S135 S290
Objective:
To describe participation in leisure time physical activity
(LTPA) (amount, intensity and type) among older adults with long-term
spinal cord injury (SCI), and to investigate the associations with soci-
odemographics and injury characteristics.
Design:
Cross-sectional study.
Setting:
Home and community settings in southern Sweden.
Participants:
Data from 84 men and 35 women (mean age 63.5 years,
mean time since injury 24 years, injury levels C1-L5, American Spinal
Injury Association Impairment Scale A-D) as part of the Swedish Aging
with Spinal Cord Injury Study (SASCIS).
Interventions:
Not applicable.
Main Outcome Measures:
The Physical Activity Recall Assessment for
people with Spinal Cord Injury (PARA-SCI). Associations were analyzed
statistically using hierarchical multiple regression.
Results:
Twenty-nine percent reported no LTPA whereas 53% per-
formed moderate-to-heavy intensity LTPA. The mean minutes/day of
total LTPA was 34.7 ( 41.5, median 15, range 0-171.7) and of mod-
erate-to-heavy LTPA 22.5 ( 35.1, median 5.0, range 0-140.0). The
most frequently performed activities were walking and wheeling.
Sociodemographics and injury characteristics explained 9.8% and
12.8%, respectively, of the variance in total and moderate to-heavy
LTPA. Age and wheelchair use were significantly, negatively associated
with total LTPA. Women, wheelchair users and employed participants
performed significantly less moderate-to-heavy LTPA than men, those
using walking devices/no mobility device and unemployed
participants.
Conclusions:
Many older adults with long-term SCI do not reach the
amount or intensity of LTPA needed to achieve fitness benefits.
Further research is needed on how to increase LTPA among older
adults with long-term SCI and to identify modifiable factors that could
enhance their participation.
Level of Evidence:
Level II
Poster 58:
High-Resolution Manometry as a Diagnostic and
Predictive Method in Dysphagic Patients
Chul-Hyun Park, MD (Kangbuk Samsung Hospital, Sungkyunkwan
University School of Medicine, Seoul, Korea, Republic of),
Yong-Taek Lee, MD, PhD, Youbin Yi, MD, Jung-Sang Le Lee, MD,
Jung Ho Park, MD, PhD, Kyung Jae Yoon, MD, PhD
Disclosures:
Chul-Hyun Park: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
High-resolution manometry as a diagnostic and predictive
method in dysphagic patients.
Design:
Prospective study.
Setting:
Tertiary care university hospital.
Participants:
Patients with clinical symptoms of dysphagia (N
¼
120).
Interventions:
Study subjects were evaluated by HRM with five times
of a 5-mL water swallow.
Main Outcome Measures:
HRM parameters and the development of
aspiration pneumonia in follow-up period after HRM evaluation.
Results:
Maximal pressure of velopharynx (VP) and relaxation
duration of upper esophageal sphincter (UES) using HRM were
independently associated with non-oral feeding. At the optimal
cutoff values of 105.0 mmHg in VP maximal pressure and 0.45 sec in
UES relaxation duration, non-oral feeding was determined with
0.950 sensitivity, 0.700 specificity and 0.763 sensitivity, 0.575
specificity, individually. During a mean follow-up of 1.5 years, 19
dysphagic patients developed aspiration pneumonia. Maximal pres-
sure of VP and relaxation duration of UES independently predicted
developing aspiration pneumonia in multivariate Cox regression
analysis. The cumulative incidence of aspiration pneumonia signifi-
cantly decreased in patients with above the optimal cutoff values of
VP maximal pressure (Log rank P
<
.01) and UES relaxation duration
(P
<
.01), respectively.
Conclusions:
We present that HRM can be a useful diagnostic method
for determination of feeding methods and for prediction of developing
aspiration pneumonia in dysphagic patients.
Level of Evidence:
Level II
Poster 72:
Use of Step Accelerometry During the 6-Minute Walk
Test to Validate Stride:Height Ratio as a Novel Measure
of Mobility in Duchenne Muscular Dystrophy (DMD)
Lisa M. Williams, MD (UC Davis), Alina Nicorici, BS
Disclosures:
Lisa Williams: I Have No Relevant Financial Relationships
To Disclose
Objective:
In normative populations, stride length to standing height
(stride: height) is approximately 1.0 and can serve as an indicator of
reduced ambulatory capacity. Currently, there are no reliable clinical
ambulation endpoint outcome measurement tools for children ages 2
to 5 years old. Developing new treatments targeting the underlying
causes of DMD has been a major focus of research, however, there is
an unmet need to develop clinical trial endpoints in DMD. Determining
the validity of stride:height using The StepWatch Activity Monitoring
(SAM), a wearable accelerometer, may allow enrollment of patients
ages 2 to 5 in clinical trials as well as interface into the electronic
medical record to monitor loss of ambulation and disease progression.
Design:
Case Control observational study.
Setting:
Neuromuscular Disease Research Center.
Participants:
24 boys with DMD aged 4-12 years and 36 age-matched
typically developing controls twice.
Interventions:
The StepWatch Activity Monitoring (SAM) to determine
the ratio of stride length to standing height, stride:height.
Main Outcome Measures:
Ambulatory ability measured by stride
length to standing height (stride: height).
Results:
Stride:height at a fast walk ranged from 0.32-1.05, mean(SD)
of 0.72(0.15) in DMD and 0.81-1.37, mean(SD) of 1.07(0.11) in controls,
with almost no overlap between groups. Regression analysis in DMD
and controls demonstrated a significant relationship between stride:
height (p
<
.05).
Conclusions:
Stride:height using SAM can serve as a simple clinic or
community-based measure to determine the ambulatory ability for use
in clinical trials. Although we used DMD as the prototype, this may be a
useful tool in all diseases causing mobility impairments to determine
responsiveness to newer therapies and record a longitudinal record
through the progression of the disease course.
Level of Evidence:
Level III
Poster 88:
Relationship Between Brain Structure and Functional
Connectivity and Disability after Spinal Cord Injury:
an MRI Study
Yu Pan (Beijing, Changping, China), Weibei Dou, PhD, Professor
Disclosures:
Yu Pan: I Have No Relevant Financial Relationships To
Disclose
Objective:
Neural plasticity is the physiological basis during func-
tional recovery after spinal cord injury (SCI), which is the intervention
mechanism of noninvasive techniques including repetitive transcranial
magnetic stimulation (rTMS) and transcranial direct current stimula-
tion (tDCS). Therefore, changes of neural plasticity may be important
factors to functional recovery in SCI patients. The aim of this study was
to explore the alteration of brain structure and functional connectivity
and the relationship to disability after SCI. We hypothesize that the
brain structural and functional changes may indicate recovery and
rehabilitation status of SCI patients. Related important brain regions
may serve as potential and direct therapeutic targets to help
rehabilitation.
S135
Abstracts / PM R 9 (2017) S131-S290