- Email: [email protected]
Training Effects and Safety of Functional Electrical Stimulation (FES) Cycling in People With Multiple Sclerosis
e34 Design: A cross-sectional design using a telephone survey. Descriptive statistics were performed and correlations were analysed separately for the stroke and MS groups. Setting: Telephone survey. Participants: 29 stroke and 9 MS participants were surveyed. Interventions: None. Main Outcome Measure(s): Nature and impact of spasticity. Results: Severe spasticity was reported in the arms (stroke), and in the legs (MS). In both stroke and MS groups, spasticity affected activities of daily living. Both groups perceived spasticity increase with outdoor cold (69% stroke, 66.7% MS), muscle fatigue (58.6% stroke, 77.8% MS) and mental stress (58.6% stroke, 88.9% MS). No statistically significant correlations were found between time since diagnosis and perceived impact of spasticity on function in stroke (rZ0.07, pZ0.37) and MS (rZ-0.15, pZ0.36) groups. Conclusions: Intrinsic and extrinsic triggers can influence spasticity differently depending on individual factors and neurological diagnosis. Clinicians can use these findings to better understand, educate, and treat individuals with stroke and MS. Key Words: stroke, Spasticity, multiple sclerosis, triggers Disclosure(s): Authors have received a study grant from Allergan in the past (FI, CB, CP). Authors have received remuneration for lectures from Allergan and Merz in the past (FI, CB). Poster 81 WITHDRAWN Poster 82 Training Effects and Safety of Functional Electrical Stimulation (FES) Cycling in People With Multiple Sclerosis Deborah Backus (Shepherd Center), Christine Manella, Laura Hawkins, Elizabeth Gonzales Objective: To evaluate safety, and the potential for FES cycling to improve fatigue, pain, spasticity and perceived quality of life, in people with moderate to severe MS. Design: Quasi-experimental pre-post Design. Setting: Non-profit rehabilitation hospital. Participants: People with multiple sclerosis and EDSS scores 6.0. Interventions: Participants trained on the RT-300 FES cycle (Restorative Therapies, Inc., Baltimore, MD) 2-3 times a week for 4 weeks. Each cycled at 35-50 rpm for 30 minutes, either with their own volition or with electrical stimulation for assist. Intensity of FES was adjusted for each participant based on comfort. Main Outcome Measure(s): Collected immediately before and after the 4week intervention: MS Quality of Life Inventory (MS QLI) subscales, Modified Ashworth Scale (MAS, spasticity), Paced Auditory Serial Addition Test (PASAT, cognitive processing speed) and manual muscle test (MMT, strength). Data was also collected after each training session to monitor progress on the cycle, and for any changes in status. Results: Fourteen participants (8 male) with MS completed the training. All were able to either maintain or increase the amount of time they could cycle; half (7/14) were able to increase the resistance against which they cycled. Participants demonstrated a significant increase in cognitive processing speed (PASAT; p<0.001), and a significant decrease in pain (MOS Pain Effects Scale; p<0.02). In addition, there was a statistically significant decrease in the physical subscale of the Modified Fatigue Impact Scale (pZ0.01) and the psychosocial subscale (pZ0.01). There was no significant change in the other subscales of the MS QLI. There was neither a significant increase nor decrease in MAS and MMT scores. There were no adverse events, or worsening of MS symptoms. Conclusions: FES cycling may be a viable and effective option of exercise for people with moderate to severe MS. Further study is required to examine the parameters of FES cycling that are most effective for people with different constellations of MS symptoms, and to fully explore the potential benefits for optimizing function and improving health in people with MS. Key Words: multiple sclerosis, FES, functional electrical stimulation Disclosure(s): None Disclosed.
Neurodegenerative Diseases Poster 83 Item Level Comparison of Self-Report Sleep Measures for Individuals With Chronic Central Nervous System Dysfunction Donald Fogelberg (University of Washington), Michael V. Vitiello, Jeanne M. Hoffman, Dagmar Amtmann Objective: To compare item-level responses on the Medical Outcomes Study Sleep scale and the PROMIS sleep domain short forms in a sample of patients with either multiple sclerosis (MS) or spinal cord injury (SCI) in an attempt to better understand previously reported discrepant findings among these measures. Design: Survey. Setting: Community-based. Participants: Seven hundred adults (age 18 and older) with MS (NZ461) or SCI (NZ239) who were enrolled in a longitudinal survey of self-reported health outcomes. Interventions: Not applicable. Main Outcome Measure(s): Medical Outcomes Study sleep (MOS-S) scale, Patient Reported Outcomes Information System (PROMIS) Sleep Disturbance (PROMIS-SD) and PROMIS Sleep Related Impairments (PROMIS-SRI) short forms. Results: The items of the MOS-S, PROMIS-SD and PROMIS-SRI scales were examined to identify items with comparable wording, yielding seven item pairs. Responses for these items were dichotomized into low and high frequency responses. For each pair of items, the number endorsing frequent difficulties on the MOS-S and the PROMIS short form was compared using chi-square tests. In both cohorts, a higher percentage of participants indicated frequent problems on the MOS-S compared to the PROMIS measures. Conclusions: Participants in both groups were more likely to indicate frequent problems with sleep and sleep related problems on the MOS-S than on the PROMIS short forms. This may be a function of the different time frames for the measures (MOS-SZ 