Depression and Spinal Cord Injury: A Scoping Review of Clinical Recommendations and Guidelines

e38 inclusive of adults with SCI were included. Two independent reviewers applied the selection criteria, and a third reviewer was available to achieve consensus as needed. Fifteen of 206 identified articles met the selection criteria. Data Extraction: Two independent reviewers identified and classified outcome measures as either objective (i.e., societal viewpoint) or subjective (i.e., patient perspective) using a QoL framework. Psychometric properties were summarized. Domains and constructs from qualitative studies were also described. Data Synthesis: Access to transportation was associated with increased QoL. Twenty-six outcome tools were identified (13 objective, 13 subjective). Eighteen tools were validated specifically for SCI, but none were developed specifically for SCI. A large SCI population survey (N Z 1549) suggests that assessment of needs-attainment is important. Qualitative findings (nZ5) suggested that accessible transportation is among the most frequently experienced barrier to achieving goals and participation. Conclusions: No existing outcome tools directly assess the influence of transportation on QoL for individuals living with SCI. Qualitative reports suggest that outcome should address ‘accessing health care’, ‘equal community participation’, and ‘individual needs-attainment’. An appropriate outcome tool can inform practice and policy related to accessible transportation post-SCI. Key Words: Spinal cord injury, Transportation, Quality of life, Participation Disclosures: None disclosed. Systematic/Meta-Analytic Review Poster 953 Depression and Spinal Cord Injury: A Scoping Review of Clinical Recommendations and Guidelines Jeremy Winget (Edward Hines Jr. VA Hospital), Judith Sweet, Jason Raad Objectives: There has been considerable interest in the prevalence, occurrence, and assessment of depression after Spinal Cord injury (SCI). This scoping review assesses current recommendations for the screening of depressive symptoms after SCI. Data Sources: Research, summary articles, and professional guidelines published in peer-reviewed journals between 1996 and 2016 were identified using the following terms: “spinal cord injury”, “depress*”, “screening”, “guideline” and “recommendation”. Databases queried included: PubMed, PsychInfo, EmBase, CINAHL, Medline, PsychiatryOnline, SCOPUS, Web of Science, and Google Scholar. Results were reviewed by an expert panel composed of SCI clinicians, researchers, and community advocates. 1,845 citations were identified, representing 1,287 unique articles. Study Selection: Inclusion criteria included research, summary articles, and reviews that made specific recommendations or provided clinical guidelines for the screening of depressive symptoms after SCI. Each article was assessed by two reviewers followed by a consensus meeting. This process yielded nine articles. Data Extraction: Using a modified version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol (PRISMA-P), the following data were extracted from each article: type of study (intervention, review, or practice guideline), sample characteristics, measure used, clinical context, and intended audience. Data Synthesis: 22 different measures were identified including the PHQ-9, BDI, Zung-SDS and CES-D. While the psychometric properties of these scales were generally accepted, four articles noted concern regarding their validity in SCI populations. Conclusions: Two themes emerged from this analysis. First, the occurrence and prevalence of depression among people living with SCI has been widely studied. Second, considerable effort has been made in establishing the psychometric properties of these measures. This review suggests that relatively little work has been done formulating actionable clinical guidelines. Key Words: Spinal Cord Injury, Depression, Screening, Clinical guidelines, Recommendations Disclosures: None disclosed.

Systematic/Meta-Analytic Review Posters Systematic/Meta-Analytic Review Poster 958 Does Pilates Exercise Versus No Pilates Exercise Improve Posture in Healthy Adults? A Systematic Review Melissa Vincent (Higher Function), Tristan Devitt, Cherie Wells Objectives: To evaluate the effectiveness of Pilates exercise in improving posture in healthy adults via a systematic review of randomised controlled trials. Data Sources: A search for “pilates” AND “posture” was conducted across five databases with no limitations in publication date: Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, Scopus, Web of Science. Study Selection: Studies were independently selected by two reviewers and were randomised controlled trials published in the English language in a peer-reviewed journal. Study participants were healthy adults, the intervention was Pilates exercise, the comparison no Pilates exercise, and outcome measure(s) assessed posture. Methodological quality of each trial was assessed using the Modified Physiotherapy Evidence Database scale. Data Extraction: Descriptions of the study population, intervention, comparison, and outcome measures were tabulated for six included studies. The methodological quality of studies was poor, indicated by quality scores ranging from 2-8 out of 14. Study findings were summarised as between group mean differences and 95% confidence intervals. Data Synthesis: A qualitative synthesis of data revealed Pilates exercise produced a statistically significant reduction in forward head posture at 6 months in one randomised controlled trial with a low risk of bias. Other studies reported no statistically or clinically significant improvements. Conclusions: Pilates exercise may improve forward head posture in healthy adults. Future randomised controlled trials need to be of high quality, adequately powered, and utilise valid and reliable measures of posture as well as ensure assessor blinding. Key Words: Pilates, Exercise, Posture, Healthy, Adults Disclosures: None disclosed. Systematic/Meta-Analytic Review Poster 964 The Need for Product Quality Standards for Wheelchairs Provided in Less-Resourced Settings Anand Mhatre (International Society of Wheelchair Professionals (ISWP)), Matt McCambridge, Norman Reese, Mark Sullivan, Don Schoendorfer, Chris Rushman, Jon Pearlman Objectives: To identify the need for additional wheelchair testing standards by performing - 1) a literature review of development of International Organization for Standardization (ISO) standards, wheelchair testing studies and product failures seen in less-resourced countries (LRCs) and 2) reviewing anecdotal data (photographic evidence) and feedback on wheelchair failures gathered from members of the Standards Working Group of International Society of Wheelchair Professionals (ISWP). Higher durability and reliability is needed for wheelchairs used in LRCs as they are subjected to unique environmental and use conditions and the need for additional testing is investigated since LRC wheelchairs fail frequently and prematurely more likely due to shortcomings in quality standards. Data Sources: A literature search was conducted on scientific and medical databases from the earliest time permitted electronically using PubMed, CIRRIE, EBSCO Host, and Scopus in March - April 2015. Keywords used for searching titles (and title/abstract for PubMed) in alphabetical order were: wheelchair + ANSI/RESNA, assessment, comparison, environment, evaluation, ISO, performance, review, standards and testing. The conference proceedings of Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) were physically retrieved since they were not available online. There was no limitation placed on the year of publication. Study Selection: Titles of the selected articles were screened by the author and another researcher and further review of articles based on abstracts

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