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A Couples-Based Intervention Improves Depressive Symptoms in Stroke Survivors and Care-Partners
Research Posters side effects. The key point of this narrative review is to help clinicians that currently must decide between very inexpensive diclofenac oral presentations and expensive topical presentations especially in the elderly population and the pros and cons of such decision-making process. Key Words: Osteoarthritis, Pain, Pharmacotherapy Disclosures: Research submitted and accepted at the Journal of Pain and Palliative Care Pharmacotherapy (indexed PubMed); February 2017. Research Poster 304872 A Clinical Study of Traumatic Shoulder Fractures Associated with Occupational Injuries Ga Eun Lee (Daegu hospital, Korea worker’s compensation & welfare service, Department Physical Medicine and Rehabilitation), Gi Young Park, Kang Woo Research Objectives: To describe the epidemiology on occupationally traumatic shoulder fractures (clavicle, scapula and proximal humerus). Design: Inpatients from 2012 to 2015, retrospective study. Setting: Hospitalized care. Participants: 23 patients with traumatic shoulder fracture. Interventions: Retrospective study. Main Outcome Measure(s): Mechanism of injury : falling down (52.2%). crushing injury (21.7%), motor vehicle accident (17.4%), slip down (4.3%), and direct blunt trauma (4.3%). 7 of 10 with clavicle fracture treated with open reduction and internal fixation (OR/IF). 6 of 7 with proximal humerus fracture had OR/IF. Only one of 8 with scapula fracture underwent surgery . 2 patients had 2 kinds of shoulder fracture simultaneously. types of associated injuries : Vertebral fracture was the most common (43.5%), hemopneumothorax or lung contusion (39.1%), fracture of lower extremity or pelvis (39.1%), fracture of upper extremity except shoulder joint (39.1%), rib fracture (30.4%), injury of central nervous system : SCI, brain hemorrhage, etc (13.0%), facial bone or skull fracture (13.0%), peripheral nerve injury : brachial plexus injury, etc (8.7%), and abdominal visceral injury : liver laceration (1 case, 4.3%). Results: 17 patients (73.9%) had more than 2 major traumatic injuries of other body part except shoulder fracture. 19 people (82.6%) required quite long term-immobilization or limitation of walking and weight bearing at the beginning of treatment due to fractures of spine, pelvis or lower extremity. 10 people experienced injuries of vital organ like lung and liver. 2 patients with brain hemorrhage treated conservatively. And one patient had spine surgery because of vertebral fracture with complete paralysis of both lower extremities. Conclusion/Discussion: Traumatic shoulder fractures can be occurred by various mechanisms of injury. Many shoulder fractures associated with occupational trauma are combined with complex and complicated injuries. Key Words: Shoulder Fracture, Occupational Injury, Traumatic Shoulder Injury Disclosures: None. Research Poster 315952 A Comparison of Hand Grip Strength between NHANES vs NIH Toolbox Studies Ying-Chih Wang (University of Wisconsin Milwaukee), Richard Bohannon, Sheng-Che Yen Research Objectives: To provide and compare grip strength reference values obtained from two population-based studies: the National Health and Nutrition Examination Survey (NHANES) and the National Institutes of Health (NIH) Toolbox. Design: Cross-sectional population based study. Setting: Community. Participants: Data from 13,918 participants (49.1% males, 91.4% right hand dominant) in the 2011-2014 NHANES, and 3,594 (44.6% males,
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e25 91.8% right hand dominant) in the 2011 normative phase of the NIH Toolbox project. Interventions: N/A. Main Outcome Measure(s): Handgrip strength. Results: Handgrip values obtained from the NHANES and NIH Toolbox were summarized after stratification by side (ie, dominant and nondominant), gender, and age. The NHANES values used were the mean and best of 3 trials; the NIH Toolbox value used was that of 1 trial after a practice trial. For NHANES best values versus NIH handgrip forces (dominant hand), analysis demonstrated that overall grip strength values were slightly higher in NHANES than NIH Toolbox (27.6 vs 26.3 kg, p < .001) and males were significantly stronger than females (30.8 vs 23.0 kg, p < .001). The age groups factor was significant (p < .001), with participants of 18 and 49 years demonstrating higher grip strength than other groups. Nonetheless, the differences of grip strength between NHANES and NIH Toolbox were not statistical significant when comparing NHANES mean values versus NIH handgrip forces in both dominant and non-dominant hands. Conclusion/Discussion: Although varying between strata, peak reference values of grip strength were significantly different between the NHANES and the NIH Toolbox, whereas mean reference values of NHANES were similar to those of the NIH Toolbox. Key Words: Hand Strength, Grip, Hand, Gender, NIH Toolbox Disclosures: None. Research Poster 304111 A Couples-Based Intervention Improves Depressive Symptoms in Stroke Survivors and Care-Partners Alexandra Terrill (University of Utah Department of Occupational & Recreational Therapies), Maija Reblin, Justin MacKenzie, Beth Cardell, Cynthia Berg, Jennifer Majersik, Lorie Richards Research Objectives: To pilot test a novel dyadic positive psychologybased intervention (PPI) for