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Locomotor Adaptation Deficits in Individuals With Cognitive Impairments
Research Posters Research Poster 318260 Limited Feasibility Evaluation Of Combining Implementation Intentions With Metacognitive Strategy Instruction Mary Radomski (Courage Kenny Research Center), Jenny Owens, Mark Showers, Gordon Giles, Joette Zola, Rob Kreiger Research Objectives: To explore limited feasibility of embedding instruction in implementation intentions (II) in metacognitive strategy instruction (MSI). Design: Case control, quasi-experimental design. Setting: Outpatient traumatic brain injury clinic on a military base. Participants: Service members (SM) with mild traumatic brain injury (NZ8) who were referred to occupational therapy for cognitive rehabilitation. Interventions: Articipants received 6 sessions of MSI/II training, twice weekly for 3 weeks. Main Outcome Measure(s): N/A. Results: Prior to receiving the intervention, participants set individualized goals which included improving follow-through on tasks and appointments; more productively using their time; managing stress, frustration, anxiety; improving sleep quality; engaging with family members and in community activities. The manualized intervention appeared to be implementable, with participants receiving between 95 - 100% of the specified intervention components across the 6 sessions. Limited-efficacy testing: Most participants (6 of 8) met thresholds demonstrating that were able to learn to set II related to individualized goals. Acceptability: Of the 7 individuals who followed through on II-goal homework, 5 (71.4%) reported it was easy to set II for personal goals and 7 (100%) reported that II training was helpful for meeting personal goals. Conclusion/Discussion: Preliminary findings suggest that incorporating training in implementation intentions into metacognitive strategy instruction is feasible. Analysis of full study findings will inform whether or not adding II training to MSI offers differential benefits. Key Words: Traumatic Brain Injury, Goals, Intentions, Rehabilitation Disclosures: None. Research Poster 304839 Locomotor Adaptation Deficits in Individuals With Cognitive Impairments Joe Nocera (Emory University School of Medicine and Atlanta Department of Veterans Affairs RR&D, Center for Visual and Neurocognitive Rehabilitation), Steven Eicholtz, Trisha Kesar Research Objectives: To investigate whether individuals with cognitive dysfunction demonstrate a reduced capacity for motor adaptation compared to age-matched controls, and to test for the presence of associations between motor and cognitive impairments. Despite the high incidence of falls in individuals with MCI and AD, there is a research gap regarding the influence of cognitive impairments on locomotor adaptation. Design: Cohort study with patients identified by Emory Alzheimer’s Disease Center Registry as having normal cognition or cognitive dysfunction (MMSE score >20/30 points). Setting: Biomechanical laboratory. Participants: 21 subjects across three groups: 6 healthy young adults (HYA), 8 healthy old adults (HOA; 69.61.5 years), and 7 older adults with cognitive impairment (MCI/AD; 635.7 years). Interventions: One 20-minute period of split-belt walking adaptation with the dominant leg at fast speed and non-dominant leg at slow speed (2:1 speed ratio). Additionally, tied-belt walking periods at both speeds were recorded before (baseline) and after split-belt adaptation (de-adaptation). Main Outcome Measure(s): Step length asymmetry during the first five steps of split belt adaptation (adaptation magnitude), and the number of steps taken to achieve plateau in step asymmetry (adaptation rate). Results: We observed a significant difference between groups in adaptation magnitude (HYA Z -0.1970.026, HOA Z -0.2670.010, MCI/AD Z -0.1400.044; p Z 0.009). There was no significant
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e79 between-group difference in adaptation rate (p Z 0.885). Correlation results showed greater reduction in adaptation magnitude in individuals with greater cognitive impairment. Conclusion/Discussion: Locomotor adaptation deficits in individuals with cognitive impairments (MCI, AD) merit further investigation. Locomotor adaptation deficits may help predict deficits in dual-tasking during gait as well as risk of falls. Key Words: Alzheimer’s Disease, Accidental Falls, Gait, Cognitive Dysfunction Disclosures: None. Research Poster 312901 Long Term Use of Nasogastric Tube Has Negative Impact in Swallowing Function in Post-stroke Patient Guo-Xin Ni (First Affiliated Hospital of Fujian Medical University), Zhi-Yong Wang Research Objectives: To investigate the impact of long term use of nasogastric tube in swallowing function in post-stroke patient. Design: Case series. Setting: Hospital. Participants: 30 post-stroke patients with nasogastric tubes for at least 2 months. Interventions: Not applicable. Main Outcome Measure(s): Videofluoroscopic swallowing study (VFSS) was performed before (VFSS1) and after (VFSS2) the removal of the nasogastric tube. We used the functional dysphagia scale (FDS), the oral transit time,the pharyngeal transit