The Lived Experience of Spinal Cord Injury: A Phenomenological Study

The Lived Experience of Spinal Cord Injury: A Phenomenological Study

Research Posters subject answered questions regarding their perceived importance on patient centered stroke goals as well as their current performance...

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Research Posters subject answered questions regarding their perceived importance on patient centered stroke goals as well as their current performance on those goals. Main Outcome Measure(s): Performance rating on stroke goals using a 5 point likert scale and importance rating on stroke goals using a 5 point likert scale. Results: The top goals for men < 65 were: arm and hand function, sexual intimacy, and prevention of another stroke. Women < 65 top goals were arm and leg function, walking, and information on resources. The areas that were most important to individuals despite continued low performance were: driving, balance, arm and hand function, endurance, and help with depression and anxiety. Areas that were not as important despite low performance included return to work, dating/activities with friends, house projects, and stairs. Conclusion/Discussion: In this pilot study, many of the areas that were rated most important to stroke survivors are areas that are not captured with current required documentation in IRFs and SNFs. Clinicians and physicians must ensure all of these areas are being addressed. Further research with a larger sample is recommended. Key Words: Stroke, Goals, Rehabilitation Disclosures: None. Research Poster 305009 The Influence of Sustained Poor Health on Participation after Traumatic Brain Injury Kimberly Erler (Spaulding Rehabilitation Hospital), Shannon Juengst, Joseph Locascio, Gale Whiteneck, Jennifer Bogner, Jamie Kaminski, Joseph Giacino Research Objectives: To determine the influence of sustained poor health, as measured by rehospitalizations, during the first 2 years post traumatic brain injury (TBI) on social participation at 5 years post TBI. Design: Retrospective analysis of a prospective study. Setting: Traumatic Brain Injury Model Systems (TBIMS) centers. Participant: Community dwelling individuals, 16 years of age and older with moderate or severe TBI who are enrolled in the TBIMS National Database with complete rehospitalization data at 1 and 2 years post TBI and complete participation data at 1, 2, and 5 years post TBI (nZ1940). Interventions: N/A. Main Outcome Measure(s): Participation Assessment with Recombined Tools-Objective (PART-O) . Results: After controlling for demographic and injury characteristics, a general linear model indicated that rehospitalization status (i.e. never rehospitalized during year 1 and 2, rehospitalized either during year 1 or 2, or rehospitalized during both year 1 and year 2) as a predictor of social participation at 5 years post TBI approached significance (pZ0.0353). The PART-O scores were in the hypothesized direction with the both category having the lowest covariate-adjusted mean and never category having the highest. A second model which replaced rehospitalization status with the total number of rehospitalizations had results analogous to those of the previous model except that the p value (pZ0.0148) was slightly more stringent. Conclusion/Discussion: Poor health disrupts an individual’s ability to engage in valued roles and routines. This study suggests that sustained poor health in the first 2 years after TBI adversely affects social participation up to 5 years after injury. Since participation is considered a key indicator of successful TBI rehabilitation, minimizing the need for rehospitalizations and promoting health should be a priority of post acute care for individuals with TBI. Key Words: Brain Injury, Social Participation, Hospitalization Disclosures: None. Research Poster 313710 The Lived Experience of Spinal Cord Injury: A Phenomenological Study Jenny Lieberman (The Mount Sinai Hospital)

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e119 Research Objectives: The purpose of this study was to understand how three people with spinal cord injury (SCI) experienced their lives, their bodies, and their lifeworld through wheelchair use. Design: Phenomenological study using narrative process to gather information on how each participant made meaning of their experience. Narratives provided data for understanding how each participant made sense of their experience of SCI. There were three phases of interviews, totaling 7-9 sessions per participant. The first phase captured lived experience until the time of injury. The second phase focused on experience from time of injury until the present. The final phase involved reflecting on the meaning of the experience. The time of data collection was three months. Setting: Each interview occurred within the participant’s residence or a public location (restaurant or park). Participants: Three participants were selected due to the extensive phenomenological process required. Interventions: Not applicable. Main Outcome Measure(s): Not applicable. Results: 1) The disconnection that occurred from SCI was physical (severing of nerves) and social (socially generated ideas of disability focused on not being normal) 2) A disruption to the personal sense of narrative occurred. This was temporal and biographical, resulting in a changed sense of identity/self-concept. 3) Meaningful Relationships were essential for recovery, including family and mentors 4) Loss of identity led to intense feelings of depression and hopelessness in the early years. Death was hoped for, but overcome through relationships and success. 5) Hope led to success (professional, academic, relationship). Conclusion/Discussion: Therapists must aid persons with SCI in discovering what is possible through demonstrating victories, no matter how small, and exposing them to positive relationships through mentors. Love and happiness are possible. Phenomenology can provide a greater understanding of individual experience of SCI. Key Words: Phenomenology, SCI, Spinal Cord Injury, Wheelchair, Disruption Disclosures: None. Research Poster 310708 WITHDRAWN

Research Poster 304704 The Role of Muscle Dysfunction in the Progression of Disability in Persons with Multiple Sclerosis Brad Willingham (University of Georgia), Kevin McCully, Deborah Backus Research Objectives: Evaluate the relationship between muscle dysfunction and walking ability in persons with MS. Design: Cross Sectional. Setting: Clinical Laboratory. Participants: Ten persons with Multiple Sclerosis with Expanded Disability Status Scale (EDSS) 2.5 - 6.5. Interventions: Muscle function and walking ability were evaluated in ten persons with MS. Main Outcome Measure(s): Muscle oxidative capacity was measured in the medial gastrocnemius using near-infrared spectroscopy (NIRS) following 15-20 seconds of electrical stimulation; muscle endurance was evaluated in the medial gastrocnemius using accelerometer-based mechanomyography during 9 minutes of twitch electrical stimulation, in three stages (3min/stage) of increasing frequency (2Hz, 4Hz, and 6Hz); muscle strength (plantar flexion) was measured using a maximal voluntary contraction (MVC). Walking function was measured using the Timed 25Foot Walk Test (T25FWT) and the Six-Minute Walk Test (6MWT). Results: Muscle oxidative capacity and muscle endurance were correlated with 6MWT distance (r2Z0.89 and 0.78, respectively; p < 0.01). Muscle