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Perceived Impacts of a Yoga Intervention for Individuals with Parkinson's Disease Related to Balance and Fear of Falling
Research Posters shoulder pathology was evaluated via a standardized physical examination on both shoulders. Results: Decreased scapular anterior tilt during scapular plane elevation (p Z .06) and weight relief pushups (p Z .09) were marginally related to higher lesion level. Decreased upward rotation during the weight relief pushups was related to higher self-reported pain score (p Z 0.04). In addition, decreased upward rotation and decreased external rotation was related to older age (p Z 0.02). Conclusions: The scapular rotations directly related to reduce subacromial space were found related to pain, lesion level, and age. Future study to investigate if scapular movement related to the sonographic evidence of shoulder pathology may provide more targeted intervention for the shoulder pain management in persons with paraplegia. Key Words: Kinematics, Spinal cord injuries, Shoulder Pain Disclosures: None Disclosed.
Research Poster 421 The Influence of Social Support on Functional Outcomes and Quality of Life in Lower Limb Amputees Michael Juszczak (Rusk Rehabilitation), Aaron Beattie, Michelle Smith, Leif Nelson, Jason Maikos, Tamara Bushnik Research Objectives: Post-lower limb amputations (LLA), patients experience variable physical/functional differences, impacting their sense of self and ambulatory ability. The purpose of this study is to examine the role social support plays in influencing functional outcomes and quality of life for patients living with LLA. Design: Data was collected through interviews, patient self-report, and recorded functional outcome measures. Setting: A university affiliated urban teaching hospital and a tertiary care Veterans Affairs Medical Center. Participants: Participants had a mean age of 56 years old (SDZ15.35), and an average time since amputation of 10 years (SDZ16.12). Approximately 61% of participants had a transtibial amputation and 25% of participants had a transfemoral amputation. Interventions: Not Applicable. Main Outcome Measure(s): The Timed Up and Go (TUG) Test, Two Minute Walking (2MWT) Test, Activities-Specific Balance Confidence Scale, Rosenberg Self-Esteem Scale, Multidimensional Scale of Perceived Social Support, Center for Epidemiologic Studies Depression Scale, and self-perceived ambulation levels. Results: One-Way ANOVATesting and post hoc T-Tests revealed a significant difference between participants with strong social support, performing better on the TUG and 2MWT compared to participants with weaker social support (p<.001). Strong social support was also indicative of higher self-esteem (p<.01), balance confidence (p<.001), and lower depression levels (p<.05) compared to participants with weaker social support. Conclusions: Based on these findings, individuals living with LLA with a strong social support system experienced better functional outcomes, possessed more balance confidence and self-esteem, and had lower levels of depression compared to LLA with weaker social support. This indicates that medical care for this population needs to be comprehensive and holistic, addressing their physical needs, as well as their psychosocial needs and developmental stage in life in order to achieve optimum functionality and quality of life. Key Words: Amputation, Ambulation, Social Adjustment Disclosures: None disclosed. Research Poster 423 A Descriptive Analysis of Pain and Psychosocial Characteristics of Civilian and Veteran Lower Extremity Amputees Michael Juszczak (Rusk Rehabilitation), Aaron Beattie, Michelle Smith, Leif Neslon, Jason Maikos, Tamara Bushnik
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e61 Research Objectives: The purpose of this study was to provide a descriptive analysis of the prevalence and severity of pain experienced by lower extremity amputees (LEA) in both civilian and veteran populations. We also sought to identify psychosocial characteristics of both populations, including depression, self-esteem, and balance confidence. Design: Data was collected through patient self-report and interviews composing a sample of nZ56. Subjective measures of pain, balance confidence, self-esteem, and depression were collected. Setting: A university affiliated urban teaching hospital and a tertiary care Veterans Affairs Medical Center. Participants: Participants were predominantly male (77%) and Caucasian (46%) with a mean age of 58 years old (standard deviation (SD) Z 15.52). Participants were either transtibial amputees (BKA) (71%) or transfemoral amputees (AKA) (29%), with an average time since amputation of 10.5 years (SDZ 14.22) Interventions: Not applicable. Main Outcome Measure(s): Activities-specific Balance Confidence (ABC) Scale, Rosenberg Self-Esteem Scale (RSES), Center for Epidemiologic Studies Depression Scale (CES-D), PROMIS Pain Interference Short