Effects of a Novel Overground Locomotor Training Program on Muscle Oxygen Extraction in Individuals with Incomplete Spinal Cord Injury

e40 Research Objectives: Assess perspectives on improvements following the Less Neuropathy after Yoga (LeNY) pilot study. Design: Qualitative analyses from a mixed-methods traditional pre-post pilot intervention study. Setting: University lab. Participants: Fifteen persons with diabetic peripheral neuropathy (DPN) completed an 8-week yoga intervention. Inclusion criteria: self-report a diagnosis of DPN; able to speak and understand English; >4 out of 6 on the short 6-item Mini-Mental State Examination; and agree to commit to assessments and 16 sessions of yoga. Potential participants were excluded if: they had consistently engaged in yoga for over a year; reported a terminal illness with life expectancy of <6 months; and/or if they were unable to secure transportation to the sessions. Interventions: Yoga occurred two times per week for one hour each session, and consisted of physical postures, breathing exercises, and meditation which were modified as needed for person with DPN. Main Outcome Measure(s): Interpretative phenomenological analysis and constant comparison principles were employed to evaluate the data. Results: On average, participants were 66.5 years old, female (53.3%), and white (80.0%). They had some college education (73.3%), Type 2 diabetes (86.7%), and completed 12.3/15 yoga sessions. Participants reported substantial improvements in function, particularly in areas of increased activities of daily living (such as improved ability to shower independently), and community participation (such as increased engagement in the community and ability to navigate curbs and inclines). Conclusions: Qualitative findings suggest that individuals with DPN can benefit in many areas, with a particular focus on function and social participation, following an 8-week yoga intervention. Key Words: Diabetes, Diabetic Peripheral Neuropathy, Yoga, Function, Activities of Daily Living Disclosures: None disclosed. Research Poster 304 Effects of a Novel Overground Locomotor Training Program on Muscle Oxygen Extraction in Individuals with Incomplete Spinal Cord Injury Jared Gollie (George Mason University), Jeffrey E. Herrick, Lisa M.K. Chin, Gino S. Panza, Randall E. Keyser, Andrew A. Guccione Research Objectives: Determine the effects of a novel overground locomotor training (OLT) program on muscle oxygen extraction in incomplete spinal cord injury. We hypothesized that OLT would improve gastrocnemius muscle oxygen extraction. Design: Before-After Pilot Trial. Setting: Human performance research laboratory. Participants: Small convenience sample of ambulatory male adults with chronic cervical incomplete spinal cord injury (nZ3; mean age, 213 years). Interventions: OLT was based on dynamical systems theory of motor control and principles of adaptation (i.e. overload, task-specificity, variation). The intervention included two 90-minute sessions per week for 12weeks. Training sessions alternated between forward stepping and multiplanar stepping (i.e. cross-over, backward, or rotational movements). Each session comprised of five segments: joint mobility; volitional muscle activation; task-isolation; task-integration; activity rehearsal. Main Outcome Measure(s): Using near-infrared spectroscopy, changes in tissue saturation index (DTSI) were determined during reperfusion following total arterial occlusion of the gastrocnemius muscle. Concentration changes in total hemoglobin (D[tHb]) and deoxygenated hemoglobin (D[HHb]) during constant work rate exercise were measured before and following training. Concentration changes in D[tHb] and D[HHb] were normalized to changes in maximal capacity as assessed during ischemia and expressed as a percentage. Results: Overall effect sizes were calculated using Cohen’s d (d). Training appeared to increase DTSI (pre 388.3% vs post 5223.8%, dZ0.76) and decrease normalized changes in D[tHb] and D[HHb] (D[tHb] pre 245.1% vs post 183.1%, dZ1.42 and D[HHb] pre 4914.5% vs post 417.6%, dZ0.75).

Research Posters Conclusions: Greater capacity for oxygen extraction was observed following this novel OLT program. The decrease in normalized D[tHb] and D[HHb] suggests oxygen extraction was lower for the same exercise work bout following training and that OLT may have improved overall work economy. Key Words: Exercise, Spinal Cord Injuries, Near-Infrared Spectroscopy, Gait Disclosures: None disclosed. Research Poster 305 SCI Clinical Video to Home Telehealth: Promoting Wellness and Care Coordination Zulma Jimenez (VA North Texas Health Care System), Evelyn Quinones, I. Manosha Wickremasinghe Research Objectives: To compare the two year outcomes of CVT to Home intervention with those of face-to-face care for Veterans with spinal cord injury. Design: Individuals with a spinal cord injury require specialized care not easily accessible at every health care facility. Access to SCI specialty care in rural areas may be a challenge for patients and caregivers. Clinical Video Telehealth to Home services has the ability to bridge gaps and bring care closer to the Veteran in non-traditional ways. From October 2013 through September 2015 patients were offered monthly CVT to Home appointments to identify areas of early intervention and provide preventative health maintenance. The scope of practice was outlined to include wellness checks, general SCI/D follow-up, treatment plan changes, patient education sessions, and additional psychosocial support to patient and/or caregiver. Setting: Spinal Cord Injury Clinical Video Telehealth into the Home Participants: Non applicable to this Project. Interventions: 1. Data was collected and analyzed to determine costeffectiveness and impact on clinical outcomes. 2. Patient/Caregiver satisfaction was measured using a standardized CVT to Home Patient Satisfaction Survey (VA Form 10-0481a). Main Outcome Measure(s): Increase access to SCI/D specialty care to Veterans with spinal cord injury. Results: 1. Increased access to SCI/D specialty care by scheduling patients as often as once a week. 2. Improved health care outcomes by providing personalized medical care. 3. Improved patient satisfaction evidenced by positive feedback from patients and caregivers. 4. Decreased unplanned hospital admissions and clinic visits by increasing efficiency of health care delivery by improving access to care. Conclusions: The results of this project indicate that CVT to Home is viable for both patients with SCI and their tele-providers. CVT to Home sessions prove to be an effective way of monitoring and improving health care outcomes by increasing access, cost-effectiveness, and satisfaction with services provided. Key Words: Spinal Cord Injury, Veterans, Cost-Benefit Analysis Disclosures: None disclosed. Research Poster 306 Fall Prevalence in Wheeled Mobility Device Users Living with Multiple Sclerosis Laura Rice (University of Illinois at Urbana-Champaign), Alon Kalron, Shani H. Berkowitz, Deborah Backus, Jacob J. Sosnoff Research Objectives: To investigate the prevalence and circumstances of falls among wheeled mobility device users living with Multiple Sclerosis (MS). Design: Cross-sectional survey. Setting: On-line survey. Participants were recruited from Sheba MS Center, Tel-Hashomer, Israel (nZ 28); University of Illinois at UrbanaChampaign (n Z 9); Shepherd Center, Atlanta, GA (n Z 7). Participants: Individuals were invited to participate if they had MS, used a wheeled mobility device (e.g. wheelchair, scooter, etc.) for the majority of

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