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Disability after Hospitalization: The Impact of Personal and Health Condition Factors for Persons Living with SCI
e138 use may yield functional effects that are comparable to those derived from RTP-only in the large and growing population of stroke survivors with moderate UE impairments. Myoelectric bracing is effective, and could be viably used as alternative for labor intensive UE training and used as an augmentative strategy that would have equivalent efficacy to hands on, manual therapy with moderately impaired stroke survivors. The device is costly, and RTP may be indicated as a more viable clinical option for some stroke survivors. These outcomes match previously published data that confirms that portable robotics are as efficacious as RTP. Key Words: Rehabilitation, stroke, hemiplegia, electromyography, occupational therapy Disclosures: None disclosed. Research Poster 828 Disability after Hospitalization: The Impact of Personal and Health Condition Factors for Persons Living with SCI Hannah Mercier (Spaulding Rehabilitation Network), Pengsheng Ni, Alan Jette Research Objectives: To determine whether education level, age, and years since injury were associated with long-term participation restriction and activity limitation after a hospitalization among adults living with a spinal cord injury (SCI). Design: Cross-sectional analysis of participants in the National (United States) SCI Model Systems (SCIMS) Database from 2010-2014. Multiple linear regressions, adjusting for demographic and injury-level characteristics, with the outcomes of participation and activity. Setting: 19 SCIMS Sites. Participants: Community-residing adults with SCI hospitalized in the past year (nZ1452). Interventions: N/A. Main Outcome Measure(s): Craig Handicap and Reporting Technique Short Forms, Functional Independence Measure. Results: After being hospitalized in the past year, physical independence restrictions were associated with fewer years since injury (bZ0.16), and a greater number of total days hospitalized (bZ-0.09). Mobility restriction was associated with lower education (bZ-0.64), older age (bZ-0.19), and a greater number of total days hospitalized (bZ-0.14). Greater occupation restrictions after hospitalization were predicted by lower education (bZ-0.53), older age (bZ-0.27), fewer years since injury (bZ0.11), and more days hospitalized (bZ-0.09). Lower social integration was associated with greater age (bZ-0.07) and longer duration of injury (bZ-0.08). Activity limitations were predicted by older age (bZ-0.07) and greater number of days hospitalized (bZ-0.06). Conclusions: Following a hospitalization, persons with SCI who are older, hospitalized for longer, and have less than high school education have the highest risk for long-term participation restriction. The greatest activity limitations are seen among persons who are older and hospitalized longer. This research informs policy around community-level intervention targeted to decreasing disability after a hospitalization. Key Words: Spinal Cord Injury, Hospitalization, Disability, Participation, Activity Disclosures: Ms. Mercier was supported in part by the 204 DeVivo Mentored Research Award from the University of Alabama Birmingham. Research Poster 829 Technology-Enhanced Maintenance Practice Following Intensive Voice Treatment in Children with Cerebral Palsy and Dysarthria Cynthia Fox (LSVT Global, Inc.), Carol Boliek Research Objectives: To evaluate the feasibility of utilizing the LSVT Companion System for practice during a 12 week maintenance phase following Lee Silverman Voice Treatment (LSVT LOUD) in 10 children with cerebral palsy (CP) and dysarthria.
Research Posters Design: A before-after trial design was used. Vocal sound pressure level data (SPL) were collected pre, post, and after the 12 weeks maintenance phase. Child and parent interviews regarding usability of the LSVT Companion System were also completed at the 12 week follow-up. Setting: The study took place in a general community setting. Participants: Ten children with CP and dysarthria participated in this study, which was part of a larger treatment design. Children ranged in age from 8 Years; 7 months to 15 years; 8 months; 3 females. All children were included in the maintenance phase of the study. The study was approved by the appropriate ethics committee. Interventions: During the 12-week maintenance phase children completed daily homework practice utilizing either a traditional paper/pencil method or the LSVT Companion System, which allowed for quantitative and objective data regarding amount and quality of homework practice. Main Outcome Measure(s): The primary outcome variable was change in vocal SPL. Secondary variables looked at amount of maintenance practice as it related to vocal SPL and usability feedback on the Companion system. Results: Data from the 12-week maintenance phase indicated that increased practice during this time period may have contributed to better maintenance of vocal SPL in sentences, except for one participant. In general, parents and children enjoyed using the Companion, but had suggestions for improving the system. Conclusions: The use of the computer program motivated some participants to maintain their practice schedule although alterations to the program are needed for more effective use. Key Words: Cerebral palsy, dysarthria, LSVT LOUD, speech treatment, maintenance Disclosures: Dr. Fox is an employee of and has ownership interest in LSVT Global, Inc. Dr. Boliek receives lecture and travel honorarium from LSVT Global, Inc. FDA: The LSVT Companion device is an FDA-cleared medical device for adults. This study presents an Off-Label use of the device in a feasibility study of its use in a pediatric population. Previously Presented: These data were presented in an early version at the Biannual Motor Speech Conference in Sarasota, FL (March, 2014) and the Movement