4 weeks, PROMISZ 1 week) or the response options offered. Further research is needed to determine the utility of both measures given the lack of consistency in responses. Key Words: multiple sclerosis, sleep, spinal cord injury Disclosure(s): None Disclosed. Poster 84 Differential Impact and Use of a Telehealth Intervention by Persons With Multiple Sclerosis or Spinal Cord Injury Hannah Warner Mercier (New England Regional Spinal Cord Injury Center), Alan Jette, Bethlyn Houlihan Objective: To compare outcomes and use of a tele-health intervention (CareCall) by participants withmultiple sclerosis (MS) or spinal cord injury (SCI). Design: Secondary analysis of baseline and 6-month data that examined use of the CareCall system and study group differences in key outcomes, separately, for those with MS or SCI. Setting: New England Regional SCI Model System. Participants: Community-residing adults with SCI (nZ106) or MS (nZ 36) from Southern New England who used a wheelchair >Z 6 hours/day. Interventions: CareCall is an interactive, automated telephone system that combines health screening and referral with cognitive behavioral counseling, vignettes, and a nurse telerehabilitation coordinator (NTC). Main Outcome Measure(s): Pressure Ulcer Scale for Healing; Patient Health Questionnaire-9; Craig Handicap Assessment and Reporting Technique-Short Form; Craig Hospital Inventory of Environmental Factors; Cornell Services Index. Results: Experimental subjects with MS made close to double the amount of calls per person than subjects with SCI, and those with SCI missed more calls (p<0.001). CareCall achieved a significant treatment effect for those with MS in decreasing severity of depression (pZ0.025), improving access to healthcare (pZ0.045), and increasing participation.No statistical differences in skin integrity were found, though the MS experimental group had completely intact skin after CareCall. There were no main treatment effects for participants with SCI.
www.archives-pmr.org
Neurodegenerative Diseases Poster 83 Item Level Comparison of Self-Report Sleep Measures for Individuals With Chronic Central Nervous System Dysfunction Donald Fogelberg (University of Washington), Michael V. Vitiello, Jeanne M. Hoffman, Dagmar Amtmann Objective: To compare item-level responses on the Medical Outcomes Study Sleep scale and the PROMIS sleep domain short forms in a sample of patients with either multiple sclerosis (MS) or spinal cord injury (SCI) in an attempt to better understand previously reported discrepant findings among these measures. Design: Survey. Setting: Community-based. Participants: Seven hundred adults (age 18 and older) with MS (NZ461) or SCI (NZ239) who were enrolled in a longitudinal survey of self-reported health outcomes. Interventions: Not applicable. Main Outcome Measure(s): Medical Outcomes Study sleep (MOS-S) scale, Patient Reported Outcomes Information System (PROMIS) Sleep Disturbance (PROMIS-SD) and PROMIS Sleep Related Impairments (PROMIS-SRI) short forms. Results: The items of the MOS-S, PROMIS-SD and PROMIS-SRI scales were examined to identify items with comparable wording, yielding seven item pairs. Responses for these items were dichotomized into low and high frequency responses. For each pair of items, the number endorsing frequent difficulties on the MOS-S and the PROMIS short form was compared using chi-square tests. In both cohorts, a higher percentage of participants indicated frequent problems on the MOS-S compared to the PROMIS measures. Conclusions: Participants in both groups were more likely to indicate frequent problems with sleep and sleep related problems on the MOS-S than on the PROMIS short forms. This may be a function of the different time frames for the measures (MOS-SZ 4 weeks, PROMISZ 1 week) or the response options offered. Further research is needed to determine the utility of both measures given the lack of consistency in responses. Key Words: multiple sclerosis, sleep, spinal cord injury Disclosure(s): None Disclosed. Poster 84 Differential Impact and Use of a Telehealth Intervention by Persons With Multiple Sclerosis or Spinal Cord Injury Hannah Warner Mercier (New England Regional Spinal Cord Injury Center), Alan Jette, Bethlyn Houlihan Objective: To compare outcomes and use of a tele-health intervention (CareCall) by participants withmultiple sclerosis (MS) or spinal cord injury (SCI). Design: Secondary analysis of baseline and 6-month data that examined use of the CareCall system and study group differences in key outcomes, separately, for those with MS or SCI. Setting: New England Regional SCI Model System. Participants: Community-residing adults with SCI (nZ106) or MS (nZ 36) from Southern New England who used a wheelchair >Z 6 hours/day. Interventions: CareCall is an interactive, automated telephone system that combines health screening and referral with cognitive behavioral counseling, vignettes, and a nurse telerehabilitation coordinator (NTC). Main Outcome Measure(s): Pressure Ulcer Scale for Healing; Patient Health Questionnaire-9; Craig Handicap Assessment and Reporting Technique-Short Form; Craig Hospital Inventory of Environmental Factors; Cornell Services Index. Results: Experimental subjects with MS made close to double the amount of calls per person than subjects with SCI, and those with SCI missed more calls (p<0.001). CareCall achieved a significant treatment effect for those with MS in decreasing severity of depression (pZ0.025), improving access to healthcare (pZ0.045), and increasing participation.No statistical differences in skin integrity were found, though the MS experimental group had completely intact skin after CareCall. There were no main treatment effects for participants with SCI.
www.archives-pmr.org