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The Best Combination of Therapy Treatment Units to Predict Discharge FIM Score Among A Stroke Population
e44 Research Poster 321 The Best Combination of Therapy Treatment Units to Predict Discharge FIM Score Among A Stroke Population Melissa Zahl (Oklahoma State University), Greg Horneber, Jennifer Piatt, Mwarumba Mwavita Research Objectives: To determine the best combination of therapy treatment units to predict discharge FIM scores (overall, and motor and cognition subscale) while controlling for age and respective admission FIM score. Design: Cross-sectional electronic medical chart review. Setting: Inpatient rehabilitation hospital. Participants: Convenience sample adults with of stroke (NZ350; ages 18 to 92; 183 males and 167 females). Interventions: Not applicable. Main Outcome Measure(s): Functional Independence Measure (FIM). Results: Three hierarchical regression analyses. Step 1, age and respective admission FIM scores. Step 2, stepwise regression of therapy treatment units (occupational therapy, physical therapy, psychology, recreational therapy, and speech language pathology). Regression analysis 1- Model 1 indicated age and admission overall FIM scores predict 62.5% of the variance to discharge FIM score. Model 2, recreational therapy treatment units added 1.8% to the variance of discharge FIM scores; all significant to the model. Regression analysis 2- Model 1 indicated age and admission motor subscale FIM scores predict 57.3% of the variance on discharge motor FIM scores. Model 2, recreational therapy added 1.5% to the variance of discharge motor FIM scores; all were significant. Regression analysis 3- Model 1 indicated age and admission cognition FIM scores predicts 70.5% of the variance of discharge cognition FIM scores. Model 2, recreational therapy treatment units added 0.9% to the variance of discharge cognition FIM scores; discharge admission cognition FIM scores and RT added statistically significant to the prediction. Conclusions: Among this stroke population, age, respective admission FIM score and recreational therapy contributed to prediction of discharge FIM. Further research is need to identify what treatment types are more beneficial for predicting discharge FIM scores. Key Words: FIM Scores, Rehabilitation Therapies, Stroke Disclosures: Dr. Zahl was provided with a small grant fund from the American Therapeutic Recreation Association (ATRA) to conduct data collection associated with this study. She is a member of the ATRA. No other others have disclosure. Research Poster 322 Development and Content Validity of the Behavioral Assessment Screening Tool (BAST) for Adults with Traumatic Brain Injury Shannon Juengst (University of Pittsburgh), Galen E. Switzer, Lauren Terhorst, Janet P. Niemeier, Brad E. Dicianno, Patricia M. Arenth, Amy K. Wagner Research Objectives: To develop the Behavioral Assessment Screening Tool (BAST), an ecologically valid behavioral symptom screening tool for community-dwelling adults with traumatic brain injury (TBI). Design: Face and content validity were established through focus groups and expert panel. A cross sectional cohort study was conducted to inform final item inclusion for the BAST. Current pilot data are presented for initial evidence that the BAST subscales are unidimensional and internally consistent. Setting: General community. Participants: Focus groups consisted of adults with TBI and their families. The expert panel included 7 clinicians and researchers with TBI expertise. Pilot data from the cohort study are presented for 89 adults with TBI who are at least 3 months post-injury and living in the community. Interventions: Not Applicable. Main Outcome Measure(s): Main outcomes included qualitative feedback from focus groups, Content Validity Index (CVI) from the expert panel,
Research Posters and inter-item correlations and internal consistency estimates (Cronbach’s alphas) within each behavior domain and satisfaction scores for the cohort study. Results: The focus groups and expert panel yielded a total of 67 items for the BAST. Initial items that were kept or minimally modified (nZ54) yielded a CVI of 89.3%, indicating good content validity. Mean interitem correlations within 6 component behavioral domains (Coping, Emotional Regulation, Emotional Symptoms, Executive Function, Disinhibition, Aggression) comprising 52 items ranged from 0.299-0.371 (0.33 for all items), with Cronbach’s alphas ranging from 0.73-0.87. Participants reported high satisfaction (6.34 out of 7) and ease of use (6.44 out of 7). Conclusions: The BAST demonstrates good content validity as a measure of behavior for community-based adults with TBI, with early evidence that subscales are unidimensional and internally consistent. Adults with TBI were satisfied with the BAST and found it easy to complete. Key Words: Brain Injuries, Behavior, Psychometrics, Symptom Assessment Disclosures: None disclosed.