Form 6B (PI), PROMIS Pain Behavior Short Form 7A (PB), and self-reported pain severity. Results: Perception of pain was low in both populations, with AKA experiencing more pain (4.5/10 >3.04/10) then BKA. AKA had higher raw scores on the PROMIS PI then BKA (13.10>11.38), and the PROMIS PB (21.89>17.90), indicating their behavior and functionality were more affected by pain then BKA. BKA displayed significantly higher balance confidence (71.66>47.94), self-esteem (23.78>22.19), and lower levels of depression (11.35<12.50) compared to AKA. Conclusions: Results indicate that AKA experience slightly more pain then BKA, however, LEAs do not associate pain with being a limiting factor affecting their behavior or functionality. These findings suggest that rehabilitation should focus on improving balance confidence among AKA to help ensure optimum functional outcome and quality of life. Key Words: Pain, Social Adjustment, Amputation Disclosures: None disclosed. Research Poster 426 Perceived Impacts of a Yoga Intervention for Individuals with Parkinson’s Disease Related to Balance and Fear of Falling Brent Hawkins (Clemson University), Marieke VanPuymbroeck, Alysha Walters, Enrique Urrea-Mendoza, Fredy Revilla, Kathleen Woschkolup, Arlene A. Schmid Research Objectives: To understand the impacts of an 8-week therapeutic yoga intervention for individuals with Parkinson’s Disease (PD) on balance and fear of falling. Design: Single blind, randomized, wait-list controlled, phase II exploratory pilot study utilizing after-trial embedded mixed methods design. Setting: University lab and neurology clinic. Participants: Individuals with PD who endorsed a fear of falling (N Z 17). Interventions: 8-week progressively difficult therapeutic yoga intervention. Main Outcome Measure(s): Participant reported impacts of the therapeutic yoga intervention on balance and fear of falling using focus group interviews. Results: Directed content analysis of the participant narratives captured in focus group interviews was largely supportive of the quantitative improvements in balance (tZ5.90, p<.000), balance confidence (tZ-3.19, pZ.006), and postural stability (tZ7.37, p<.000). The International Classification of Functioning, Disability and Health served as the guiding framework for the directed content analysis. Participant narratives provided context to the extent to which their balance, fear of falling, and postural stability improved. These data all described the extent that yoga aided in other aspects of the lives within the domains of Activities and
e62 Participation (e.g., leisure participation, walking, tying shoes, going to the grocery store, home tasks). Conclusions: Both quantitative and qualitative results support the success of the therapeutic yoga intervention adapted for individuals with PD. Participant narratives provided support and context for the functional skill and participation outcomes of the therapeutic yoga intervention. Their perceived changes in balance and fear of falling reached beyond the intervention and into their daily lives. Key Words: Therapeutic yoga, Parkinson’s Disease, mixed methods, balance, fear of falling Disclosures: None disclosed. Research Poster 429 Crude and Adjusted Prevalence of Balance Problems And Falls in Relation to Time of Diagnosis Among Older Cancer Survivors Vicki Johnson-Lawrence (University of Michigan-Flint), Jennifer Blackwood, Lucinda A. Pfalzer, Monica Godoshian, Min Hui Huang Research Objectives: To determine the prevalence of balance problems and falls over the last 12 months by time since diagnosis among older cancer survivors. Design: Cross-sectional design. We analyzed data from Surveillance, Epidemiology and End Results (SEER) national cancer registry and Medicare Health Outcomes Survey (MHOS) linkage. Setting: SEER collects information on all newly diagnosed cancer cases. MHOS is administered annually to randomly Medicare Advantage beneficiaries. Participants: This study includes 2004-2013 SEER-MHOS survey data. Respondents were aged 65+ at first cancer diagnosis and only had one cancer. These data include surveys collected 12 months prior to 48 months post cancer diagnosis. Survivors of non-Hodgkin’s lymphoma (NHL) (nZ620), uterine (nZ440), kidney (nZ458), or bladder (nZ952) cancer were included. The institutional review board at University of MichiganFlint approved the study. Interventions: Not applicable. Main Outcome Measure(s): The two outcomes are problems with balance or walking in the past 12 months and falls in the past 12 months. Logbinomial regression was used to estimate the demographic- adjusted prevalence of each outcome in relation to time since diagnosis. Results: Falls were most prevalent at 12-18 months for bladder (29.6%, SEZ0.05) and kidney (35.0%, SEZ0.09) cancer patients, at 18-24 months for NHL patients (26.0%, SEZ0.05), and after 36 months for uterine patients (37.4%, SEZ0.10). Balance problems were most prevalent 24-36 months post-diagnosis