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the ARAT tasks were taken into analysis. Angular positions and range of
motion for shoulder internal rotation, elbow flexion, forearm supina-
tion, and wrist dorsiflexion/volarflexion were extracted. Neutral po-
sitions for shoulder rotation and wrist flexion, and full elbow extension
and forearm pronation were set as zero degree.
Results:
Angular positions while grasping for shoulder internal rota-
tion, elbow flexion, forearm supination, and wrist volarflexion were
90.67 2.69, 4.49 3.77, 29.01 2.43, and 22.06 2.66 degrees (mean-
standard error mean), respectively, and 83.79 1.27, 1.50 1.28,
26.01 2.36, and 12.81 2.11 degrees for pinching, respectively
(p
¼
.024, .455, .379, and .009 for grasping vs pinching, by independent
t test). While reaching to a top of an eye-level shelf, the range of
motion for each movement components in the direction of shoulder
external rotation, elbow extension, forearm pronation, and wrist
dorsiflexion were 68.81 15.19, 19.76 16.67, 38.65 10.08, and
12.01 9.49 degrees (mean standard deviation), respectively.
Conclusions:
This study provides essential angular positions and range
of motion for major upper extremity joints for performing reaching,
grasping, and pinching movements. This may serve as an important
database for designing simplified and light weight upper extremity
rehabilitation robots. Further investigation on angular characteristics
during various activities of daily living is necessary.
Level of Evidence:
Level III
Poster 94:
Posterior Cord Syndrome: Demographics and
Rehabilitation Outcomes
Adam S. Hills (Virginia Commonwealth University), William McKinley,
MD
Disclosures:
Adam Hills: I Have No Relevant Financial Relationships To
Disclose
Objective:
To describe demographics, clinical characteristics, and
functional outcomes of patients with incomplete spinal cord injuries
and a diagnosis of posterior cord syndrome (PCS).
Design:
A retrospective case series.
Setting:
A spinal cord injury (SCI) rehabilitation unit at a Level 1
tertiary university medical center.
Participants:
9 patients with incomplete cord injuries and PCS
admitted within the past 5 years.
Interventions:
Not applicable.
Main Outcome Measures:
Functional Independence Measure (FIM)
motor scores, length of stay (LOS), discharge disposition.
Results:
Average age at onset of incomplete SCI with PCS was 61.5
years. Racial makeup was as follows: Caucasian (4), African American
(3), African (1), Asian (1). 78% of patients developed paraparesis vs. 22%
tetraparesis. All patients received an American Spinal Injury Association
impairment scale (AIS) classification of AIS D. Most common etiology was
spinal cord compression (78%) from localized tumors [thoracic (5),
lumbar (1), cervical (1)]; other etiologies included thoracic epidural
abscess and severe cervical spinal stenosis. SCI-related complications
most commonly included: neuropathic pain (78%), spasticity (44%),
neurogenic bladder (44%), neurogenic bowel (33%), and UTI (33%).
Average LOS on the rehabilitation unit was 22 days. Average admission
and discharge FIM motor scores were 28 and 56, respectively. Conti-
nence at admission and dischargewas 22% vs 56% (for bladder) and 67% vs
78% (for bowel). 67% of patients were able towalk at least 150 feet with a
rolling walker prior to discharge. 67% of patients were discharged home.
Conclusions:
We can conclude that PCS most often results in para-
paresis due to tumor compression, and in typical SCI-related medical
complications. These patients often experience significant functional
improvements during SCI rehabilitation with the majority also having
bladder and bowel continence allowing them to return home at
discharge.
Level of Evidence:
Level IV
Poster 95:
Functional Decline in Multiple Sclerosis: Effect of
Etiology on the Outcome of Rehabilitation
Kanakadurga R. Poduri, MD (Univ of Rochester, Rochester, NY, United
States), Jean L. Nickels, MD, Catherine O. Flanagan, RN, MBA
Disclosures:
Kanakadurga Poduri: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
Multiple sclerosis (MS) is a disease with chronic disability
resulting in progressive functional decline. The common causes for the
decline are disease exacerbation/progression and unrelated illnesses.
The purpose of this study is to compare the outcome of rehabilitation
on functional decline from an exacerbation/progression versus an
unrelated illness.
Design:
A retrospective study of patients who underwent acute
inpatient rehabilitation with MS and an admitting diagnosis of exac-
erbation/progression versus an unrelated illness resulting in functional
decline.
Setting:
Acute inpatient rehabilitation.
Participants:
51 patients with average age of 58 years with a diagnosis
of MS who underwent rehabilitation between 2011 and 2016. They
were divided into two groups; group I with an exacerbation/progres-
sion resulting in functional decline and group II with an illness that was
unrelated to MS.
Interventions:
The multidisciplinary team assessed the functional
status of the patients through the Functional Independence Measure
(FIM) at admission and discharge. Patients’ length of rehabilitation
stay (LOS), FIM gain and Length of Stay Efficiency(LSE) (LSE
¼
LOS/FIM
gain) were recorded.
Main Outcome Measures:
FIM Gain and LSE and the effect of etiology:
exacerbation/progression vs. unrelated illness.
Results:
Group I was younger 54 vs. 61 group II. The difference of the
mean age is significant at p
<
.05. The means of admission FIM (68 and
69), discharge FIM (90 and 96) and LOS (17 and 19 days) for the groups
are not significant. The mean FIM gain 26 vs 22 is also not significantly
different with the standard error of 3.15 for the difference (Z
¼
1.27).
The Length of Stay Efficiencies (LSE) for the groups are significantly
different (mean 2 vs. 1.42, standard error of the difference of the
means is 0.28 with a Z
¼
2.1 and the p
<
.05).
Conclusions:
MS patients with functional decline from exacerbation/
progression make more efficient functional improvements with reha-
bilitation than patients whose functional decline is due to an illness.
Level of Evidence:
Level III
Poster 96:
Additive Effects of
b
-3 Agonist (Mirabegron) for
Treatment of Neurogenic Detrusor Overactivity in
Spinal Cord Injury Patients who had been Treated
with Antimuscarinic Agent
Jeong-Hwan Seo, MD, PhD (Chonbul Nat Univ Hosp)
Disclosures:
Jeong-Hwan Seo: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
Mirabegron is a beta-3 adrenoreceptor agonist used to
treat neurogenic detrusor overactivity by relaxing detrusor muscle.
Combination of conventional antimuscarinic drug and mirabegron can
be more effective in spinal cord injury, however related study is hardly
can be seen. The objective is to see the additive effect of mirabegron
to the neurogenic bladder of spinal cord injury.
Design:
Single center, retrospective, clinical study.
Setting:
University hospital setting.
Participants:
Twenty-five spinal cord injured patients who were able
to void without intermittent catheterization.
Interventions:
When anti-muscarinic drug usage was not effective
enough, mirabegron was added to see some clinical differences.
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Abstracts / PM R 9 (2017) S131-S290