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Long-term Functional Outcome in Patients with SAH Compared with ICH among the Hemorrhagic Stroke
e120 performing transfers with minimal assistance. He remained maximal assist level for bowel and bladder management. The etiology is still elusive as all serum and CSF studies for viral, bacterial and fungal infectious, as well as autoimmune work up, were unremarkable. Conclusions: Comprehensive inpatient rehabilitation had a significant functional and cognitive impact in this complex medical case. Lumbosacral plexopathy is a rare finding in the absence of neoplastic, diabetes or traumatic processes. Moreover, mostly unilateral lumbosacral plexopathies have been reported in the literature making this case a unique diagnostic challenge. Key Words: Pediatric rehabilitation, Meningoencephalitis, Bilateral Lumbosacral Plexopathy Disclosures: None disclosed. Research Poster 740 Long-term Functional Outcome in Patients with SAH Compared with ICH among the Hemorrhagic Stroke Bo-Ram Kim (Department of Rehabilitation Medicine), You Na Yang, Min Kyun Sohn, Deog Young Kim, Sam-Gyu Lee, Yong-Il Shin, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, Eun Young Han, Young Shil Lim, Yun-Hee Kim, Jongmin Lee Research Objectives: Some studies show that patients with SAH have a better clinical outcome than ICH patients, but long-term clinical recovery following SAH compared with ICH have not been well studied. The aim of this study is to evaluate the long-term clinical outcomes between SAH and ICH groups, and the patterns of the recovery of the both groups depend on their initial severity. Design: Cohort study. Setting: We analyzed first-ever stroke patients enrolled in the Korean Stroke Cohort for Functioning and Rehabilitation (KoSCo) designed for 10 years of follow-up. Participants: First-ever hemorrhagic stroke patients who admitted to 9 university hospitals of Korea from August 2012 to May 2015 were recruited. Interventions: Not Applicable. Main Outcome Measure(s): The primary outcome of this study is K-NIHSS, and the secondary outcomes are Korean Mini-Mental State Examination (K-MMSE) for cognitive function, Fugl-Meyer Assessment (FMA) for motor function, Functional Ambulatory Category (FAC) for mobility and gait, the American Speech-Language-Hearing Association National Outcome Measurement System Swallowing Scale (ASHA-NOMS) for swallowing function, the Korean Version of the Frenchay Aphasia Screening Test (K-FAST) for language function, and mRS for general functional level. Results: 2076 patients (1030 men; 1046 women, 1046 ICH; 769 SAH; 27 ICH with SAH; 175 ICH with IVH; 59 SAH with IVH) were enrolled in this study. The mean age. of ICH and SAH groups were 61.014.1 and 56.813.1 years-old (T-test, p<0.01), and a ratio of male to female was 614:432 in ICH group and 292:477 in SAH group. SAH group exhibited better recovery in terms of FMA, MMSE, FIM, ASHA-NOMS, K-FAST and FAC at all time points. (T-test, p<0.01) Moreover, the recovery of initially moderate to severe SAH group almost caught up the clinical improvement of mild SAH group after 12 months except for FAC and MRS; otherwise, initially moderate to severe ICH group had poor recovery patterns from beginning to end. (RMANOVA , p<0.05). Conclusions: This study suggests that the overall long-term recovery of SAH group was better than that of ICH group, and the initially moderate to severe SAH patients showed a good recovery in 12months, similar to the clinical improvement of the initially mild group. Key Words: Subarachnoid hemorrhage, Intracerebral hemorrhage, recovery Disclosures: None disclosed. Research Poster 741 Post-Stroke Reductions in Impairment and Functional Limitation Using a TelerehabilitationBased Upper Extremity Protocol Julie Faieta (Ohio State University), Stephen Page, Heather Tanksley
Research Posters Research Objectives: To explore the feasibility and efficacy of remotelydelivered upper extremity (UE) therapy in a moderately impaired stroke survivor. Design: Descriptive case study. Setting: This study took place in the B.R.A.I.N. Lab at The Ohio State University and in the participant’s home. Participants: One adult male 2 years post stroke exhibiting moderate, stable UE hemiparesis. Interventions: Repetitive, task-specific training (RTP) was delivered three times per week (one per week in a laboratory setting and twice per week in the participant’s home via Webex video conferencing). RTP sessions included activities of daily living, such as changing out the laundry in his machine, managing dishes and opening doors. Additionally, the MyoPro myoelectric UE power orthosis was used in all therapy sessions, which provides EMG-activated active assist for elbow flexion and extension. Main Outcome Measure(s): The Stroke Impact Scale, Arm Motor Ability Test, Arm Motor Fugl-Meyer, and Motor Activity Log were administered twice pre-intervention, immediately following the conclusion of the intervention and at two months post-intervention. Results: A 4 point improvement was seen in the participant’s Arm Motor Fugle-Meyer score from pretest to posttest; the Motor Activity Log Amount of Use Scale Log yielded an increase of 12 points after intervention. Results show meaningful gains in activities of daily living tasks and overall increased use of the affected upper extremity. Conclusions: These findings suggest that therapy delivered through telecommunication is a feasible method of treatment in the moderately impaired stroke population. Future randomized controlled studies with larger sample sizes are needed to allow for generalizability of results. Key Words: Telerehabilitation, Activities of Daily Living, Hemiplegia Disclosures: None disclosed. Research Poster 742 Effects of a High Intensity Tapering Conventional Balance Training for Improving Balance Control Among Chronic Stroke