improving depression in couples post-stroke. Design: An 8-week clinical intervention pilot trial with pre- and postassessments, and 3-month follow-up. Setting: Assessments and activity training were completed in-person at a University-affiliated community-based clinic. Intervention activities were completed at home. Participants: Participants were recruited through University-affiliated outpatient neurology and rehabilitation clinics. Twelve communitydwelling couples consisting of one partner who had a stroke >6 months ago and a cohabiting partner/caregiver were enrolled. One or both partner(s) reported depressive symptoms. Mean age was 56 years (range: 2784). Time since stroke ranged from 8 months to >5 years. Interventions: After a short training, participants engaged in an 8-week self-administered behavioral PPI at home, completing two activities alone and two together each week (examples: expressing gratitude, fostering relationships, savoring). Activity booklets, tracking calendars, and weekly check-in calls were provided. Main Outcome Measure(s): PROMIS-Depression-Short Form. Results: 11 couples completed the program (92% retention). Post-PPI, depressive symptoms significantly decreased (p < .02), with nearly 70% of participants reporting less depression. Depressive symptoms continued to improve at follow-up (p < .02); 70% of survivors and 85% of caregivers either continued to improve or maintained mood at 3-month follow-up. Conclusion/Discussion: Preliminary results suggest PPI may be effective for improving depressive symptoms in survivors and care-partners poststroke. This represents a promising first step in a novel dyadic approach in this population. Key Words: Stroke, Depression, Couples, Behavioral Medicine, Rehabilitation Disclosures: Nothing disclosed.
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e25 91.8% right hand dominant) in the 2011 normative phase of the NIH Toolbox project. Interventions: N/A. Main Outcome Measure(s): Handgrip strength. Results: Handgrip values obtained from the NHANES and NIH Toolbox were summarized after stratification by side (ie, dominant and nondominant), gender, and age. The NHANES values used were the mean and best of 3 trials; the NIH Toolbox value used was that of 1 trial after a practice trial. For NHANES best values versus NIH handgrip forces (dominant hand), analysis demonstrated that overall grip strength values were slightly higher in NHANES than NIH Toolbox (27.6 vs 26.3 kg, p < .001) and males were significantly stronger than females (30.8 vs 23.0 kg, p < .001). The age groups factor was significant (p < .001), with participants of 18 and 49 years demonstrating higher grip strength than other groups. Nonetheless, the differences of grip strength between NHANES and NIH Toolbox were not statistical significant when comparing NHANES mean values versus NIH handgrip forces in both dominant and non-dominant hands. Conclusion/Discussion: Although varying between strata, peak reference values of grip strength were significantly different between the NHANES and the NIH Toolbox, whereas mean reference values of NHANES were similar to those of the NIH Toolbox. Key Words: Hand Strength, Grip, Hand, Gender, NIH Toolbox Disclosures: None. Research Poster 304111 A Couples-Based Intervention Improves Depressive Symptoms in Stroke Survivors and Care-Partners Alexandra Terrill (University of Utah Department of Occupational & Recreational Therapies), Maija Reblin, Justin MacKenzie, Beth Cardell, Cynthia Berg, Jennifer Majersik, Lorie Richards Research Objectives: To pilot test a novel dyadic positive psychologybased intervention (PPI) for improving depression in couples post-stroke. Design: An 8-week clinical intervention pilot trial with pre- and postassessments, and 3-month follow-up. Setting: Assessments and activity training were completed in-person at a University-affiliated community-based clinic. Intervention activities were completed at home. Participants: Participants were recruited through University-affiliated outpatient neurology and rehabilitation clinics. Twelve communitydwelling couples consisting of one partner who had a stroke >6 months ago and a cohabiting partner/caregiver were enrolled. One or both partner(s) reported depressive symptoms. Mean age was 56 years (range: 2784). Time since stroke ranged from 8 months to >5 years. Interventions: After a short training, participants engaged in an 8-week self-administered behavioral PPI at home, completing two activities alone and two together each week (examples: expressing gratitude, fostering relationships, savoring). Activity booklets, tracking calendars, and weekly check-in calls were provided. Main Outcome Measure(s): PROMIS-Depression-Short Form. Results: 11 couples completed the program (92% retention). Post-PPI, depressive symptoms significantly decreased (p < .02), with nearly 70% of participants reporting less depression. Depressive symptoms continued to improve at follow-up (p < .02); 70% of survivors and 85% of caregivers either continued to improve or maintained mood at 3-month follow-up. Conclusion/Discussion: Preliminary results suggest PPI may be effective for improving depressive symptoms in survivors and care-partners poststroke. This represents a promising first step in a novel dyadic approach in this population. Key Words: Stroke, Depression, Couples, Behavioral Medicine, Rehabilitation Disclosures: Nothing disclosed.