-related quality of life (HRQoL) in patients with urinary incontinence (UI) due to neurogenic detrusor overactivity (NDO). Design: Two international, multicenter, double-blind, randomized, placebo-controlled studies. Setting: Urology, urogynecology, and rehabilitation clinics or hospitals. Participants: Patients aged ⬎18 years with UI (ⱖ14 episodes/ wk) due to NDO that results from multiple sclerosis (MS) or spinal cord injury (SCI), inadequately managed with anticholinergics. Interventions: Placebo (n⫽241), onabotulinumtoxinA 200 U (n⫽227) or onabotulinumtoxinA 300 U (n⫽223). Main Outcome Measures: The primary end point was change from baseline in UI episodes/wk (week 6). HRQoL assessments (administered every 6 weeks) included the 22-item incontinence quality of life (I-QOL) (with 1 overall score and 3 subscale scores) and the 16-item modified OAB Patient Satisfaction with Treatment Questionnaire (OAB-PSTQ), which consisted of the original 12 items (which comprised the total score), and 4 additional items that were added to assess satisfaction, goal attainment, treatment expectations, and adverse effects. Data from 2 phase III trials were pooled for analysis. Results: At week 6, significant improvements in mean I-QOL total