S165 S290
Main Outcome Measures:
Post-intervention caliper measurements of
the dye spread were taken after each technique. A descriptive analysis
of the dye diffusion before and after technique application was pre-
sented. A two-way ANOVA for repeated measurements was applied. In
function of the ANOVA, a post LSD Fisher test was applied (p .05).
Results:
After the first mobilization, the mean experimental post-
test, longitudinal dye spread measurement (7.51 6.63mm) was
significantly greater (p
¼
.024) compared to the resting position. There
was a significant diffusion effect with either tensioning (p
¼
.018) or
sliding (p
¼
.016), with no statistically significant difference between
both techniques (p
¼
.976, TT: 7.5 5.5mm SLT: 7.5 8.1mm). The order
in which TT and SLT were administered did not influence diffusion in a
significant way.
Conclusions:
Passive neurodynamic techniques in the form of 5-min-
ute therapy of tensioning or sliding induced significant fluid dispersion
in the median nerve at the level of the carpal tunnel of human ca-
davers. The close nerve relationship with the ligament could have had
an increased effect as this has been previously suspected. These data
provide an explanation regarding a potential mechanism of NDM in
reducing intraneural edema.
Level of Evidence:
Level IV
Poster 90:
Safety and Efficacy of Repeated Abobotulinumtoxin A
Injections for Dynamic Equinus Foot in Children Less
Than 6 Years of Age: A Subgroup Analysis
Ann Tilton (LSUHSC & Children’s Hospital New Orleans, New Orleans,
LA, USA), Mark Gormley, MD, Edward Dabrowski, MD,
Dennis J. Matthews, MD, Luisa Rodriguez Pose, MD,
Anne-Sophie AS. Grandoulier, MD, Philippe Picaut, Pharm D, PhD,
Mauricio R. Delgado, MD
Disclosures:
Ann Tilton: Research Grants - Ipsen, Consulting fees or
other remuneration (payment) - Ipsen
Objective:
The safety and efficacy of single injections of abobotuli-
numtoxinA for pediatric dynamic equinus have recently been estab-
lished in a Phase 3 trial. Treatment often begins in early childhood; we
describe the effect of repeat injections from the open-label extension
study, focusing on the subgroup of children aged
<
6 years.
Design:
Open-label extension study of repeat (up to 4 cycles) abo-
botulinumtoxinA injections into the gastrocnemius-soleus complex.
Doses could be individually adjusted (minimum 5U/kg, maximum 30U/
kg) and other limb muscles were injected as required. Data were
analyzed for the total safety population (TP; N
¼
216) and the younger
patient subgroup aged
<
6 years (YP; N
¼
127).
Setting:
23 sites across 6 countries.
Participants:
Ambulatory children (aged 2
e
17 y) with dynamic equi-
nus due to cerebral palsy.
Interventions:
Repeated lower limb abobotulinumtoxinA injections.
Main Outcome Measures:
Mean change in Modified Ashworth Scale
(MAS) and Physician’s Global Assessment (PGA) scores, and adverse
events (AEs).
Results:
Mean SD age was 5.9 3.3y in the TP and 3.7 1.0y in the YP
(both groups 60% male). Compared to the TP, more children were bot-
ulinum toxin treatment naı¨ve in the YP (53.2 vs. 63.8%). Treatment-
emergent adverse events (TEAEs) were reported in 73.5% of the TP and
75.2% of the YP, the most common being upper respiratory infection in
both groups. 1 patient (YP) withdrew from the study due to a TEAE in
Cycle 1 (unrelated to treatment). Rates of serious AEs were also similar
(TP:3.4%, YP: 5.0%). The magnitude of efficacy across open-label
treatment cycles 1
e
3was similar; mean change frombaseline toWeek-4
in MAS scores ranged from -1.0 to -1.1 in the TP and from -0.95 to -1.1 in
the YP; mean Week-4 PGA scores were 1.4
e
1.5 in both groups.
Conclusions:
The efficacy and safety of abobotulinumtoxinA in-
jections appear to be similar in the sub-population of younger children
aged
<
6 years as compared to the total safety population.
Level of Evidence:
Level I
Poster 92:
Evaluation of Clinical Institute Withdrawal
Assessment for Alcohol (CIWA) in Patients with
Traumatic Brain Injury
Jessica L. Hupe, MD (Virginia Commonwealth Univ Hlth Sys, Richmond,
VA, United States), William E. Carter, MD, James Newman, MD,
Adam Sima, PhD
Disclosures:
Jessica Hupe: I Have No Relevant Financial Relationships
To Disclose
Objective:
Clinical Institute Withdrawal Assessment (CIWA) informa-
tion regarding TBI severity outcomes and the role and impact of the
Clinical Institute Withdrawal Assessment (CIWA) protocol on patient
care is unclear. The purpose of this study is to evaluate the use and
outcomes of those with TBI who received the CIWA protocol with
primary hypothesis that severity of TBI will be positively correlated
with elevated CIWA scores.
Design:
Retrospective cohort study.
Setting:
Single level one trauma center.
Participants:
375 subjects identified from a single level 1 trauma
center’s trauma registry positive for alcohol and/or who had suffered a
brain injury from January 2009- July 2015. Inclusion criteria included
CIWA protocol being implemented, age greater than 16, length of stay
of at least 5 days.
Interventions:
Not Applicable.
Main Outcome Measures:
Frequency of elevated CIWA score, seizure
incidence, medication administration incidence based on TBI severity.
Results:
When TBI specific outcomes are examined, no significant dif-
ference is found in the length of CIWA protocol utilization in days based on
TBI severity. Patients with no TBI were on CIWA protocol for an average of
3.4 days,mild TBI 3.7 days, moderate TBI 4.2 days and severe TBI 4.0 days.
Patients with noTBI were treated in the acute care hospital for an average
of 7.0 days, mild TBI 9.0 days, moderate TBI 10.0 days and severe TBI 18.5
days. For subjects with no diagnosis of TBI the percentage of subjects
receiving a CIWA score greater than eight was 4.5%, for mild TBI 12.5%, for
moderate TBI 27.1% and for severe TBI the percentage of subjects
receiving a CIWA score greater than eight was 50.0%.
Conclusions:
Subjects with TBI were assigned higher CIWA scores then
their non-TBI counterparts. This highlights the importance of differ-
entiating between acute ETOH withdrawal and TBI sequela when
implementing CIWA protocol during acute care hospitalization.
Level of Evidence:
Level III
Poster 93:
Characterization of Upper Extremity Motion in
Grasping and Reaching using Inertial Sensor Based
Motion Capture System
Hyung Seok Nam (Seoul National University College of Medicine),
Han Gil Seo, MD, Sungwan Kim, PhD
Disclosures:
Hyung Seok Nam: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
To characterize upper extremity joint movements while
performing grasping and reaching tasks in order to apply to the design
of simplified rehabilitation robots.
Design:
Observational measurement study.
Setting:
University biomedical engineering and rehabilitation
department.
Participants:
Five healthy volunteers without any upper limb
impairments.
Interventions:
A whole body motion capture system based on 9-axis
inertial measurement unit sensors were put on the volunteers and the
upper extremity movements were recorded while performing the Ac-
tion Research Arm Test (ARAT) tasks.
Main Outcome Measures:
Grasping (6 trials for each subject),
pinching (6), and reaching (12) movements of the dominant arm during
S165
Abstracts / PM R 9 (2017) S131-S290