Disorders Society meeting in San Diego, CA (June, 2015). Research Poster 831 Secondary Falls/Osteoporotic Fracture Prevention ffor Patients with Distal Radius Fracture: Survey of Therapist’s Knowledge and Clinical Practice Patterns Neha Dewan (McMaster University), Joy C. MacDermid, Norma MacIntyre, Ruby Grewal Research Objectives: The objective of our study was to describe therapists’ knowledge and clinical practice patterns with respect to secondary fall/osteoporotic fracture prevention (SFOFP) for patients with distal radius fracture (DRF) over 45 years of age. Design: A cross-sectional, multi-national (Canada, USA and India) survey was conducted among 272 therapists from August-October 2014. Setting: Not Applicable. Participants: Our sampling frame primarily consisted of registered physical and hand therapists from Canada and United states (US). Interventions: Not Applicable. Main Outcome Measure(s): Not Applicable. Results: 157 completed surveys were analyzed descriptively. The majority of therapists were from the USA (59%), certified hand therapists (54%) and females (87%). Most therapists’ (65-90%) believed they had knowledge about assessment, treatment and referral options about SFOFP for patients with DRF. However, the majority of therapists reported never using fracture risk assessment tool (90%) and lower-extremity (LE) muscle strength testing (54%). Instead, medication history was most commonly assessed (82%). With respect to treatment, w33% of therapists always used upper-extremity muscle strengthening exercises. Most therapists’ did not use balance (79%), LE muscle strengthening (85%), bone strengthening (54%) or communityaˆV“based physical activity (72%) programs (responses rating from sometimes to never). Similarly, when surveyed about patient education, therapists
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Research Posters Design: A before-after trial design was used. Vocal sound pressure level data (SPL) were collected pre, post, and after the 12 weeks maintenance phase. Child and parent interviews regarding usability of the LSVT Companion System were also completed at the 12 week follow-up. Setting: The study took place in a general community setting. Participants: Ten children with CP and dysarthria participated in this study, which was part of a larger treatment design. Children ranged in age from 8 Years; 7 months to 15 years; 8 months; 3 females. All children were included in the maintenance phase of the study. The study was approved by the appropriate ethics committee. Interventions: During the 12-week maintenance phase children completed daily homework practice utilizing either a traditional paper/pencil method or the LSVT Companion System, which allowed for quantitative and objective data regarding amount and quality of homework practice. Main Outcome Measure(s): The primary outcome variable was change in vocal SPL. Secondary variables looked at amount of maintenance practice as it related to vocal SPL and usability feedback on the Companion system. Results: Data from the 12-week maintenance phase indicated that increased practice during this time period may have contributed to better maintenance of vocal SPL in sentences, except for one participant. In general, parents and children enjoyed using the Companion, but had suggestions for improving the system. Conclusions: The use of the computer program motivated some participants to maintain their practice schedule although alterations to the program are needed for more effective use. Key Words: Cerebral palsy, dysarthria, LSVT LOUD, speech treatment, maintenance Disclosures: Dr. Fox is an employee of and has ownership interest in LSVT Global, Inc. Dr. Boliek receives lecture and travel honorarium from LSVT Global, Inc. FDA: The LSVT Companion device is an FDA-cleared medical device for adults. This study presents an Off-Label use of the device in a feasibility study of its use in a pediatric population. Previously Presented: These data were presented in an early version at the Biannual Motor Speech Conference in Sarasota, FL (March, 2014) and the Movement Disorders Society meeting in San Diego, CA (June, 2015). Research Poster 831 Secondary Falls/Osteoporotic Fracture Prevention ffor Patients with Distal Radius Fracture: Survey of Therapist’s Knowledge and Clinical Practice Patterns Neha Dewan (McMaster University), Joy C. MacDermid, Norma MacIntyre, Ruby Grewal Research Objectives: The objective of our study was to describe therapists’ knowledge and clinical practice patterns with respect to secondary fall/osteoporotic fracture prevention (SFOFP) for patients with distal radius fracture (DRF) over 45 years of age. Design: A cross-sectional, multi-national (Canada, USA and India) survey was conducted among 272 therapists from August-October 2014. Setting: Not Applicable. Participants: Our sampling frame primarily consisted of registered physical and hand therapists from Canada and United states (US). Interventions: Not Applicable. Main Outcome Measure(s): Not Applicable. Results: 157 completed surveys were analyzed descriptively. The majority of therapists were from the USA (59%), certified hand therapists (54%) and females (87%). Most therapists’ (65-90%) believed they had knowledge about assessment, treatment and referral options about SFOFP for patients with DRF. However, the majority of therapists reported never using fracture risk assessment tool (90%) and lower-extremity (LE) muscle strength testing (54%). Instead, medication history was most commonly assessed (82%). With respect to treatment, w33% of therapists always used upper-extremity muscle strengthening exercises. Most therapists’ did not use balance (79%), LE muscle strengthening (85%), bone strengthening (54%) or communityaˆV“based physical activity (72%) programs (responses rating from sometimes to never). Similarly, when surveyed about patient education, therapists
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