Trunk Lean and Android Mass Using Magnetic Resonance Imaging and DXA After Spinal Cord Injury

e124 Research Poster 317192 Treatment Patterns Among Soldiers With or Without Psychological Health Problems, TBI, and Pain Rachel Adams (Brandeis University), Mark Bauer, Sue Lee, Thomas Williams, Mary Jo Larson Research Objectives: To examine treatments received among subgroups with and without comorbidity of traumatic brain injury (TBI), psychological health (PH), and chronic pain to identify areas for improvement. Design: Investigated treatments received during the 12 months postdeployment for soldiers returning from Afghanistan/Iraq deployments in FYs 2008-14. Setting: Military Health System inpatient and outpatient health care utilization. Participants: 573,453 active duty soldiers. We describe the one-year postdeployment prevalence of TBI diagnoses; PH diagnoses (adjustment disorder, anxiety, PTSD, depression, alcohol use disorder and substance use disorder); and chronic pain. Among those with PH conditions (nZ96,975) or TBI (nZ21,984), we constructed subgroups based on comorbidity with chronic pain. Interventions: Retrospective, observational study. Main Outcome Measure(s): Receipt of complementary/alternative treatments (e.g., acupuncture, biofeedback) and prescriptions for opioids during the postdeployment year, by subgroups. Results: 17% received a PH diagnosis, 3.8% had diagnosed TBI, 2.2% had both PH and TBI, and 19.2% had chronic pain. The most common PH diagnosis was adjustment disorder (9.3%). The prevalence of chronic pain varied by PH diagnosis: the highest comorbidity occurred among those with PH and TBI (58.8%). One third (35.2%) of soldiers received an opioid during the year, and receiving more than 31 days of opioids was uncommon (5.3%). Utilization of acupuncture or biofeedback was low (2.3% and 4.7%, respectively). Conclusion/Discussion: PH diagnoses were twice as common among those with chronic pain. Certain complementary therapies may be underutilized among those with PH conditions. Because of high levels of comorbid chronic pain, a substantial proportion received opioids, which may interfere with resolution of their PH conditions. Additional research is needed to examine the impact of treatments received on outcomes, by subgroup. Key Words: Military Personnel, Traumatic Brain Injuries, Chronic Pain, Comorbidity Disclosures: None to disclose. Research Poster 304846 Triangulating Focus Group and Qualitative Interview Data Regarding Quality of Life After Spinal Cord Injury Edward Rohn (University of Michigan) Research Objectives: To compare focus group and interview data and triangulate findings regarding quality of life (QOL) for a sample of persons with neurogenic bladder and bowel (NBB) following spinal cord injury (SCI). Design: Results from two six-person focus groups are compared to the one-on-one interviews from the same 12 participants. Analysis involved direct comparisons of the range of topics covered, and the depth and salience of each topic. Setting: Interviews were conducted at University of Michigan’s Department of Physical Medicine & Rehabilitation (UMPMR) offices and Ann Arbor Veteran’s Affairs Hospital outpatient clinic. Focus groups were conducted at UMPMR offices. Participants: Twelve individuals participated in our focus group sessions, and were divided into two groups. Group 1 included two women and four

Research Posters men (four were paraplegic and two were tetraplegic). Group 2 included six men (five were paraplegic, one was tetraplegic). Interventions: Not applicable. Main Outcome Measure(s): Focus group data were coded using the same coding scheme from the parent study. Coded text was compiled into a matrix, which was analyzed for themes and associative patterns. Comparisons to previous matrices on QOL were made to identify similarities and differences. Results: The range of topics was much higher in individual interviews. Fewer topics were discussed in focus groups, but to a much greater depth, suggesting the most salient topics came out in group settings. The most salient factors contributing to QOL included: a grievous loss of spontaneity, lack of knowledgeable physicians, and diligence in managing changing NBB. Conclusion/Discussion: Focus groups confirmed patterns in interview data but revealed saliency that would have been otherwise missed. Findings suggest the inclusion of focus groups should be intentional and well-planned, rather than an uncritical inclusion following norms of qualitative research. Key Words: Focus Groups, Spinal Cord Injuries, Quality of Life, Urinary Bladder, Neurogenic, Neurogenic Bowel Disclosures: None. Research Poster 324556 Trunk Lean and Android Mass Using Magnetic Resonance Imaging and DXA After Spinal Cord Injury Ashraf Gorgey (Hunter Holmes McGuire VA Medical Center), Kathleen Rankin, Laura O’Brien Research Objectives: To quantify trunk LM using magnetic resonance imaging (MRI) and dual energy x-ray absorptiometry (DXA). Moreover, the relationships between trunk LM and body composition or basal metabolic rate variables were determined. Design: Cross-sectional and correlational design. Setting: Research setting in a medical center. Participants: Twenty-two men with motor complete paraplegia (nZ14; T4-T11) and tetraplegia (nZ8; C5-C7) were recruited as part of a clinical trial. Interventions: LM of six trunk muscle groups were quantified using MRI and DXA at the trunk and android regions. Subcutaneous and visceral adipose tissue (SAT and VAT), and intramuscular fat (IMF) CSAs were also measured. After overnight fast, basal metabolic rate (BMR) was evaluated using indirect calorimetry. Main Outcome Measure(s): trunk LM, muscle CSA, IMF, VAT and BMR. Results: Trunk LM-DXA (243.3 kg) and android LM (3.550.7kg) overestimated (P < .0001) trunk LM-MRI (1.70.5 kg). Paraplegics had 13% greater total trunk muscle CSAs compared to persons with tetraplegia (PZ.02) and accounting for IMF CSA resulted in a significant decrease in individual trunk muscle CSA. Percentage trunk muscle and LM were inversely related to VAT and only trunk LM-DXA predicted BMR. Conclusion/Discussion: Trunk LM-DXA (243.3 kg) and android LM (3.550.7kg) overestimated (P < .0001) trunk LM-MRI (1.70.5 kg). Paraplegics had 13% greater total trunk muscle CSAs compared to persons with tetraplegia (PZ.02) and accounting for IMF CSA resulted in a significant decrease in individual trunk muscle CSA. Percentage trunk muscle and LM were inversely related to VAT and only trunk LM-DXA predicted BMR. Key Words: Trunk Lean Mass, DXA, MRI, Body Composition, Spinal Cord Injury Disclosures: None. Research Poster 304932 Trunk Stability Limit: A Novel Measure of TrunkIndependence for Individuals with Spinal Cord Injury Kamyar Momeni (Kessler Foundation / Rutgers NJ Medical School), Arvind Ramanujam, Erica Garbarini, Gail Forrest

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