for bladder (28.5%, SEZ0.05) and kidney (50.9%, SEZ0.08) cancer patients, but most prevalent between 18-24 months post-diagnosis for NHL (44.6%, SEZ0.07) and uterine patients (44.6%, SEZ0.07). Conclusions: The prevalence of falls and balance problems for older cancer survivors differed between cancer diagnoses, and varied based on time since diagnosis. Key Words: Neoplasm, Accidental Falls/statistics & quantitative data, Population Surveillances Disclosures: None disclosed. Research Poster 430 Combining Dalfampridine with Physical Therapy May Improve Treatment Effects in Dalfampridine Non-responders with Multiple Sclerosis: A Case Study Prue Plummer (University of North Carolina at Chapel Hill), Alexis A. Williams, Corinne J. Bohling, Ellese Nickles, Silva Markovic-Plese, Mark Skeen, Barbara Giesser Research Objectives: To examine the effects of dalfampridine extendedrelease (D-ER) combined with physical therapy (D-ER+PT), after a period
Research Posters of D-ER alone, on gait speed, dual-task performance, balance, cognition, and patient-reported outcomes. Design: Single-subject design. Setting: Rehabilitation research laboratory. Participants: 59 year-old female with a 6-year history of relapsingremitting MS who was prescribed D-ER by her neurologist. Interventions: D-ER therapy (10 mg, 2x/day) for 2 weeks, followed by DER+PT treatment for 6 weeks. PT consisted of 2, 40-minute sessions/ week. PT focused on gait, balance, coordination, functional strengthening, and dual-task performance. Main Outcome Measure(s): Timed 25-Foot Walk (T25FW), dual-task assessment (walking while performing clock task), Mini BESTest, Four Square Step Test (FSST), Activities-Specific Balance Confidence Scale (ABC), Fatigue Severity Scale, MS Impact Scale (MSIS-29), 12-Item MS Walking Scale (MSWS-12), and Symbol Digit Modality Test. Assessments were conducted before commencing D-ER, after 2-weeks of D-ER therapy, after 6 weeks of D-ER+PT, and at 3-week follow up. Results: The participant demonstrated a 7% improvement in gait speed (T25FW) after 2 weeks of D-ER treatment (thus, a non-responder). After 6 weeks of D-ER+PT, she demonstrated a further 15% improvement; a 21% total increase from baseline. Dual-task gait speed increased by 0.07 m/s (7%) during the D-ER only phase. After 6 weeks of D-ER+PT, dual-task gait speed increased by a further 0.19 m/s (18%), for a total increase of 0.26 m/s (27%). Clinically important improvements were also observed in ABC, MSIS-29, MSWS-12, and FSST, all maintained at follow up. Conclusions: Combining PT with D-ER may improve gait speed, dual-task performance, and perceived disease impact in individuals with MS who have experienced a sub-meaningful response to D-ER. Further investigation of DER+PT or PT as an alternative to D-ER in non-responders is warranted. Key Words: Gait, dual-task, multiple sclerosis Disclosures: Dr. Prue Plummer has been a consultant and advisory board member for Acorda Therapeutics, Inc and was paid for her services. Research Poster 432 Promoting Resilience in Couples After Stroke: Testing Feasibility of a Dyadic Positive PsychologyBased Intervention Alexandra Terrill (University of Utah Division of Occupational Therapy), Jackie Einerson, Maija Reblin, Justin MacKenzie, Beth Cardell, Cynthia Berg, Jennifer Majersik, Lorie Richards Research Objectives: To develop and test the feasibility of an 8-week dyadic positive psychology-based intervention (PPI) for couples coping with stroke. Design: Clinical intervention feasibility trial with pre- and post-assessments, and 3-month follow-up. Setting: Assessments and activity training were completed in-person at a University-affiliated community-based clinic. Intervention activities were completed at home. Participants: Participants were recruited through University-affiliated outpatient rehabilitation clinics. Couples consisted of one partner who had a stroke >6 months ago and a cohabiting partner/caregiver. One or both partner(s) reported depressive symptoms. Two survivors and four caregivers were women. Mean age was 56.7 years (range: 36-84). Time since stroke ranged from 1 to >5 years. IRB approval was obtained prior to starting study. Interventions: Participants engaged in an 8-week self-administered behavioral PPI, completing two activities alone and two together each week (examples: expressing gratitude, practicing kindness). Activity booklets, tracking calendars, and weekly check-in calls were provided. Main Outcome Measure(s): Feasibility of study design, recruitment and study procedures, and acceptability of the intervention (feedback questionnaire/interview). Results: Six of eight respondents to recruitment letters met eligibility criteria and were enrolled with their partners. Five couples completed the program (83% retention). Participants engaged in activities for at least 6 out of 8 weeks. Participants were “very satisfied” with the intervention (MZ3.5 out of 4) and rated it as “extremely beneficial” (MZ3.3/4).