times, the residue in valleculae, the residue in pyriform sinuses to assess swallowing function. By fiberoptic laryngoscope, physiological change was examined of the pharynx and larynx. Results: There were significant differences between VFSS1 and VFSS2 in total score of FDS, pharyngeal transit time,the residue in valleculae, the residue in pyriform sinuse. However, no statistical difference existed in oral transit time. By fiberoptic laryngoscope, about 80% patients presented with swelling of pharynx and/or larynx. Conclusion/Discussion: A negative impact was confirmed of long term use of nasogastric tube in swallowing function of post-stroke patient, which may be attributed to its interference with the movement of epiglottis cartilage and the desensitization and/or pain in the pharyngeal structures. Key Words: Dysphagia, Stroke, Nasogastric Tube, Swallowing Function, Videofluoroscopic Swallowing Study Disclosures: None. Research Poster 303499 Lumbar Erector Spinae Will Accelerate Senescence in Patients With Lumbar Disc Herniation: Case Control Study Yiming Xu (Shanghai Jiaotong University Affiliated Sixth People’s Hospital), Xianxuan Feng, Yuehong Bai Research Objectives: To observe lumbar disc herniation(LDH) how to affect regeneration and senescence of lumbar skeletal muscle. Design: Case control study. Setting: Tertiary-care academic medical center. Participants: 10 volunteer patients with LDH who underwent surgery were recruited as experimental group, and LDH induced by trauma were excluded. 5 volunteer patients with lumbar spine tumors who underwent surgery were recruited as normal control group. All patients of two groups were male, aged 40 -50 years old. Interventions: Not applicable. Main Outcome Measure(s): Patient information and medical history (especially past medical history and course of disease) were collected. Telomere lengths of lumbar erector spinae cells were obtained by terminal restriction fragment method.
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e79 between-group difference in adaptation rate (p Z 0.885). Correlation results showed greater reduction in adaptation magnitude in individuals with greater cognitive impairment. Conclusion/Discussion: Locomotor adaptation deficits in individuals with cognitive impairments (MCI, AD) merit further investigation. Locomotor adaptation deficits may help predict deficits in dual-tasking during gait as well as risk of falls. Key Words: Alzheimer’s Disease, Accidental Falls, Gait, Cognitive Dysfunction Disclosures: None. Research Poster 312901 Long Term Use of Nasogastric Tube Has Negative Impact in Swallowing Function in Post-stroke Patient Guo-Xin Ni (First Affiliated Hospital of Fujian Medical University), Zhi-Yong Wang Research Objectives: To investigate the impact of long term use of nasogastric tube in swallowing function in post-stroke patient. Design: Case series. Setting: Hospital. Participants: 30 post-stroke patients with nasogastric tubes for at least 2 months. Interventions: Not applicable. Main Outcome Measure(s): Videofluoroscopic swallowing study (VFSS) was performed before (VFSS1) and after (VFSS2) the removal of the nasogastric tube. We used the functional dysphagia scale (FDS), the oral transit time,the pharyngeal transit times, the residue in valleculae, the residue in pyriform sinuses to assess swallowing function. By fiberoptic laryngoscope, physiological change was examined of the pharynx and larynx. Results: There were significant differences between VFSS1 and VFSS2 in total score of FDS, pharyngeal transit time,the residue in valleculae, the residue in pyriform sinuse. However, no statistical difference existed in oral transit time. By fiberoptic laryngoscope, about 80% patients presented with swelling of pharynx and/or larynx. Conclusion/Discussion: A negative impact was confirmed of long term use of nasogastric tube in swallowing function of post-stroke patient, which may be attributed to its interference with the movement of epiglottis cartilage and the desensitization and/or pain in the pharyngeal structures. Key Words: Dysphagia, Stroke, Nasogastric Tube, Swallowing Function, Videofluoroscopic Swallowing Study Disclosures: None. Research Poster 303499 Lumbar Erector Spinae Will Accelerate Senescence in Patients With Lumbar Disc Herniation: Case Control Study Yiming Xu (Shanghai Jiaotong University Affiliated Sixth People’s Hospital), Xianxuan Feng, Yuehong Bai Research Objectives: To observe lumbar disc herniation(LDH) how to affect regeneration and senescence of lumbar skeletal muscle. Design: Case control study. Setting: Tertiary-care academic medical center. Participants: 10 volunteer patients with LDH who underwent surgery were recruited as experimental group, and LDH induced by trauma were excluded. 5 volunteer patients with lumbar spine tumors who underwent surgery were recruited as normal control group. All patients of two groups were male, aged 40 -50 years old. Interventions: Not applicable. Main Outcome Measure(s): Patient information and medical history (especially past medical history and course of disease) were collected. Telomere lengths of lumbar erector spinae cells were obtained by terminal restriction fragment method.