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Ethics approval: Griffith University Human Research Ethics Committee, Griffith University, Queensland Health Human Research Ethics Committee, Australia. http://dx.doi.org/10.1016/j.physio.2015.03.449 Research Report Poster Presentation Number: RR-PO-01-02-Sun Sunday 3 May 2015 13:00 Exhibit halls 401–403 HEART RATE VARIABILITY PREDICTS SUCCESS IN WEANING PROCESS F.A. Contreras Brice˜no 1 , C. Guajardo Rojas 1 , D. Arellano Sepúlveda 1 , P. Garcia 1 , D. Guidi 1 , L. Miret Venegas 2 , T. Pagés 3 , G. Viscor 3 1 Pontificia
Universidad Católica de Chile, Facultad de Medicina, Santiago, Chile; 2 Hospital San José, Unit of Physical Therapist, Santiago, Chile; 3 Universidad de Barcelona, Departamento de Inmunología y Biología, Barcelona, Spain Background: The success in weaning process demand a good balance between cardiac and respiratory system. Heartrate variability (HRV), a new non invasive tool to characterize autonomic function and cardiorespiratory interaction, may be useful to assess patient capability during weaning process. The frequency-domain of HRV has the low and high frequency components. Low-frequency (L.F) has relationship with the sympathetic branch, and high-frequency (H.F) with parasympathetic branch of the autonomic nervous system of sinus node. The interactions of these branches on control of sinus node are expressed as normalized unit (n.u; %). Purpose: To assess the association between frequencydomain of HRV and success in weaning process in critically ill patients. Methods: This study was conducted in adult intensive care unit (ICU) of Hospital San José (Chile). From November 2013 to April 2014, 24 patients with acute lung failure who had been intubated and placed on mechanical ventilation for 48 or more hours, and were ready for their first spontaneous breathing trial (SBT) were assessed. Were not included patients with tracheotomies, atrial or ventricular arrhytmia, or unable to follow verbal instructions. The normalized unit (n.u) of low-frequency (L.F) and high-frequency (H.F) of HRV were assessed using a portable heart-rate monitor (Polar RS800cx) during a 1-hour SBT (through a T-piece), specifically at 10 and 60 minutes. These parameters were correlated with tobin-index at 1 hour of SBT. All statistical analysis was conducted by SPSS 19.0 software. Results: All patients had success in SBT and were extubated. 4 patients (2 male) required reintubation within 48 hours and were excluded from analysis. 20 patients (12
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male) had success in weaning process. At 10 minutes of SBT, L.F was 50.5 ± 7.0; and H.F 49.5 ± 7.6; and at 60 minutes, L.F 45.3 ± 5.6; and H.F 54.7 ± 6.8. The tobin index was 55 ± 6. Pearson correlation was 0.879 (p = 0.001) and 0.729 (p = 0.002) at 10 and 60 minutes in SBT, respectively. Conclusion(s): Frequency domain of HRV showed a relevant association with tobin index, and could be a new parameter to incorporate in protocols of weaning for helping to respiratory therapist in their daily routine of improving patient care, because could predicts success in weaning process. Implications: To incorporate HRV analysis in protocols of weaning ventilators. To help to respiratory therapist in daily routine of improving patient care and outcomes. Keywords: Ventilator weaning; Heart rate; Critical care Funding acknowledgements: The authors declare that this research was not supported by specific resources. Ethics approval: This study was approved by the Research Ethics Committee of Hospital San José (Santiago, Chile). http://dx.doi.org/10.1016/j.physio.2015.03.450 Special Interest Report Poster Presentation Number: SI-PO-03-20-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 CHALLENGING NEW PHYSIOTHERAPISTS TO THINK DIFFERENTLY: THE INAUGURAL STUDENT PHYSIOTHERAPY CONFERENCE SCOTLAND 2014 F. Cook, M. Katie, J. Chang, A. Christoforou, J. Lane Queen Margaret University, Physiotherapy, Edinburgh, United Kingdom Background: The Student Physiotherapy Conference Scotland 2014 (SPCS14) was developed as a result of four final year students who shared a vision of an event that would challenge, inspire and empower physiotherapy students and recent graduates to ‘think outside the box’ and shape their own futures. It was conceived, organised and executed for students by students with the aim of uniting students, educators and clinicians to enhance knowledge, encourage collaboration and inspire innovation. The theme, ‘Tradition and Trajectory’, emerged from the recognition that physiotherapy is both grounded in traditional, holistic and non-invasive approaches and directed by changing sociodemographic and health and social care demands. Purpose: The conference aimed to create an environment where students would be challenged to readdress their perceptions of leadership and their role in creating change in healthcare. We also hoped to highlight the impact of phys-