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Research Poster 421 The Influence of Social Support on Functional Outcomes and Quality of Life in Lower Limb Amputees Michael Juszczak (Rusk Rehabilitation), Aaron Beattie, Michelle Smith, Leif Nelson, Jason Maikos, Tamara Bushnik Research Objectives: Post-lower limb amputations (LLA), patients experience variable physical/functional differences, impacting their sense of self and ambulatory ability. The purpose of this study is to examine the role social support plays in influencing functional outcomes and quality of life for patients living with LLA. Design: Data was collected through interviews, patient self-report, and recorded functional outcome measures. Setting: A university affiliated urban teaching hospital and a tertiary care Veterans Affairs Medical Center. Participants: Participants had a mean age of 56 years old (SDZ15.35), and an average time since amputation of 10 years (SDZ16.12). Approximately 61% of participants had a transtibial amputation and 25% of participants had a transfemoral amputation. Interventions: Not Applicable. Main Outcome Measure(s): The Timed Up and Go (TUG) Test, Two Minute Walking (2MWT) Test, Activities-Specific Balance Confidence Scale, Rosenberg Self-Esteem Scale, Multidimensional Scale of Perceived Social Support, Center for Epidemiologic Studies Depression Scale, and self-perceived ambulation levels. Results: One-Way ANOVATesting and post hoc T-Tests revealed a significant difference between participants with strong social support, performing better on the TUG and 2MWT compared to participants with weaker social support (p<.001). Strong social support was also indicative of higher self-esteem (p<.01), balance confidence (p<.001), and lower depression levels (p<.05) compared to participants with weaker social support. Conclusions: Based on these findings, individuals living with LLA with a strong social support system experienced better functional outcomes, possessed more balance confidence and self-esteem, and had lower levels of depression compared to LLA with weaker social support. This indicates that medical care for this population needs to be comprehensive and holistic, addressing their physical needs, as well as their psychosocial needs and developmental stage in life in order to achieve optimum functionality and quality of life. Key Words: Amputation, Ambulation, Social Adjustment Disclosures: None disclosed. Research Poster 423 A Descriptive Analysis of Pain and Psychosocial Characteristics of Civilian and Veteran Lower Extremity Amputees Michael Juszczak (Rusk Rehabilitation), Aaron Beattie, Michelle Smith, Leif Neslon, Jason Maikos, Tamara Bushnik
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e61 Research Objectives: The purpose of this study was to provide a descriptive analysis of the prevalence and severity of pain experienced by lower extremity amputees (LEA) in both civilian and veteran populations. We also sought to identify psychosocial characteristics of both populations, including depression, self-esteem, and balance confidence. Design: Data was collected through patient self-report and interviews composing a sample of nZ56. Subjective measures of pain, balance confidence, self-esteem, and depression were collected. Setting: A university affiliated urban teaching hospital and a tertiary care Veterans Affairs Medical Center. Participants: Participants were predominantly male (77%) and Caucasian (46%) with a mean age of 58 years old (standard deviation (SD) Z 15.52). Participants were either transtibial amputees (BKA) (71%) or transfemoral amputees (AKA) (29%), with an average time since amputation of 10.5 years (SDZ 14.22) Interventions: Not applicable. Main Outcome Measure(s): Activities-specific Balance Confidence (ABC) Scale, Rosenberg Self-Esteem Scale (RSES), Center for Epidemiologic Studies Depression Scale (CES-D), PROMIS Pain Interference Short Form 6B (PI), PROMIS Pain Behavior Short Form 7A (PB), and self-reported pain severity. Results: Perception of pain was low in both populations, with AKA experiencing more pain (4.5/10 >3.04/10) then BKA. AKA had higher raw scores on the PROMIS PI then BKA (13.10>11.38), and the PROMIS PB (21.89>17.90), indicating their behavior and functionality were more affected by pain then BKA. BKA displayed significantly higher balance confidence (71.66>47.94), self-esteem (23.78>22.19), and lower levels of depression (11.35<12.50) compared to AKA. Conclusions: Results indicate that AKA experience slightly more pain then BKA, however, LEAs do not associate pain with being a limiting factor affecting their behavior or