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Poster 13
E10 Poster 13 The Effect of Augmented Feedback on Motor Function of the Affected Upper Extremity in Rehabilitation Participants: A Systematic Review of Randomized Controlled Trials. Henk van Dijk (Roessingh Research and Development, Enschede, Netherlands), Michiel Jannink, Hermie Hermens. Disclosure: None declared. Objective: To assess the available evidence regarding the effect of therapeutic interventions by using augmented feedback on motor function of the upper extremity in rehabilitation patients. Data Sources: Systematic literature search designed in accordance with the Cochrane Collaboration criteria was performed by using (1) MEDLINE, EMBASE, Cochrane Controlled Trials Register, CIRRIE, and REHABDATA and (2) reference lists. Study Selection: Inclusion criteria were (1) therapeutic intervention using augmented feedback applied to improve motor function of the affected upper extremity, (2) outcomes measured at impairment and/or disability level, and (3) randomized controlled trial (RCT). Data Extraction: The following data were extracted: methodologic quality, patient characteristics, type of intervention, outcome measures, and reported effects. Data Synthesis: 26 RCTs were included, 9 of which reported a positive effect on arm function tests. Follow-up measurements were performed in 8 trials, 1 of which reported a positive effect. Different therapeutic interventions using augmented feedback (ie, electromyographic, kinetic, or kinematic feedback) or knowledge of results showed no difference in effectiveness. Conclusions: No firm evidence of effectiveness on the use of augmented feedback to improve motor function of the upper extremity in rehabilitation patients was found. Key Words: Feedback; Motor skills; Rehabilitation. Poster 14 Vertebroplasty on Patients With Osteoporotic Vertebral Compression Fractures and Epidemiologic Analysis. Kao-Chung Tsai (Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan), Ming-Chi Lin, Shuu-Hai Jiang, Shin-Tsu Chang, Tsung-Ying Li. Disclosure: None declared. Objective: To compare the variable methods for treatment of osteoporotic vertebral compression fracture in terms of outcome and prognosis. Design: Retrospective study. Setting: University medical center. Participants: 103 consecutive patients were recruited who had been hospitalized during the periods from January 2000 to December 2000 and from January 2003 to December 2003. Interventions: Various treatments were undertaken, including conservative treatment, conventional surgical approach, and percutaneous vertebroplasty. Main Outcome Measures: Treatment outcomes. Results: The most common location of fracture was the T12 vertebra or the L1 vertebra. Traumatic accidents (like falls) accounted for the most common cause. Greater incidence was noted in women than in men (3:1). Significant lower hospitalization days were shown after vertebroplasty therapy than after traditional internal fixation or conservative treatment. Multiple levels of vertebral fracture occurred more frequently in the elder patients over 70 years old. Conclusions: Vertebroplasty significantly relieved fracture-related back pain, reduced the duration of the hospital stay, and thus had a higher rate of doctors’ preference. Key Words: Osteoporosis; Vertebroplasty; Rehabilitation. Poster 15 Mortality Over 4 Decades After Traumatic Brain Injury Rehabilitation. Cynthia Harrison-Felix (Craig Hospital, Englewood, CO), Gale Whiteneck, Denise Hart, Amitabh Jha, Michael DeVivo, Flora Hammond. Disclosure: None declared. Arch Phys Med Rehabil Vol 86, October 2005
Objective: To investigate mortality, life expectancy, and risk factors for death in persons with traumatic brain injury (TBI). Design: Retrospective cohort study. Setting: Used data from an inpatient rehabilitation facility; the Social Security Death Index; and the U.S. population age-, race-, and sex-specific mortality rates for 1992 and 2002. Participants: 1495 persons with TBI surviving to at least 1 year postinjury admitted from a hospital to inpatient rehabilitation within 1 year of injury between 1961 and 2002. Interventions: Not applicable. Main Outcome Measures: Standardized mortality ratio, life expectancy, and risk factors. Results: Persons with TBI were 1.59 times more likely to die compared with persons in the general population of similar age, sex, and race, resulting in an estimated average life expectancy reduction of 4.5 years for persons with TBI. Within the TBI population, the strongest independent risk factors for death 1 year postinjury were older age at injury, being male, less education at injury, longer postinjury hospitalization, and being in a persistent vegetative state at rehabilitation discharge. Conclusions: 4 decades of follow-up showed that life expectancy after TBI rehabilitation is reduced, with several factors influencing mortality, including age, sex, education, and severity of injury and disability indicators. Key Words: Mortality; Brain injuries; Rehabilitation; Life expectancy. Poster 16 Dysphagia Recovery After Initial Diagnosis of Polymyositis: A Case Report. Radhika Bapineedu (Marianjoy Rehabilitation Hospital, Wheaton, IL), Noel Rao, Melissa Nickell, Kathy Fisher. Disclosure: None declared. Setting: Rehabilitation hospital. Patient: A 40-year-old man admitted to an acute care hospital with a 1-month history of worsening extremity edema and weakness. Case Description: Workup, including blood chemistries, electromyography, and muscle biopsy, showed findings consistent with polymyositis. The hospital course was significant for severe dysphagia, necessitating gastrostomy-tube placement, and pneumonia. Steroid