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iotherapy in contemporary areas of practice thus stimulating student interest and encouraging lateral thinking. Methods: The conference committee invited internationally renowned keynote speakers and workshop leaders with a view to respecting traditional physiotherapy values whilst introducing an alternative trajectory for practice, the profession and healthcare. A variety of AHP speakers were selected in order to illustrate the value of MDT approaches in a society where there is a need to integrate health and social care. The conference also offered an environment for students to recognise their potential and ability by showcasing their research on national stage. Sponsorship was also sought from local companies, charities and healthcare providers. A conference website enabled widespread communication of the event. The impact of the conference was evaluated via social media and delegate feedback. Results: On October 25, 2014, 209 delegates representing five universities and three countries converged on Queen Margaret University in Edinburgh for SPCS2014. Over £1300 in sponsorship was obtained and eight stalls were provided. Delegate feedback identified three major themes of empowerment, motivation and inspiration. Motivation and inspiration for change was reflected in comments from students, clinicians and academic staff alike. Twitter comments indicated that the conference was highly successful and had created sense of community amongst delegates. Twitter was also used for knowledge sharing throughout the day. The positive energy created by the conference was summed up by one delegate who said ‘I now feel as though I could change the world!’. Conclusion(s): This successful conference has shown what can be achieved by students when empowered to take responsibility for their own personal development. Implications: The implications of this event occur on 3 different levels; personal, institutional and practical. Through the ripple effect, inspiration, motivation and empowerment on a personal level translates into both institutional and practice changes. Encouraging fresh thinking, flexibility, ground breaking research and practice at your front door will ensure the university programmes produce physiotherapists who are fit to practice in this ever-evolving healthcare climate. The skills learnt through the exposure to non-conventional physiotherapy will develop practical skills and clinical reasoning. Striving for excellence in a personal, institutional and practical manner will ensure the next generation of physiotherapists will settle for nothing but the best. Keywords: Student; Conference; Empowerment Funding acknowledgements: Living it Up, Spire, Athletes Angels, Pro-active, PALtech, Edinburgh Leisure, NHS Education for Scotland, Queen Margaret University, CSP Scottish Board. Ethics approval: Ethical approval for this conference was not required. http://dx.doi.org/10.1016/j.physio.2015.03.451
Research Report Platform Presentation Number: RR-PL-2844 Monday 4 May 2015 11:18 Room 334–335 AN EXPLORATION OF ASPECTS OF HEALTH ALTERED BY BREAST CANCER AND ITS TREATMENT USING THE INTERNATIONAL CLASSIFICATION AND FUNCTIONING (ICF) M. Cooney 1 , R. Galvin 2 , E. Stokes 1 1 Trinity College Dublin, Discipline of Physiotherapy, Dublin, Ireland; 2 Royal College of Surgeons in Ireland, HRB Centre for Primary Care Research, Department of General Practice, Dublin, Ireland
Background: Treatment for breast cancer is associated with residual symptoms including pain and functional compromise which may benefit from physiotherapy. The total range aspects of health affected by treatment have not previously been studied and none of the existing instruments cover all aspects of the experience. To this end, the Core Set for breast cancer, an 80 item condition specific subset of the ICF, was developed to map the range of aspects of health affected by treatment for breast cancer. Purpose: The purpose of this study was to validate the ICF Core Set for breast cancer from the perspective of women with the condition. Methods: Design: A sequential mixed methodology study was conducted; qualitative data was gathered in focus groups which informed the subsequent self-report postal questionnaire. Women with breast cancer who were >0.5–<4 years post-surgery were identified from a database at a national symptomatic breast unit. All surgery types and all treatments for breast cancer were included. The presence of any diagnosed condition that may affect function was a criterion for exclusion. Results: Thirty four women with breast cancer participated in seven focus groups. The items in the Core Set were confirmed and an additional 30 ICF categories were identified. A self-report postal questionnaire was sent to 414 women and a 67% (n = 298) response rate was achieved. Respondents had a mean age of 56 years (SD ± 12.8) and time since surgery was 23 months (SD ± 13). The questionnaire contained the 80 items in the original Core Set and the 30 additional categories. Respondents confirmed the categories within in the Core Set and the additional items identified by focus groups. Pain (86%), reduced energy (77%) and sleep disturbance (71%) were most frequently reported altered functions. Pain was current for 71% of the women and 40% experienced pain in more than one site. Lifting and carrying was the activity reported by largest number of respondents (69%). Women also reported a change in attitude of family and friends (37%) towards them since treatment. Five of the