PM&R Vol. 6, Iss. 8S2, 2014 S123

occurred as direction-dependent brain activation. SCPD technique mayfacilitate the descending motor commands.

No. 134 The Proper Choice of Arm Sling for Hemiplegic andHemiparetic Patients.Yu Ri Son, MD; Min Ho Chun, MD; Sook Joung Lee; Jin Hwa Yi.

There has been no proper indication of arm sling for stroke patients.This study was designed to determine the proper arm sling for strokepatients according to the motor recovery state by comparing the differ-ences in the effectiveness and satisfaction between Kenny-Howard (KH)type and extension (EXT) type sling. Hemiparetic and hemiplegic strokepatients who were within 3 months from stroke onset were enrolled inthis study. We excluded the patients who had a history of shouldertrauma or chronic stroke. We compared KH type sling and EXT typesling in hemiplegic patients group. Also we compared these slings inhemiparetic patients group. The vertical distance (VD), horizontaldistance (HD), and joint distance (JD) of the shoulders on the plainAP views were measured initially and 3 weeks after. Twenty four hemi-plegic patients and twenty one hemiparetic patients were included inthis study. There were no significant differences between the groupson baseline evaluation in hemiplegic group. The results were same inhemiparetic group. After the treatment all patients showed improvementin VD, HD and JD. There were no significant differences of upper limbtone between hemiplegic and hemiparetic patients after 3 weeks. Whenthe treatment effects were compared between the groups in hemiplegicpatients changes of VD significant improved in patients wearing KHtype sling. There were no significant differences among changes ofVD, HD and JD in hemiparetic group when KH or EXT type slingswere applied.

No. 135 The Influence of Patient’s Weight on StrokeRehabilitation Outcome.Iuly Treger, MD PhD MHA; Leonid Kalichman, PT PhD;Deborah Alperovitch-Najanson.

Disclosure: None. Objective: To check hypothesis that overweight caninfluence the stroke functional outcome and that rehabilitation is lesseffective in overweight and obese patients compared to normal weightpatients in terms of functional independence measure (FIM) improvementin first-event stroke patients. Design: Retrospective comparative study.Setting: Inpatient rehabilitation facility. Participants: 102 first-timestroke male and female patients admitted to the 52-bed acute neurologyrehabilitation department in a rehabilitation hospital were included in thestudy. Intervention: Body mass index (BMI) and FIM were fixed. Statis-tical tests were performed to find out the correlation between parameters.Main Outcome Measures: BMI, FIM on admission and at discharge,as well as the delta-FIM (FIM on admission e FIM at discharge) wereevaluated. Results: A statistically significant negative correlation (r¼-0.27p¼0.014) was found between FIM change and BMI. Conclusions: Acutepost stroke patients’ rehabilitation effectiveness is negatively associated withthe patients’ BMI in terms of improvement of functional parametersaccording to FIM measurements. Patients’ weight should be takeninto consideration when predicting rehabilitation outcome for strokepatients. Further investigations are needed to identify the functionalparameters affected by the patients’ weight. New rehabilitation strategiesshould be designed to improve functional outcomes of rehabilitation inobese patients.

No. 136 Impact of Home-Based Exercises on Function andWalking Ability of Stroke Patients.Iuly Treger, MD PhD MHA; Leonid Kalichman, PT PhD.

Disclosure: None. Objective: To evaluate the effect of post rehabilita-tion home-based exercises program on walking ability and function of

post-stroke patients upon returning home. Design: Single-blindedrandomized controlled trial. Setting: Inpatient rehabilitation facility.Participants: Ninety-eight ischemic stroke patients were randomlyassigned to an intervention or control group. Intervention: During thelast part of hospitalization subjects in the intervention group receiveda list with detailed program of 14 exercises and were instructed to walkat least 30 minutes daily. Physical therapists ensured that subjectsunderstood the exercises and were able to perform them independentlyaccording to the list. To monitor the execution of the exercises eachsubject in the intervention group received a diary in which the numberof exercises performed and amount of time spent walking were dailyrecorded and a phone call every two weeks encouraging the continuationof home-based training. Subjects in the control group received onlystandard discharge forms and only one phone call with a reminder of thefollow-up visit. Main Outcome Measures: The ten meter walk test(10MWT), six minute walk test (6MWT), and timed up & go (TUG) wereperformed twice at the end of the inpatient rehabilitation period and threemonths later (E1 and E2) by a researcher blinded to patients’ allocation.Results: No significant difference was found in the control group as toany studied parameter between E1 and E2. A significant improvement wasshown in the intervention group as to time parameter of the 10MWT(p¼0.008), 6MWT (p<0.001), and TUG (p¼0.009). When comparingdelta values (E2-E1) for each test we found that only 6MWT significantlydiffered between the two groups and no difference was found in the10MWT and TUG. Conclusions: Home-based exercises significantlyimproved the 6MWT results in post-stroke patients. We recommendintegrating home-based exercises into the standard post-hospitalizationstroke rehabilitation.

No. 137 Functional Outcome of Ischemic andHemorrhagic Stroke Patients After InpatientRehabilitation.Maria Vazquez Guimaraens; Belen Maside Oliete;Veronica Rodriguez Lopez; Carmen Crespo Lopez.

