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Relationship between NIHSS scoring and FIM scoring among patients with CVA on an inpatient rehabilitation unit
e86 Main Outcome Measure(s): Total WeeFIM score at admission, discharge, and follow up, week-to-week WeeFIM score differences, WeeFIM efficiency score, admission, discharge, and follow up ASIA exam. Results: Total WeeFIM score at discharge was 105, an increase of 30 points from admission scores with a WeeFIM efficiency score of 0.75. Admission ASIA scoring resulted in T5 ASIA A, which progressed to T5 ASIA D upon discharge. The most significant progress for the patient and her family was her ambulation status upon discharge, which had progressed from wheelchair dependent to walking with minimal assistance and the use of a rolling walker in 8 weeks. Conclusions: Despite all prognostic indicators suggesting little chance at marked recovery, the patient was able to make great gains in self-care, functional mobility, and cognition leading to greatly improved independence and quality of life through a comprehensive integrated acute inpatient rehabilitation approach. Key Words: Pediatric Rehabilitation, Spinal Cord Injury, Neuromyelitis Optica Disclosures: None disclosed. Research Poster 567 The Effects of a Motorized Aquatic Treadmill Exercise on Isometric Strength of Knee and Cardiorespiratory Fitness in Subacute Stroke Patients So Young Lee (Jeju National University Hospital), Yong Ki Lee Research Objectives: To assess the effects of a 4 week hydrotherapy program performed on a motorized aquatic treadmill on isometric muscle strength, cardiorespiratory fitness, and functional outcome (motor function, balance, activities of daily living [ADL], and quality of life [QOL]) in patients suffering subacute stroke. Design: Randomized controlled trial. Setting: Rehabilitation center. Participants: Thirty-two subacute stroke patents (hydrotherapy group (n Z 18) or control group (n Z 14)). Interventions: Participants received 4 week training sessions of either motorized aquatic treadmill exercise program or land-based aerobic exercise. Main Outcome Measure(s): Isometric strength (knee extensors and flexors) was measured using an isokinetic dynamometer. Cardiopulmonary fitness was evaluated using a symptom-limited exercise tolerance test and by measuring brachial ankle pulse wave velocity. Moreover, motor function (Fugl-Meyer Assessment [FMA] and the FMA-lower limb [FMA-LL]), balance (Berg Balance Scale [BBS]), ADL (Korean version of the Modified Barthel Index [K-MBI]), and QOL (EQ-5D index) were examined. Results: The hydrotherapy group showed significant improvements in peak oxygen consumption (pZ0.02), maximal isometric strength of the bilateral knee extensors and paretic knee flexors (p<0.01), and the FMA (p<0.01), FMA-LL (pZ0.01), BBS (p<0.01), K-MBI (p<0.01), and EQ-5D index (pZ0.02). The control group showed significant improvements in the FMA (pZ0.01), FMA-LL (pZ0.01), BBS (p<0.01), and K-MBI (p<0.01). Improvements in maximal isometric strength in the knee extensors and flexors were greater in the hydrotherapy group than in the control group (pZ0.04). Conclusions: Aquatic treadmill exercise improves isometric muscle strength in the lower limb, as well as cardiopulmonary fitness and functional outcome, in subacute stroke patients. Key Words: Hydrotherapy, muscle strength, physical fitness, stroke, vascular stiffness Disclosures: None disclosed. Research Poster 570 Relationship between NIHSS scoring and FIM scoring among patients with CVA on an inpatient rehabilitation unit Laurel Packard (Spectrum Health), Muhib Khan, Benjamin Gillespie
Research Posters Research Objectives: The aim of this study is to understand and validate the relationship between initial NIHSS scoring and Functional Independence Measure (FIM) scoring on an acute inpatient rehabilitation unit. Design: A retrospective review of medical charts for all acute stroke patients transferred to acute inpatient rehabilitation from January 2013 through December 2015. Setting: The highest NIHSS score was collected within the first 24 hours of admission to the acute care floor (in hospital). All Functional Independence Measure (FIM) scoring was collected upon admission (first 48 hours of admission), and at discharge (last 48 hours of admission). Participants: A total of 270 patients charts were reviewed, of which 82 were included in the final analysis. Interventions: Not applicable. Main Outcome Measure(s): NIHSS scores are expressed as mean standard deviation, while FIM scoring are expressed as a percentage. The relationship between NIHSS and FIM score was determined through spearman correlation setting the level of significance at p<0.05. Results: NIHSS had a strong negative correlation with total FIM scores (p<0.0001). Moreover, NIHSS also had negative correlation with both cognitive (p<0.0001) and motor (p<0.0001) domains as well. Conclusions: Our study shows an inverse relationship between initial NIHSS scoring and Functional Independence Measure (FIM) scoring. Our study validates the utility of the NIHSS as a tool for acute stroke care team members to heed when setting realistic, achievable goals and providing patient/family education on assistance levels for discharge to the community. The NIHSS score may also serve as a tool for rehabilitation clinical decision making, in regards to treatment planning for compensatory approaches, as opposed to remediation, for those with significant stroke impairment, per the NIHSS scoring. Key Words: Stroke, Prognosis, Rehabilitation Disclosures: None disclosed. Research Poster 573 Exploring Neural Correlates in Endurance and Skill- Biased Non-Athletes Radhika Patel (University of Illinois at Chicago), Sangeetha Madhavan Research Objectives: Studies examining the interaction between task specificity and neural plasticity have typically been done in athletic population. In this study, we combined physical