Survivors Jinal Vora (University of Illinois at Chicago), Lakshmi Kannan, Rini Varghese, Prakruti Patel, Tanvi Bhatt Research Objectives: Efficacy of conventional balance rehabilitation paradigm for fall-risk remains debatable. The purpose of this study was to examine the effect of a novel six weeks high-intensity, tapering dosage conventional balance training paradigm on fall-risk. Design: Intervention Study: before-after trial. Setting: Motor Behavior and Balance Laboratory. UIC. Participants: Twelve hemi-paretic stroke survivors participated in the study. Interventions: 20 sessions of training distributed in a tapering manner over 6 weeks with first two weeks consisting of high intensity (5 sessions/ week). Each training session was for approximately 90 minutes. Weekly progressions were made based on performance improvements on clinical balance measures. It focused on four main constructs stretching, functional strengthening, balance and endurance. Main Outcome Measure(s): One week baseline monitoring of physical activity (number of steps) and balance assessment using the Limits of stability test (LOS) (Neurocom Inc.) along with clinical balance measures, such as the Timed up and go test (TUG), Lateral Timed Step test, Chair Stand test and Four Square step test. Results: The gain in postural stability pre- and post-training was computed by recording COM excursion [(pre-stability-post-stability)/pre-stability]. Fall incidence was also recorded during LOS test. Paired t-test was used to compare the pre-post interventions changes. Post-training clinical balance measures such TUG, Lateral Timed Step test, Chair Stand test and Four Square step and stability gain on LOS test improved significantly (p<0.05). The falls incidence decreased from 50% to 16% on LOS test. Number of steps recorded post-training improved significantly over a period of 6 weeks.
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Research Posters Research Objectives: To explore the feasibility and efficacy of remotelydelivered upper extremity (UE) therapy in a moderately impaired stroke survivor. Design: Descriptive case study. Setting: This study took place in the B.R.A.I.N. Lab at The Ohio State University and in the participant’s home. Participants: One adult male 2 years post stroke exhibiting moderate, stable UE hemiparesis. Interventions: Repetitive, task-specific training (RTP) was delivered three times per week (one per week in a laboratory setting and twice per week in the participant’s home via Webex video conferencing). RTP sessions included activities of daily living, such as changing out the laundry in his machine, managing dishes and opening doors. Additionally, the MyoPro myoelectric UE power orthosis was used in all therapy sessions, which provides EMG-activated active assist for elbow flexion and extension. Main Outcome Measure(s): The Stroke Impact Scale, Arm Motor Ability Test, Arm Motor Fugl-Meyer, and Motor Activity Log were administered twice pre-intervention, immediately following the conclusion of the intervention and at two months post-intervention. Results: A 4 point improvement was seen in the participant’s Arm Motor Fugle-Meyer score from pretest to posttest; the Motor Activity Log Amount of Use Scale Log yielded an increase of 12 points after intervention. Results show meaningful gains in activities of daily living tasks and overall increased use of the affected upper extremity. Conclusions: These findings suggest that therapy delivered through telecommunication is a feasible method of treatment in the moderately impaired stroke population. Future randomized controlled studies with larger sample sizes are needed to allow for generalizability of results. Key Words: Telerehabilitation, Activities of Daily Living, Hemiplegia Disclosures: None disclosed. Research Poster 742 Effects of a High Intensity Tapering Conventional Balance Training for Improving Balance Control Among Chronic Stroke Survivors Jinal Vora (University of Illinois at Chicago), Lakshmi Kannan, Rini Varghese, Prakruti Patel, Tanvi Bhatt Research Objectives: Efficacy of conventional balance rehabilitation paradigm for fall-risk remains debatable. The purpose of this study was to examine the effect of a novel six weeks high-intensity, tapering dosage conventional balance training paradigm on fall-risk. Design: Intervention Study: before-after trial. Setting: Motor Behavior and Balance Laboratory. UIC. Participants: Twelve hemi-paretic stroke survivors participated in the study. Interventions: 20 sessions of training distributed in a tapering manner over 6 weeks with first two weeks consisting of high intensity (5 sessions/ week). Each training session was for approximately 90 minutes. Weekly progressions were made based on performance improvements on clinical balance measures. It focused on four main constructs stretching, functional strengthening, balance and endurance. Main Outcome Measure(s): One week baseline monitoring of physical activity (number of steps) and balance assessment using the Limits of stability test (LOS) (Neurocom Inc.) along with clinical balance measures, such as the Timed up and go test (TUG), Lateral Timed Step test, Chair Stand test and Four Square step test. Results: The gain in postural stability pre- and post-training was computed by recording COM excursion [(pre-stability-post-stability)/pre-stability]. Fall incidence was also recorded during LOS test. Paired t-test was used to compare the pre-post interventions changes. Post-training clinical balance measures such TUG, Lateral Timed Step test, Chair Stand test and Four Square step and stability gain on LOS test improved significantly (p<0.05). The falls incidence decreased from 50% to 16% on LOS test. Number of steps recorded post-training improved significantly over a period of 6 weeks.
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