S182 S290
Conclusions:
Screening tools such as the Hendrich II Fall Risk Model
are commonly used in most hospital setting. However, our study sug-
gests that simple modifications can improve sensitivity and improve
outcomes. Despite increasing medical acuity of the patient popula-
tion, the falls rate has not only remained below the national average
but improved more dramatically.
Level of Evidence:
Level III
Poster 154:
Root Cause Analysis of Late Admissions to the Acute
Rehabilitation Hospital
Annamaria L. Dunn, MD (JFK Med Cntr), Alessandra Dunn, Student
Disclosures:
Annamaria Dunn: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
To perform a root cause analysis to determine the cause of
late admissions to an acute rehabilitation hospital.
Design:
Charts were reviewed for a one year period. All patients
arriving after the 6PM cutoff from the main referral hospital were
included. List of probable causes was determined: Pending financial/
insurance clearance, awaiting discharge orders, awaiting testing,
ambulance transportation, family transportation, or other. Each late
arrival was assigned a cause based on chart review.
Setting:
Acute care 700 bed level one trauma center.
Acute rehabilitation hospital.
Participants:
Acute rehab admissions.
Interventions:
NA.
Main Outcome Measures:
Percentage of patients arriving late in each
category was determined in each of the probable causes.
Results:
Ambulance transportation was the main cause of late ad-
missions. Ambulance transportation 70%, awaiting discharge orders 2%,
awaiting test results 5%, pending financial/insurance clearance 10%,
family transportation 8%, other 5 %.
Conclusions:
Late admissions to the acute rehabilitation hospital can
be problematic due to staffing, inability to perform tests, and lack of
consultants. Ambulance transportation was the main reason for late
admissions. Pickup times were set but not adhered to by the ambu-
lance company. This information was brought to the acute hospital
administration and an overhaul of the system was performed. Ambu-
lance companies who adhered to pickup times became the preferred
provider.
Level of Evidence:
Level V
Poster 155:
Material Analysis of Prosthetic Sockets and
Comparison to Clinical Outcomes
Garrett Hurley, CPO (LIM Innovations, San Francisco, CA, United
States), George Burnard
Disclosures:
Garrett Hurley: Employment - LIM Innovations
Objective:
To quantify properties of materials in prosthetic sockets
and associate results with clinical outcomes.
Design:
Unblinded clinical study with amputee participants.
Setting:
Ambulatory plus laboratory.
Participants:
Volunteer amputee subjects.
Interventions:
The study relates to measuring physical attributes of
sockets fabricated from varied materials and associating these data
with the patient experience. Patient outcome measures and Hanspal
Socket Comfort Scores (SCS) were collected at intervals after patients
were fit with a prosthetic socket.
Main Outcome Measures:
Modular sockets prosthetics have been
designed and engineered with materials with the objective of better
complementing residual limb anatomy, thereby providing improved
comfort and function. Measurements of durometer, modulus of elas-
ticity, tensile modulus, and flexural modulus have been performed on
a dynamic modular socket system (a registered class 1 FDA device) and
on conventional laminated sockets, typically of integral hard plastic
construction. Materials tested in the modular socket include ther-
moset plastic, thermoplastic, thermoplastic fiber composites, 3D
printed plastic, and various textiles. Patient performance was evalu-
ated by users reporting Hanspal Socket Comfort Scores (SCS) at in-
tervals after patients were fit.
Results:
Material testing for dynamic modular sockets showed
greater variation in flexural modulus than that of conventional lami-
nated sockets. Patient reported Hanspal Socket Comfort Scores
doubled on average (
m
¼
101%, n
¼
75, p
<
.0001) with the dynamic
modular socket system as compared to conventional laminated
sockets.
Conclusions:
The results suggest that prosthetic sockets that better
mimic human anatomy by including greater variation in flexural moduli
could be a promising approach towards improved prosthetic outcomes.
Research directed to gain a better quantify and understand the rela-
tionship between socket materials and clinical outcomes is continuing.
Level of Evidence:
Level IV
Poster 156:
Correlation Between the M.D. Anderson Dysphagia
Inventory Scale and the UPDRS and Hoehn & Yahr
Disability Scale in Early Stage Parkinson’s Disease
Ting Ta Tsai (Taipei, Taiwan, R.O.C.), Yu Wei Hu, Resident,
Chin Man Wang, MD
Disclosures:
Ting Ta Tsai: I Have No Relevant Financial Relationships
To Disclose
Objective:
This study was designed to identify the correlation be-
tween the MDADI scales and the total Unified Parkinson Disorder Rating
Scale (UPDRS) scores in PD and Hoehn & Yahr disability scale (H&Y).
Design:
Prospective cohort study.
Setting:
Early-stage PD.
Participants:
42 patients with early-stage PD were recruited, the
subjects’ characteristics were recorded including age, gender, body
height, body weight, H&Y scale in the patients with PD. Furthermore,
MDADI scales and UPDRS questionnaires were also filled.
Interventions:
Not applicable.
Main Outcome Measures:
MD Anderson Dysphagia Inventory (MDADI)
questionnaires, total Unified Parkinson Disorder Rating Scale (UPDRS)
scores, Hoehn & Yahr disability scale (H&Y).
Results::
The swallowing subscale of UPDRS was correlated with
MDADI scales and showed global-subscale (r
¼
-0.487, p
¼
.001),
emotional-subscale (r
¼
-0.374, p
¼
.015), physical-subscale(r
¼
-0.358,
p
¼
.02) and the sum of all subscales (r
¼
-0.391, p
¼
.01). The total
UPDRS scores were correlated with each of four subscales and the sum
of all subscales (r
¼
-0.319, -0.309, -0.350, -0.451 and -0.448; p
¼
.040,
.046, .023, .003 and .003, respectively). The H&Y scale was correlated
with the physical-subscale (r
¼
-0.375, p
¼
.014) and the sum of all
subscales (r
¼
-0.336, p
¼
.03).
Conclusions:
MDADI questionnaires may be used to assess the impact
of dysphagia on the quality of life in PD patients. Besides, the pro-
gression of the disease may also influence the swallow-specific quality
of life (QOL) in PD patients.
Level of Evidence:
Level II
Poster 158:
Open-Source Rehabilitation Reference Mobile Web
Application: A Novel Approach to Creating
Collaborative Resources for Physiatrists in Training
George E. Marzloff, MD (Mt Sinai Hlth Sys, New York, New York, United
States), Tariq Z. Rajnarine, MD, Andrew Abdou, DO, Anokhi Mehta,
MD, Miguel X. Escalon, MD
Disclosures:
George Marzloff: I Have No Relevant Financial Relation-
ships To Disclose
S182
Abstracts / PM R 9 (2017) S131-S290