Neurodegenerative Diseases e33

Neurodegenerative Diseases

Poster 77

Correlates of Respiratory Function and Fatigue in Multiple Sclerosis

Andrew D. Ray (University at Buffalo), Martin C. Mahoney,Nadine M. Fisher

Objective: To examine the association between respiratory function and

fatigue in individuals with mild-to-moderate disability Multiple Scle-

rosis (MS).

Design: Survey.Setting: University laboratory.

Participants: Thirty-seven volunteers with mild-to-moderate MS (28 F/9

M, 52.7�10.2 years, EDSSZ3.5�1.9; EDSS range 1.0- 6.5). No patients

withdrew from the study.Exclusion criteria were a relapse or steroid use

within the past 6 weeks, smoker, wheelchair-bound, breathing/respiratory

illness within past 4 weeks, unable to pedal a stationary bike continuously

for 15 minutes or contraindications for exercise.

Interventions: Not applicable.Main Outcome Measure(s): Absolute and percent predicted values are

reported for maximal inspiratory (MIP) and expiratory (MEP) pressures,

forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1),

maximal voluntary ventilation (MVV12), and the Modified Fatigue Impact

Scale (MFIS).All subjects completed a series of secondary measures

including the 6-minute walk (6MWT), a timed stair climb, the Short Form

(SF)-36, the Epworth Sleepiness Scale and the Physical Activity and

Disability Scale (PADS).

Results: Significant correlations were shown between expiratory muscle

strength (MEP) and the MFIS: total (rZ-0.362, pZ0.028), physical fa-

tigue (rZ-0.360, pZ0.028) and psychosocial scores (rZ-0.382,

pZ0.020).Correlations were also shown between MVV12 (respiratory

muscle endurance) and both the % predicted 6MWT (rZ0.346, pZ0.045)

and the Epworth Sleepiness Scale (rZ0.447, pZ0.006).

Conclusions: Reductions in respiratory muscle strength and endurance

were observed that correlated with fatigue, physical function and sleep

quality in individuals with mild-to-moderate MS. These results are clini-

cally meaningful as fatigue is one of the most common and debilitating

symptoms associated with mild-to-moderate MS.

Key Words: Fatigue, Respiratory muscle, Multiple Sclerosis, Pulmonary

function, Exercise

Disclosure(s): None Disclosed.

Poster 78

Helpful Components of Rehabilitation for People With MultipleSclerosis

Anna-Liisa Salminen (The Social Insurance Institution),Maarit E. Karhula

Objective: To investigate the helpful components of rehabilitation from the

point of view of people with Multiple Sclerosis (MS).

Design: Qualitative focus group study.

Setting: The participants were six months through their two-year multi-

professional group-based out-patient rehabilitation programmes in three

regions of Finland.

Participants: Sixty-eight adults with MS. Their mean age was 47 years

and 68% of them were women. The median duration of their disease was

11.6 years.

Interventions: The participants shared six months’ experience of their

multi-professional group-based rehabilitation, and they had varying

experience of different types of individual therapies and in-patient

rehabilitation.

Main Outcome Measure(s): Inductively coded and counted components

from qualitative focus group data.

Results: Participants described 20 helpful components of rehabilitation

that were clustered to themes of the rehabilitee himself/herself, structures

www.archives-pmr.org

of everyday life, information, activity, environmental interventions, social

relationships and support. The most frequently described components were

peers, advice, physical exercise, assistive technology and home adapta-

tions, and personal responsibility.

Conclusions: The helpful components of rehabilitation that are of particular

importance to people with MS are diverse. They show the relevance of ICF

framework in rehabilitation and the need for a comprehensive view in

rehabilitation. The importance of peers and peer support should be taken into

account in rehabilitation planning and related recommendations. The find-

ings show that helpful rehabilitation for people with MS is not a set of

mechanistic interventions but requires good social relationships and support.

Key Words: person responsibility, multiple sclerosis, social support

Disclosure(s): None Disclosed.

Poster 79

Feasibility of Implementing a Computerized Working MemoryTraining Program in Patients With Pediatric-OnsetMultiple Sclerosis

Bravina Kuni (York University), E. Ann Yeh, Christine Till

Objective: To investigate feasibility of implementing a cognitive training

program in pediatric-onset multiple sclerosis (MS) patients.

Design: Pilot feasibility intervention study.

Setting: Computerized working memory (WM) training occurred in par-

ticipants’ homes.

Participants: Nine cognitively-impaired pediatric-onset MS patients

recruited from The Hospital for Sick Children in Toronto.

Interventions: Participants underwent a five-week (5 days/week) internet-based computer WM training program (Cogmed) that adapts level of task

difficulty based on individual performance. Weekly coaching was provided.

Main Outcome Measure(s): Cogmed-specific outcomes, questionnaire and

interview data, and standardized neuropsychological measures.

Results: From an eligible pool of 17 patients, 9 (mean age 19.3 � 4.1

years) agreed to undergo the training program. Six patients, particularly

those who required less parental supervision, completed the program

within the recommended time frame. On average, patients completed

44.6 � 5.2 minutes of active training per session. Active training time

correlated with average improvement on the practiced Cogmed tasks

(Spearman’s rhoZ.79, p <.05). Repeated measures ANOVA revealed

improved performance from baseline to follow-up on a non-trained test of

visual WM (p <.01) and a trend towards significance on a verbal WM task

(p <.10). There was no improvement on non-trained control tests.No

adverse symptoms were reported throughout the training period.

Conclusions: Pediatric-onset MS patients can tolerate and complete an

intensive cognitive rehabilitation program, though time-to-completion of

the program was influenced by the degree of independence exhibited by

the patient. Replication of near transfer effects is required using a larger

sample, controlled design, and a wider variety of tasks.

Key Words: Cognition, Demyelinating Diseases, Therapy, Computer-

Assisted, Psychology, Clinical

Disclosure(s): None Disclosed.

Poster 80

Factors that Influence Spasticity in Individuals with Stroke andMultiple Sclerosis

Janice Cheung, Jessica Hoang, Stephanie DiPoce (University ofToronto), Amanda Rancourt, Amy Levine, Farooq Ismail, Chris Boulias,Chetan P. Phadke

Objective: To describe the nature and impact of spasticity, determine

factors that are perceived to change spasticity, and to examine the rela-

tionship between chronicity and impact of spasticity on activities of daily

living in individuals with stroke and multiple sclerosis (MS).