Postural Balance During Pregnancy And Postpartum: A Pilot Study

Other Diagnosis mineral density. To investigate the client adherence to the program and to compare key characteristics of adherers versus non-adherers. Design: A longitudinal study involving a retrospective chart review was conducted on participants of the three month OsteoCircuitä Building Better Bones program. Setting: The study took place at Pro-Motionä Physiotherapy, a private practice clinic. Participants: The 45 participants were women aged 50 and older who commenced OsteoCircuitä between January 2012 and March 2013 at Pro Motionä Physiotherapy. There were no exclusion criteria. Interventions: A data abstraction form was used to collect information from patient charts regarding subjective and physical examinations. Main Outcome Measure(s): The primary outcome measures used were hand grip strength, the timed-up-and-go, gait speed, single-leg stance, and the 5-repetition sit-to-stand, with comparisons at baseline versus three months. Results: Of the 45 participants, 24 were adherent, attending 12 sessions in a 16week period. There was a significant increase in the left grip strength, 5-repetition sit-to-stand, left single leg stance and timed up-and-go (p<0.05) physical performance measures in the adherent group, with no significant changes in the non-adherent group. A comparison of demographic information between the two groups showed no significant differences in characteristics. Conclusions: OsteoCircuitä effectively modifies key risk factors for falls, subsequently reducing the risk for fractures through exercise and education in participants who were adherent. It is the first physiotherapist supervised osteoporosis exercise program in private practice to be evaluated. Key Words: Physiotherapy, Osteoporosis, Exercise, Falls, Adherence Disclosure(s): None Disclosed. Poster 322 Outpatient Physical Therapy Expenditures in the Medicare Population: Influence of Diagnosis and Functional Mobility Poonam Pardasaney (RTI International), Gregory Pope, Peter Amico, Jill Dever, Anne Deutsch, Traci Gordon, Pamela West, Ann Meadow Objective: To examine annual outpatient physical therapy (PT) expenditures of Medicare patients after cross-classifying patients by primary diagnosis and admission functional mobility, and to define case-mix (CM) groups. Design: In the Medicare-sponsored Developing Outpatient Therapy Payment Alternatives project, a sample of outpatient therapy providers completed the Continuity Assessment Record and EvaluationeCommunity assessment (CARE-C) on Medicare patients. We examined annual PT expenditures across 48 initial CM groups based on 12 primary diagnosis groups stratified by four categories of clinician-observed mobility scores (0-<50; 50-<70; 70-<97; 97-100), created from admission assessments. We collapsed groups after examining expenditures and sample sizes. Setting: Outpatient. Participants: nZ4,197; mean age 73.19.9 years; 64.6% female. Interventions: Not applicable. Main Outcome Measure(s): Mean annual PT expenditures from claims. Results: Seventeen final CM groups were defined that depicted clear variation in annual outpatient PT expenditures across Medicare patients. Seven groups were based on primary diagnosis alone (Stroke; Joint Replacement; Parkinson’s/Other Progressive Neurological; Circulatory/Pulmonary; Fracture; Genitourinary Conditions; Vertigo), because of small samples or little further discrimination in expenditures using admission mobility. The remaining 10 groups comprised five primary diagnosis groups (Unspecified/ Miscellaneous Diagnoses; Multiple Etiologies, at least One Major; Osteoarthritis, Other Major Musculoskeletal, Unspecified Musculoskeletal; Peripheral Nervous System/Other Neurological Disorders; Sprain/Strain/ Bursitis/Tendonitis) stratified by dichotomous mobility categories using a 70 cutoff score, found to be the most important splitter. Conclusions: Case-mix groups created from the two dimensions explored in this study are clinically intuitive. These groups may provide a foundation for future work further classifying patients using demographic and clinical variables, given larger samples. Key Words: Physical therapy specialty, Health expenditures, Medicare Part B

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e101 Disclosure(s): This project was funded by the Centers for Medicare & Medicaid Services under contract no. HHSM-500-2012-00169G. The statements contained in this abstract do not necessarily reflect the views or policies of the Centers for Medicare & Medicaid Services. Poster 323 Postural Balance During Pregnancy And Postpartum: A Pilot Study Laiane Santos Eufra´sio, Vanessa Patrı´cia Soares Sousa, Tatiana Souza Ribeiro (Federal University of Rio Grande do Norte), Vito´ria Jessica, Teixeira Dantas, Ruthe de Go´es Xavier Nascimento, Raquel Rodrigues Lindquist, Elizabel Souza Ramalho Viana Objective: To evaluate postural balance during pregnancy and postpartum. Design: Longitudinal Study. Setting: Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil. Participants: 9 women in postpartum. The selection criteria were absence of diseases that affected the balance and history of depression or anxiety. Interventions: Volunteers had postural balance assessed through the Balance MasterÒ, considering the single leg support test in different sensory conditions: 1) open eyes and firm surface (OFS), 2) closed eyes and firm surface (CFS), 3) open eyes and unstable surface (OUS) e 4) closed eyes and unstable surface (CEU). Main Outcome Measure(s): Oscillation speed ( /s). Results: The mean age of the volunteers was 29.1 years. During pregnancy, the balance was assessed when they were, on average, 29.1 (3.6) weeks gestation. The revaluation of the mothers was taken 4.3 (1.5) months after delivery. In equilibrium analysis before (pregnancy - P) and after delivery (postpartum - PP), no significant differences were found (OFS: P 0.27 /s (0.10) x PP 0.30 /s (0.15) PZ0.55 // CFS: P 0.28 /s (0.15) x PP 0.28 /s (0.09) PZ1 // OUS: P 0.38 /s (0.16) x PP 0.40 /s (0.13) PZ0.81 // CEU: P 0.63 (0.17) x PP 0,64 (0.18) PZ0.78). Conclusions: No difference in postural balance in women evaluated during pregnancy and after childbirth. Key Words: Postpartum., Postural balance, Pregnancy Disclosure(s): None disclosed. Poster 324 WITHDRAWN Poster 325 High Resolution Manometry of Pharyngeal Swallow Pressure Events Associated With Food Viscosity Seok Tae Lee (CHA Bundang Medical Center), Ju Seok Ryu Objective: To evaluate the effect of food viscosities on pharyngeal swallow pressure in healthy subjects using high resolution manometry. Design: Prospective experimental study. Setting: General teaching hospital. Participants: Ten healthy subjects. Interventions: Ten subjects swallowed 5ml of water, yogurt and bread two times each in neutral position. Main Outcome Measure(s): Pressure and timing data were extracted using BioVIEW ANALYSIS software (Sandhill Scientific, Version 5.6.3.0). Pressure and timing events were recorded with a 32-sensor HRM catheter. The regions of interest were velopharynx (VP), tongue base (TB), epiglottis, lower pharynx (the peristaltic wave from the TB to UES) and Pre- and Post-peak upper esophageal sphincter (Pre-UES and Post-UES). Results: Among three groups of different viscosity, there were no significant differences in maximal pressure and area of VP, TB, low pharynx, Pre-UES and Post-UES, and minimal UES pressure. There were also no significant differences in rise time and duration of VP and TB, UES activity time (the time interval between Pre-UES and Post-UES), Nadir UES pressure duration, the interval between VP and TB, VP and epiglottis, VP and Pre/Post-UES peak. This procedure had no adverse events during study.