functionality. These findings suggest that rehabilitation should focus on improving balance confidence among AKA to help ensure optimum functional outcome and quality of life. Key Words: Pain, Social Adjustment, Amputation Disclosures: None disclosed. Research Poster 426 Perceived Impacts of a Yoga Intervention for Individuals with Parkinson’s Disease Related to Balance and Fear of Falling Brent Hawkins (Clemson University), Marieke VanPuymbroeck, Alysha Walters, Enrique Urrea-Mendoza, Fredy Revilla, Kathleen Woschkolup, Arlene A. Schmid Research Objectives: To understand the impacts of an 8-week therapeutic yoga intervention for individuals with Parkinson’s Disease (PD) on balance and fear of falling. Design: Single blind, randomized, wait-list controlled, phase II exploratory pilot study utilizing after-trial embedded mixed methods design. Setting: University lab and neurology clinic. Participants: Individuals with PD who endorsed a fear of falling (N Z 17). Interventions: 8-week progressively difficult therapeutic yoga intervention. Main Outcome Measure(s): Participant reported impacts of the therapeutic yoga intervention on balance and fear of falling using focus group interviews. Results: Directed content analysis of the participant narratives captured in focus group interviews was largely supportive of the quantitative improvements in balance (tZ5.90, p<.000), balance confidence (tZ-3.19, pZ.006), and postural stability (tZ7.37, p<.000). The International Classification of Functioning, Disability and Health served as the guiding framework for the directed content analysis. Participant narratives provided context to the extent to which their balance, fear of falling, and postural stability improved. These data all described the extent that yoga aided in other aspects of the lives within the domains of Activities and
e62 Participation (e.g., leisure participation, walking, tying shoes, going to the grocery store, home tasks). Conclusions: Both quantitative and qualitative results support the success of the therapeutic yoga intervention adapted for individuals with PD. Participant narratives provided support and context for the functional skill and participation outcomes of the therapeutic yoga intervention. Their perceived changes in balance and fear of falling reached beyond the intervention and into their daily lives. Key Words: Therapeutic yoga, Parkinson’s Disease, mixed methods, balance, fear of falling Disclosures: None disclosed. Research Poster 429 Crude and Adjusted Prevalence of Balance Problems And Falls in Relation to Time of Diagnosis Among Older Cancer Survivors Vicki Johnson-Lawrence (University of Michigan-Flint), Jennifer Blackwood, Lucinda A. Pfalzer, Monica Godoshian, Min Hui Huang Research Objectives: To determine the prevalence of balance problems and falls over the last 12 months by time since diagnosis among older cancer survivors. Design: Cross-sectional design. We analyzed data from Surveillance, Epidemiology and End Results (SEER) national cancer registry and Medicare Health Outcomes Survey (MHOS) linkage. Setting: SEER collects information on all newly diagnosed cancer cases. MHOS is administered annually to randomly Medicare Advantage beneficiaries. Participants: This study includes 2004-2013 SEER-MHOS survey data. Respondents were aged 65+ at first cancer diagnosis and only had one cancer. These data include surveys collected 12 months prior to 48 months post cancer diagnosis. Survivors of non-Hodgkin’s lymphoma (NHL) (nZ620), uterine (nZ440), kidney (nZ458), or bladder (nZ952) cancer were included. The institutional review board at University of MichiganFlint approved the study. Interventions: Not applicable. Main Outcome Measure(s): The two outcomes are problems with balance or walking in the past 12 months and falls in the past 12 months. Logbinomial regression was used to estimate the demographic- adjusted prevalence of each outcome in relation to time since diagnosis. Results: Falls were most prevalent at 12-18 months for bladder (29.6%, SEZ0.05) and kidney (35.0%, SEZ0.09) cancer patients, at 18-24 months for NHL patients (26.0%, SEZ0.05), and after 36 months for uterine patients (37.4%, SEZ0.10). Balance problems were most prevalent 24-36 months post-diagnosis for bladder (28.5%, SEZ0.05) and kidney (50.9%, SEZ0.08) cancer patients, but most prevalent between 18-24 months post-diagnosis for NHL (44.6%, SEZ0.07) and uterine patients (44.6%, SEZ0.07). Conclusions: The prevalence of falls and balance problems for older cancer survivors differed between cancer diagnoses, and varied based on time since diagnosis. Key Words: Neoplasm, Accidental Falls/statistics & quantitative data, Population Surveillances Disclosures: None disclosed. Research Poster 430 Combining Dalfampridine with Physical Therapy May Improve Treatment Effects in Dalfampridine Non-responders with Multiple Sclerosis: A Case Study Prue Plummer (University of North Carolina at Chapel Hill), Alexis A. Williams, Corinne J. Bohling, Ellese Nickles, Silva Markovic-Plese, Mark Skeen, Barbara Giesser Research Objectives: To examine the effects of dalfampridine extendedrelease (D-ER) combined with physical therapy (D-ER+PT), after a period
