S143 S290
valvular heart disease). At baseline, 24 (40%) were classified as frail
based on any of the following criteria: 6-minute walk distance (6MWD)
<
300m, gait speed (GS)
<
1m/s, timed up and go (TUG)
>
15s, tandem
stand (TS)
<
10s.
Interventions:
Completing at least 24 sessions of CR including indi-
vidualized exercise training and risk factor education.
Main Outcome Measures:
Change in 6MWD, GS, TUG, and TS from pre-
to post-assessment in frail and non-frail patients.
Results:
Frail and non-frail CR patients improved significantly in 6MWD
(274 70m vs. 331 69m, p
<
.001; 379 54m vs. 411 62m, p
¼
.001,
respectively). The magnitude of change was significantly greater for
frail vs. non-frail (58 49m vs. 31 52m, p
¼
.050). Improvements in GS,
TUG, and TS were demonstrated in frail and non-frail patients, but
statistical significance was only evident in the non-frail for GS and TUG
(GS: 0.01 0.25m/s, p
¼
.805 vs. 0.11 0.24m/s, p
¼
.014; TUG:
e
0.9 2.8s, p
¼
.136 vs.
e
0.8 1.6s, p
¼
.004; TS: 4.8 5.9s, p
¼
0.152 vs.
1.4 6.4s, p
¼
.189; frail vs. non-frail, respectively). Of the 24 patients
classified as “frail” at enrollment, 13 (54%) were no longer classified as
frail at completion of CR.
Conclusions:
Frail and non-frail patients in CR achieved multiple do-
mains of functional enhancement. These results provide strong ratio-
nale for referring frail adults to CR. Additional modifications to CR that
specifically address balance, strength, cognition, and other frailty
hazards may further enhance its utility for today’s growing population
of frail CVD patients.
Level of Evidence:
Level III
Poster 2:
Prognostic Values of Electrodiagnostic Studies in
Traumatic Brachial Plexus Injury
David M. Impastato, MD (Univ of WA Med Ctr, Seattle, z, United
States), Aaron E. Bunnell, MD, Kate A. Impastato, MD, Jason H. Ko,
MD, Parinaz J. Dabestani, Master of Arts (MA)
Disclosures:
David Impastato: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
This study aimed to determine if motor unit potential
recruitment, specifically no recruitment versus discrete recruitment,
in traumatic brachial plexus injuries predicted spontaneous motor
recovery to assist in determining if surgical management is indicated.
Design:
Retrospective Study.
Setting:
County Hospital/Trauma 1 Center.
Participants:
18 number of subjects with brachial plexus injuries
affecting deltoid, supraspinatus/infraspinatus, and biceps brachii who
received care from January 2005 until December 2015. Patients were
excluded if they had concomitant peripheral nerve injury, central
nervous system injury, amputation, vascular injury of the involved
limb, or received nerve transfer that would affect the above muscles.
Interventions:
Not Applicable.
Main Outcome Measures:
Strength on manual muscle testing at the
time of injury and at least one year after injury. Good outcome is
considered strength greater than antigravity (4-5 on MRC scale).
Results:
0% of muscles with no recruitment (n
¼
23) at 1-9 months
improved to 4-5 strength at least 1 year post injury. 33% of muscles
with discrete or severely reduced recruitment regained strength
>
3/5
at least one year post injury. A difference between the two groups was
demonstrated with statistical significance (p-value .037).
Conclusions:
As expected, absent voluntary motor recruitment at 1-9
months predicted poor prognosis for spontaneous recovery and these
injuries should be considered for early nerve transfer surgery. Although
sample size is small, a high percentage of patients with discrete or
severely reduced recruitment did not improve to
>
3/5 strength. This
calls into question the practice advocated by some to not surgically
intervene if any motor units are present. Multi-center studies are
needed to further evaluate which patients should receive conservative
care versus surgical management to maximize functional return.
Level of Evidence:
Level II
Poster 4:
The Implications of Power Mobility on Body Weight
Christo X. Arbonies, MD (Virginia Commonwealth Univ Hlth Sys),
Deborah Caruso, MD
Disclosures:
Christo Arbonies: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
Explore the effects of powered mobility device (PMD) on
body weight after two years within a general veteran population.
Design:
Cross-sectional retrospective study.
Setting:
Veteran Affairs Medical Center.
Participants:
185 veterans prescribed PMD for the first time.
Interventions:
Not applicable.
Main Outcome Measures:
Change in weight 2 years after receiving
PMD.
Results:
There was a significant decrease in body mass index (BMI; P
¼
.01) and weight (P
¼
.01) among 185 veterans in the first two years after
receiving an initial PMC. However, subjects younger than 65 years (n
¼
84)
experienced a slight increase in BMI, while those 65 or older (n
¼
101)
experienced a significant decrease (P
<
.001). Obese subjects (n
¼
92) saw
a significant decrease in their weight (P
¼
.003) compared to no appre-
ciable change inweight for subjects whowere not obese (n
¼
93). A higher
proportion of obese patients at Time 1 had BMI below the obesity
threshold at Time 2 (14%) than non-obese patients at Time 1 who had BMI
above the obesity threshold at Time 2 (8%) (
c
2
(1)
¼
114.11, P
<
.001).
Conclusions:
This study failed to show a change in body weight or BMI
in a general veteran population for patients under 65 years of age
receiving PMD for the first time. However, patients 65 or older showed
a decrease in their body weight and BMI, consistent with expected
weight loss with age. Obese patients saw a significant decrease in their
body weight whereas non-obese patients experienced no appreciable
change. An otherwise appropriate prescription for PMD should not be
delayed due to concerns of contributing to obesity.
Level of Evidence:
Level III
Poster 5:
The Effects of Community Based Group Exercise
Program in Frail Older Adults: 24 Weeks Prospective
Study
Jang Hyuk Cho, MD (Seoul National University College of Medicine,
Seoul, Korea, Republic of), Jae Hyeon Park, MD, Minkyung Cho, PT,
Sun G. Chung, MD, PhD, Keewon Kim, MD, Jeong Gil Kim, MD
Disclosures:
Jang Hyuk Cho, MD: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
To determine the effects of supervised community based
group exercise (SCGE) program in frail older adults by assessing mul-
tiple aspects of frailty including muscle strength, whole body and local
muscle mass, physical activity, fear for fall, balance function, gait
function and depressive mood.
Design:
Prospective clinical trial.
Setting:
A regional community for the elderly.
Participants:
22 physically frail older individuals (21 female, age 76.3
4.4 years old, height 151.2 4.9cm, weight 55.1 6.2cm, body
mass index 24.2 3.1kg/m
2
, appendicular skeletal muscle mass index
5.8 0.5kg/m
2
, cross sectional area of rectus femoris 417 58mm
2
,
cross-sectional area of multifidus 609 72mm
2
).
Interventions:
24 weeks exercise program consisted of spine
extension stretching, abdominal bracing exercise, extremity
stretching exercise, strengthening exercise, balance training and
gait training.
Main Outcome Measures:
Muscle strength, physical activity scale for
the elderly, short-geriatric depression scale, fall efficacy scale, bal-
ance function, gait function, whole body muscle mass by bioelectrical
impedance analysis, ultrasonographic measurement of cross-sectional
areas of the rectus femoris and multifidus.
S143
Abstracts / PM R 9 (2017) S131-S290