performance and transcranial magnetic stimulation (TMS) measures to investigate the interaction of skilled motor performance and its underlying neural correlates in non-athletes. Design: Exploratory study. Setting: Brain Plasticity Lab at the University of Illinois at Chicago (UIC). Participants: 20 non-athletes (12 males and 8 females; mean age: 24 years; BMI: 23.5 kg/m2). Interventions: Not Applicable. Main Outcome Measure(s): Physical performance measures included the T-test, a measure of leg power, leg speed, and agility and plank to fatigue (PTF), measure of endurance. Based on the percentile scores in the T-test and PTF, participants were classified as having a skill-bias (SB, nZ11) and/ or endurance-bias (EB, nZ11). Corticomotor excitability (CME) was tested with single pulse TMS for non-dominant tibialis anterior (TA) muscle. Performance of a skilled motor task was measured via custom designed visuomotor ankle tracking task and tracking accuracy score was calculated. Results: CME was not significantly different between the EB and SB groups. The EB group had significantly higher accuracy in performing the skilled motor task compared to the SB group (p<0.05). A significant positive correlation (r Z 0.6) was seen between the PTF scores and tracking accuracy. A significant negative correlation (rZ -0.50) was seen between the T-test scores and tracking accuracy. Conclusions: The results of this study suggests that non-athletes do not show a difference in CME based on their skill or endurance bias. However there may be an interaction of skill/endurance bias and ability to perform a skilled motor task. Key Words: Neuroplasticity, Transcranial magnetic stimulation, Physical fitness, Physical Endurance, Motor Skill Disclosures: None disclosed.
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Research Posters Research Objectives: The aim of this study is to understand and validate the relationship between initial NIHSS scoring and Functional Independence Measure (FIM) scoring on an acute inpatient rehabilitation unit. Design: A retrospective review of medical charts for all acute stroke patients transferred to acute inpatient rehabilitation from January 2013 through December 2015. Setting: The highest NIHSS score was collected within the first 24 hours of admission to the acute care floor (in hospital). All Functional Independence Measure (FIM) scoring was collected upon admission (first 48 hours of admission), and at discharge (last 48 hours of admission). Participants: A total of 270 patients charts were reviewed, of which 82 were included in the final analysis. Interventions: Not applicable. Main Outcome Measure(s): NIHSS scores are expressed as mean standard deviation, while FIM scoring are expressed as a percentage. The relationship between NIHSS and FIM score was determined through spearman correlation setting the level of significance at p<0.05. Results: NIHSS had a strong negative correlation with total FIM scores (p<0.0001). Moreover, NIHSS also had negative correlation with both cognitive (p<0.0001) and motor (p<0.0001) domains as well. Conclusions: Our study shows an inverse relationship between initial NIHSS scoring and Functional Independence Measure (FIM) scoring. Our study validates the utility of the NIHSS as a tool for acute stroke care team members to heed when setting realistic, achievable goals and providing patient/family education on assistance levels for discharge to the community. The NIHSS score may also serve as a tool for rehabilitation clinical decision making, in regards to treatment planning for compensatory approaches, as opposed to remediation, for those with significant stroke impairment, per the NIHSS scoring. Key Words: Stroke, Prognosis, Rehabilitation Disclosures: None disclosed. Research Poster 573 Exploring Neural Correlates in Endurance and Skill- Biased Non-Athletes Radhika Patel (University of Illinois at Chicago), Sangeetha Madhavan Research Objectives: Studies examining the interaction between task specificity and neural plasticity have typically been done in athletic population. In this study, we combined physical performance and transcranial magnetic stimulation (TMS) measures to investigate the interaction of skilled motor performance and its underlying neural correlates in non-athletes. Design: Exploratory study. Setting: Brain Plasticity Lab at the University of Illinois at Chicago (UIC). Participants: 20 non-athletes (12 males and 8 females; mean age: 24 years; BMI: 23.5 kg/m2). Interventions: Not Applicable. Main Outcome Measure(s): Physical performance measures included the T-test, a measure of leg power, leg speed, and agility and plank to fatigue (PTF), measure of endurance. Based on the percentile scores in the T-test and PTF, participants were classified as having a skill-bias (SB, nZ11) and/ or endurance-bias (EB, nZ11). Corticomotor excitability (CME) was tested with single pulse TMS for non-dominant tibialis anterior (TA) muscle. Performance of a skilled motor task was measured via custom designed visuomotor ankle tracking task and tracking accuracy score was calculated. Results: CME was not significantly different between the EB and SB groups. The EB group had significantly higher accuracy in performing the skilled motor task compared to the SB group (p<0.05). A significant positive correlation (r Z 0.6) was seen between the PTF scores and tracking accuracy. A significant negative correlation (rZ -0.50) was seen between the T-test scores and tracking accuracy. Conclusions: The results of this study suggests that non-athletes do not show a difference in CME based on their skill or endurance bias. However there may be an interaction of skill/endurance bias and ability to perform a skilled motor task. Key Words: Neuroplasticity, Transcranial magnetic stimulation, Physical fitness, Physical Endurance, Motor Skill Disclosures: None disclosed.
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