Research Posters of D-ER alone, on gait speed, dual-task performance, balance, cognition, and patient-reported outcomes. Design: Single-subject design. Setting: Rehabilitation research laboratory. Participants: 59 year-old female with a 6-year history of relapsingremitting MS who was prescribed D-ER by her neurologist. Interventions: D-ER therapy (10 mg, 2x/day) for 2 weeks, followed by DER+PT treatment for 6 weeks. PT consisted of 2, 40-minute sessions/ week. PT focused on gait, balance, coordination, functional strengthening, and dual-task performance. Main Outcome Measure(s): Timed 25-Foot Walk (T25FW), dual-task assessment (walking while performing clock task), Mini BESTest, Four Square Step Test (FSST), Activities-Specific Balance Confidence Scale (ABC), Fatigue Severity Scale, MS Impact Scale (MSIS-29), 12-Item MS Walking Scale (MSWS-12), and Symbol Digit Modality Test. Assessments were conducted before commencing D-ER, after 2-weeks of D-ER therapy, after 6 weeks of D-ER+PT, and at 3-week follow up. Results: The participant demonstrated a 7% improvement in gait speed (T25FW) after 2 weeks of D-ER treatment (thus, a non-responder). After 6 weeks of D-ER+PT, she demonstrated a further 15% improvement; a 21% total increase from baseline. Dual-task gait speed increased by 0.07 m/s (7%) during the D-ER only phase. After 6 weeks of D-ER+PT, dual-task gait speed increased by a further 0.19 m/s (18%), for a total increase of 0.26 m/s (27%). Clinically important improvements were also observed in ABC, MSIS-29, MSWS-12, and FSST, all maintained at follow up. Conclusions: Combining PT with D-ER may improve gait speed, dual-task performance, and perceived disease impact in individuals with MS who have experienced a sub-meaningful response to D-ER. Further investigation of DER+PT or PT as an alternative to D-ER in non-responders is warranted. Key Words: Gait, dual-task, multiple sclerosis Disclosures: Dr. Prue Plummer has been a consultant and advisory board member for Acorda Therapeutics, Inc and was paid for her services. Research Poster 432 Promoting Resilience in Couples After Stroke: Testing Feasibility of a Dyadic Positive PsychologyBased Intervention Alexandra Terrill (University of Utah Division of Occupational Therapy), Jackie Einerson, Maija Reblin, Justin MacKenzie, Beth Cardell, Cynthia Berg, Jennifer Majersik, Lorie Richards Research Objectives: To develop and test the feasibility of an 8-week dyadic positive psychology-based intervention (PPI) for couples coping with stroke. Design: Clinical intervention feasibility trial with pre- and post-assessments, and 3-month follow-up. Setting: Assessments and activity training were completed in-person at a University-affiliated community-based clinic. Intervention activities were completed at home. Participants: Participants were recruited through University-affiliated outpatient rehabilitation clinics. Couples consisted of one partner who had a stroke >6 months ago and a cohabiting partner/caregiver. One or both partner(s) reported depressive symptoms. Two survivors and four caregivers were women. Mean age was 56.7 years (range: 36-84). Time since stroke ranged from 1 to >5 years. IRB approval was obtained prior to starting study. Interventions: Participants engaged in an 8-week self-administered behavioral PPI, completing two activities alone and two together each week (examples: expressing gratitude, practicing kindness). Activity booklets, tracking calendars, and weekly check-in calls were provided. Main Outcome Measure(s): Feasibility of study design, recruitment and study procedures, and acceptability of the intervention (feedback questionnaire/interview). Results: Six of eight respondents to recruitment letters met eligibility criteria and were enrolled with their partners. Five couples completed the program (83% retention). Participants engaged in activities for at least 6 out of 8 weeks. Participants were “very satisfied” with the intervention (MZ3.5 out of 4) and rated it as “extremely beneficial” (MZ3.3/4).
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