therapy was initiated. A videofluoroscopic swallow study (VFSS) at the acute care hospital revealed aspiration, and the patient was given nothing by mouth. Assessment/Results: On admission to the rehabilitation hospital, swallowing therapy was initiated including thermal-tactile stimulation, taste stimulation, base of tongue exercises, and laryngeal elevation exercises. Follow-up VFSS 12 days later and after initiation of steroid therapy revealed moderate to severe vallecular residue with solids secondary to reduced pharyngeal constrictor strength and reduced base of tongue retraction; however, there was no evidence of laryngeal penetration or aspiration. Discussion: The patient was advanced to a soft diet with thin liquids. A subsequent VFSS performed 11 days later revealed improved pharyngeal transit with no pharyngeal residue, aspiration, or penetration. The patient was advanced to a regular diet and swallowing therapy was discontinued. Conclusions: Dysphagia secondary to oropharyngeal involvement occurs in about a third of the patients and is a poor prognostic sign. This case report clearly shows the importance of early diagnosis and medical management to restore swallowing ability and improve overall quality of life. Dysphagia symptoms in patients with polymyositis may improve with appropriate medical management and swallowing rehabilitation. Key Words: Dysphagia; Rehabilitation. Poster 17 Older Adults Managing Activities of Daily Living Difficulties at Home: Who Helps and What Helps? Brian J. Dudgeon (University of Washington, Seattle, WA), Jeanne M. Hoffman, Marcia A. Ciol, Ann Shumway-Cook, Kathryn M. Yorkston, Leighton Chan. Disclosure: None declared. Objective: To examine special-equipment use and care-provider assistance to accommodate difficulty with activities of daily living
Objective: To investigate mortality, life expectancy, and risk factors for death in persons with traumatic brain injury (TBI). Design: Retrospective cohort study. Setting: Used data from an inpatient rehabilitation facility; the Social Security Death Index; and the U.S. population age-, race-, and sex-specific mortality rates for 1992 and 2002. Participants: 1495 persons with TBI surviving to at least 1 year postinjury admitted from a hospital to inpatient rehabilitation within 1 year of injury between 1961 and 2002. Interventions: Not applicable. Main Outcome Measures: Standardized mortality ratio, life expectancy, and risk factors. Results: Persons with TBI were 1.59 times more likely to die compared with persons in the general population of similar age, sex, and race, resulting in an estimated average life expectancy reduction of 4.5 years for persons with TBI. Within the TBI population, the strongest independent risk factors for death 1 year postinjury were older age at injury, being male, less education at injury, longer postinjury hospitalization, and being in a persistent vegetative state at rehabilitation discharge. Conclusions: 4 decades of follow-up showed that life expectancy after TBI rehabilitation is reduced, with several factors influencing mortality, including age, sex, education, and severity of injury and disability indicators. Key Words: Mortality; Brain injuries; Rehabilitation; Life expectancy. Poster 16 Dysphagia Recovery After Initial Diagnosis of Polymyositis: A Case Report. Radhika Bapineedu (Marianjoy Rehabilitation Hospital, Wheaton, IL), Noel Rao, Melissa Nickell, Kathy Fisher. Disclosure: None declared. Setting: Rehabilitation hospital. Patient: A 40-year-old man admitted to an acute care hospital with a 1-month history of worsening extremity edema and weakness. Case Description: Workup, including blood chemistries, electromyography, and muscle biopsy, showed findings consistent with polymyositis. The hospital course was significant for severe dysphagia, necessitating gastrostomy-tube placement, and pneumonia. Steroid therapy was initiated. A videofluoroscopic swallow study (VFSS) at the acute care hospital revealed aspiration, and the patient was given nothing by mouth. Assessment/Results: On admission to the rehabilitation hospital, swallowing therapy was initiated including thermal-tactile stimulation, taste stimulation, base of tongue exercises, and laryngeal elevation exercises. Follow-up VFSS 12 days later and after initiation of steroid therapy revealed moderate to severe vallecular residue with solids secondary to reduced pharyngeal constrictor strength and reduced base of tongue retraction; however, there was no evidence of laryngeal penetration or aspiration. Discussion: The patient was advanced to a soft diet with thin liquids. A subsequent VFSS performed 11 days later revealed improved pharyngeal transit with no pharyngeal residue, aspiration, or penetration. The patient was advanced to a regular diet and swallowing therapy was discontinued. Conclusions: Dysphagia secondary to oropharyngeal involvement occurs in about a third of the patients and is a poor prognostic sign. This case report clearly shows the importance of early diagnosis and medical management to restore swallowing ability and improve overall quality of life. Dysphagia symptoms in patients with polymyositis may improve with appropriate medical management and swallowing rehabilitation. Key Words: Dysphagia; Rehabilitation. Poster 17 Older Adults Managing Activities of Daily Living Difficulties at Home: Who Helps and What Helps? Brian J. Dudgeon (University of Washington, Seattle, WA), Jeanne M. Hoffman, Marcia A. Ciol, Ann Shumway-Cook, Kathryn M. Yorkston, Leighton Chan. Disclosure: None declared. Objective: To examine special-equipment use and care-provider assistance to accommodate difficulty with activities of daily living