S167 S290
Main Outcome Measures:
Volume of post-void residual (PVR),
micturition frequency and mean volume voided (MVV) were docu-
mented in a voiding diary before and after 12-week therapy. All pa-
rameters were analyzed by Wilcoxon signed rank test to validate their
statistical significance.
Results:
Among the parameters, a significant decrement in micturi-
tion frequency and increment in mean volume voided (MVV) was
observed after 12-week betmiga add-on therapy. (P value .007 for
micturition frequency, .015 for MVV). However, the change of PVR was
in was insignificant after 12-week therapy (P value .249).
Conclusions:
We found significant improvements in bladder capacity
in patients with SCI who were treated with combination of anti-
muscarinics and add-on mirabegron. This finding can be clinically
beneficial to treat the bladder of spinal cord injury patients. To
evaluate more specific activity of detrusor muscle activity before and
after 12-week therapy, the result of urodynamic study would have
been helpful. Larger sample size can be helpful, too, for better study
outcome.
Level of Evidence:
Level III
Poster 97:
The Body Function, Activity Limitation, and
Participation Restriction of Individuals with Poly-
Trauma Clinical Triad
Armando S. Miciano, MD, FAAPMR (Nevada Rehabilitation Institute,
Las Vegas, NV, United States), Briauna K. Bissen, BS, Chad L. Cross,
PhD, PStat(R)
Disclosures:
Armando Miciano: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
Quantify body function (BF), activity limitation (AL), and
participation restriction (PR), using the International Classification of
Functioning, Disability and Health’s (ICF) disablement components, in
individuals with Poly-Trauma Clinical Triad (PCT: chronic pain, trau-
matic brain injury, and post-traumatic stress disorder); and, correlate
the ICF components and scores from performance-based assessments
(PBA).
Design:
Retrospective cross-sectional study.
Setting:
PMR clinic.
Participants:
46 subjects with PCT (age range 22-59).
Interventions:
Not applicable.
Main Outcome Measures:
The Pain Numerical Rating Scale (NRS),
Neurobehavioral Symptom Inventory (NSI), and PTSD CheckList
e
Civi-
lian Version (PCL-C) quantified BF, i.e. pain severity, post-concussion,
and post-traumatic stress symptoms, respectively.
The PDQ (stratified into mild/moderate [m/m] and severe/extreme
[s/e] pain-related impairment) and PROMIS-57 v1.0 physical-func-
tion sub-scale (PROMIS-PF) assessed AL. The PROMIS-57 v1.0 satis-
faction-with-social role (PROMIS-SSR) and pain-impact sub-scales
(PROMIS-PI) described PR status. PBA included the 6-Minute Walk
Test-Speed (6MWT); Dynamic Gait Index (DGI); and Berg Balance
Scale (BBS).
Results:
Data met normality assumptions; mean differences were
examined among variables using ANOVA. Age was not significant in
any variable comparisons. There were no gender interaction with
PRI terms: m/m and s/e. The mean (SD) scores were as follows (m/
m, s/e): NRS 6.13 (2.14), 7.72 (1.19); NSI 40.17 (15.14), 54.42
(15.33); PCL-C 48.66 (8.61), 62.75 (16.09); PDQ 72.45 (25.56),
118.88 (11.70); PROMIS-PF 37.75 (3.45), 32.50 (5.20); PROMIS-SSR
40.36 (7.69), 33.54 (5.36); and, PROMIS-PI 63.79 (7.70), 69.73 (5.35).
Pearson’s Correlation Coefficient calculated associations among
variables; p.
Conclusions:
In individuals with PCT and m/m PRI, BF was associated
with physical performance while in those with s/e PRI, AL and PR were
associated with physical performance. The study supports that the
three ICF components can be assessed via patient-reported outcomes,
hence being applicable to clinical practice. Future studies should focus
on how environmental factors affect the ICF components’ multi-
dimensionality.
Level of Evidence:
Level II
Poster 98:
Pain and Its Correlates in a Treatment-Seeking Mild
Traumatic Brain Injury Sample
Michelle E. Lalonde, MD (Spaulding Rehab Hosp/Harvard Med Schl),
Grant L. Iverson, PhD, William Panenka, MD, Ross D. Zafonte, DO,
FAAPMR, Noah Silverberg, PhD, R Psych
Disclosures:
Michelle Lalonde: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
Headaches are common following mild traumatic brain
injury (mTBI), but little is known about pain in other body regions in
patients with persistent symptoms. This study describes the distribu-
tion of bodily pain and its correlates in patients who are seeking
treatment at a concussion clinic.
Design:
Prospective Cohort Study.
Setting:
Four concussion clinics (50.5% worker’s compensation cases)
throughout Vancouver.
Participants:
Eighty-seven participants (46 women) meeting World
Health Organization Neurotrauma Task Force diagnostic criteria for
mTBI.
Interventions:
NA.
Main Outcome Measures:
The patients were assessed at their first
clinic visit post-injury (M
¼
11.2, SD
¼
6.0, IQR
¼
5.5-14.5 weeks post-
injury). Participants rated current pain intensity in five body re-
gions on a scale from zero (no pain) to three (severe pain). The
assessment battery included measures of depression (Personal
Health Questionnaire-9), postconcussive symptoms (British
Columbia Postconcussion Symptom Inventory), and neuropsycho-
logical performance validity (Medical Symptom Validity Test;
MSVT).
Results:
The average age of the participants was 40.7 years; range,
19 to 64. The most common mechanisms of injury were struck by
object (33.3%), motor vehicle crash (27.6%), and falls (25.3%). The
neck and head/skull were the most commonly reported sites of pain
(85.1% and 79.3%, respectively). Some also reported pain in the
chest/abdomen/back (51.7%), arms/shoulders (57.5%), and pelvis/
legs (34.5%). Participants who failed performance validity testing
(n
¼
20) had a higher total pain score (M
¼
7.7) than those who passed
the MSVT, (n
¼
66) [M
¼
4.4; t(84)
¼
-4.33, p
<
.001, Cohen’s d
¼
-1.07]
regardless of clinic location. Total pain scores correlated with both
postconcussive symptom severity [r(66)
¼
0.40, p
¼
.001] and depres-
sion [r(66)
¼
0.46, p
<
.001]. These correlations were minimally
altered by excluding patients who failed performance validity
testing.
Conclusions:
Pain in body regions other than the head was com-
mon, highlighting the need for thorough pain assessments for
patients seeking treatment in mTBI clinics. Clinicians should be
aware of possible pain over-reporting, and the association
between depression and pain in patients who are likely not over-
reporting.
Level of Evidence:
Level II
S167
Abstracts / PM R 9 (2017) S131-S290