Research Poster 323 Pressure Ulcer Development in the Context of A Lifestlye-Based Intervention Lucia Florindez (USC), Florence Clark, Mike Carlson, Elizabeth Pyatak, Alix Sleight, Jesus Diaz, Valerie Hill, Alison Cogan Research Objectives: Medically serious pressure ulcers (MSPUs) are the most prevalent secondary complication for individuals with a spinal cord injury (SCI), compromising physical and emotional quality of life. The objective of this study was to identify the life circumstances that lead to MSPU development while people with SCI participated in a lifestyle-based pressure ulcer prevention program, and to provide recommendations for future intervention design. Design: This mixed method study entailed summarizing baseline comorbidity data and a qualitative cross-case analysis of treatment notes from the Pressure Ulcer Prevention Study (PUPS), a randomized controlled trial evaluating the efficacy and cost-effectiveness of a multifaceted lifestyle-based intervention in reducing incidence of MSPUs in people with SCI. Setting: Participants were recruited from a major rehabilitation facility in Los Angeles County. Participants: Participants were ethnically and socio-economically diverse, community-dwelling people with SCI living in Los Angeles County who developed an MSPU during the course of the intervention (nZ25). Interventions: Not Applicable. Main Outcome Measure(s): Analysis of treatment notes and baseline comorbidity data from eligible PUPS participants revealed themes that captured the range of circumstances that led to MSPU development during study participation. Results: The six themes that may have contributed to development of MSPUs are as follows: 1) Circumstances unrelated to the intervention, 2) lack of rudimentary knowledge pertaining to wound care, 3) equipment and supply issues, 4) co-morbidities, 5) non-adherence to prescribed bed rest, and 6) passivity. Conclusions: Many factors may contribute to the development of MSPUs in ethnically diverse, community-dwelling adults with SCI. These conditions, especially when compounded by limited financial resources, seemed to have undermined the effectiveness of a multifaceted intervention program. Several programmatic modifications have potential for increasing the intervention’s effectiveness for individuals similar to those in the sample we studied. Key Words: Spinal Cord Injuries, Pressure Ulcer, Life Style, Quality of Life, Clinical Trial Disclosures: None disclosed.
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Research Posters and inter-item correlations and internal consistency estimates (Cronbach’s alphas) within each behavior domain and satisfaction scores for the cohort study. Results: The focus groups and expert panel yielded a total of 67 items for the BAST. Initial items that were kept or minimally modified (nZ54) yielded a CVI of 89.3%, indicating good content validity. Mean interitem correlations within 6 component behavioral domains (Coping, Emotional Regulation, Emotional Symptoms, Executive Function, Disinhibition, Aggression) comprising 52 items ranged from 0.299-0.371 (0.33 for all items), with Cronbach’s alphas ranging from 0.73-0.87. Participants reported high satisfaction (6.34 out of 7) and ease of use (6.44 out of 7). Conclusions: The BAST demonstrates good content validity as a measure of behavior for community-based adults with TBI, with early evidence that subscales are unidimensional and internally consistent. Adults with TBI were satisfied with the BAST and found it easy to complete. Key Words: Brain Injuries, Behavior, Psychometrics, Symptom Assessment Disclosures: None disclosed.
Research Poster 323 Pressure Ulcer Development in the Context of A Lifestlye-Based Intervention Lucia Florindez (USC), Florence Clark, Mike Carlson, Elizabeth Pyatak, Alix Sleight, Jesus Diaz, Valerie Hill, Alison Cogan Research Objectives: Medically serious pressure ulcers (MSPUs) are the most prevalent secondary complication for individuals with a spinal cord injury (SCI), compromising physical and emotional quality of life. The objective of this study was to identify the life circumstances that lead to MSPU development while people with SCI participated in a lifestyle-based pressure ulcer prevention program, and to provide recommendations for future intervention design. Design: This mixed method study entailed summarizing baseline comorbidity data and a qualitative cross-case analysis of treatment notes from the Pressure Ulcer Prevention Study (PUPS), a randomized controlled trial evaluating the efficacy and cost-effectiveness of a multifaceted lifestyle-based intervention in reducing incidence of MSPUs in people with SCI. Setting: Participants were recruited from a major rehabilitation facility in Los Angeles County. Participants: Participants were ethnically and socio-economically diverse, community-dwelling people with SCI living in Los Angeles County who developed an MSPU during the course of the intervention (nZ25). Interventions: Not Applicable. Main Outcome Measure(s): Analysis of treatment notes and baseline comorbidity data from eligible PUPS participants revealed themes that captured the range of circumstances that led to MSPU development during study participation. Results: The six themes that may have contributed to development of MSPUs are as follows: 1) Circumstances unrelated to the intervention, 2) lack of rudimentary knowledge pertaining to wound care, 3) equipment and supply issues, 4) co-morbidities, 5) non-adherence to prescribed bed rest, and 6) passivity. Conclusions: Many factors may contribute to the development of MSPUs in ethnically diverse, community-dwelling adults with SCI. These conditions, especially when compounded by limited financial resources, seemed to have undermined the effectiveness of a multifaceted intervention program. Several programmatic modifications have potential for increasing the intervention’s effectiveness for individuals similar to those in the sample we studied. Key Words: Spinal Cord Injuries, Pressure Ulcer, Life Style, Quality of Life, Clinical Trial Disclosures: None disclosed.
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