Objectives: To quantify recovery after rehabilitation therapy andto identify factors that predicted functional outcome in survivors ofintracerebral hemorrhage (ICH) compared with cerebral infarction.Design: Retrospective study of consecutive stroke admissions to a reha-bilitation hospital over a 2-year period. Setting: Rehabilitation unit.Participants: We retrospectively identified all persons with a diagnosis ofstroke who were consecutively admitted to Hospital Marítimo de Oza (ACoruña, Spain) between January 1, 2012, and December 31, 2013. A total of156 cases met the inclusion criteria (56 women, 100 men; 102 with cerebralinfarction, 54 with ICH; 133 supratentorial lesion; 48.7 % left laterality).Interventions: Not applicable. Main Outcome Measures: Func-tional status was measured using the Functional Independence Measure-ment (FIM motor, FIM cognitive, and FIM total score) recorded atadmission and discharge. Recovery was quantified by the rate of FIM changewith time and the main outcome measures were total discharge FIM (motor,cognitive and total score). Univariate and multivariate analyses were per-formed. Level of Evidence: Level 2 (mid-level). Results: AdmissionFIM cognitive was higher in patients with cerebral infarction than inpatients with ICH (20 vs 16 p¼.014). Discharge FIM cognitive scorewas higher in patients with cerebral infarction than in patients with ICH(26 vs 22 p¼.007). The patients with ICH had longer rehabilitationlength of stay (LOS) than in patients with cerebral infarction (94 vs 76p¼.043). No difference in discharge FIM motor and FIM total score werepresent. On multivariate analysis, admission FIM motor, admissionFIM cognitive, supratentorial lesion, and LOS independently predictedtotal discharge FIM. Admission FIM motor, supratentorial lesion, andLOS independently predicted the rate of FIM change with time.Conclusions: The patients with ICH had greater functional impairmentthan the cerebral infarction patients at admission and discharge. Initial

S124 PRESENTATIONS

severity of disability, localization of lesion and LOS predicted functionaloutcome after rehabilitation.

No. 138 Functional Imaging Study Comparing MovementMirroring With Movement Observation in Both Hands in anOtherwise Identical Setting.Jing Wang; Dohle Christian; Mauritz Karl Heinze;Fritzsch Claire.

Objective: To compare lateralized cerebral activations elicited duringself-initiated movement mirroring and observation of movements.Design: Functional imaging study comparing movement mirroring withmovement observation in both hands in an otherwise identical setting.Imaging data were analysed using statistical parametric mapping softwarewith significance threshold set at p<0.01 (false discovery rate) anda minimum cluster size of 20 voxels. Setting: MRI department. Partic-ipants: A total of 15 right-handed healthy subjects age range 22-56 years.Intervention: Not applicable. Main Outcome Measures: Cerebralactivation during movement mirroring and movement observation. Levelof Evidence: level 1. Results: Movement mirroring induced additionalactivation in primary and higher-order visual areas strictly contralateral tothe limb seen by the subject. There was no significant difference of brainactivity when comparing movement observation of somebody else’s righthand with left hand. Conclusion: Lateralized cerebral activations areelicited by inversion of visual feedback (movement mirroring) but not bymovement observation.

No. 139 Full-Movement Neuromuscular ElectricalStimulation Can Reduce Plantar FlexorsSpasticity and Increase Ankle JointMovement But Can’t Improve Gait Functionin Stroke Patients.Yonghui Wang; Fei Meng; Yang Zhang; Shouwei Yue.

Disclosure: None. Objective: To investigate whether full-movementneuromuscular electrical stimulation (F-NMES), which could generatefull range movement when applied to motor point (MP) in subacutestroke patients, decreases spasticity and/or improves motor function moreeffectively than control sensory threshold-NMES (S-NMES) and motorthreshold-NMES (M-NMES) stimulation. Design: A randomized blindedcontrolled study. Setting: Physical therapy room and functional assess-ment room. Participants: 72 adult patients with subacute post-strokehemiplegia and spasticity were included in the study as subjects. Inter-ventions: Patients received 30-minute sessions of NMES on MP ofextensor digitorum longus twice a day for 5 days a week. The stimulationintensity of NMES was adjusted in terms of different requirements in 4groups: control S-NMES, M-NMES and F-NMES. Main OutcomeMeasures: Composite spasticity scale (CSS), the scale of ankle jointmotion function (AJMF) and the gait velocity by the timed up and gotest (TUGT) were assessed at the times of before treatment, 4 weeks oftreatment, and 2 weeks follow up. Level of Evidence: Level 1.Results: After 4 weeks of treatment when compared difference of pre-treatment and post -treatment with interclass only F-NMES groupproduced greater reduction percentage in CSS and the greaterimprovement in AJMF. Furthermore these improvements can be main-tained 2 weeks after treatment ended. However after 4 weeks oftreatment there was no significant difference in the percentage of increasein gait velocities by TUGT among 4 groups although in F-NMESgroup there had an obvious increased compared with pre-treatment.Conclusions: F-NMES with stimulus intensity generating full move-ment can significantly decrease plantar flexor spasticity and increase anklejoint movement but can’t improve gait function in subacute strokepatients. This work was supported by the NNSF of China (grant no.

81000855 and 81272155) and the NSF of Shandong (grant no.Zr2010hq021).

No. 145 The Effects of Biodex System AssistedBy Task-Specific Walking Training on Motor Functionof Lower Limbs After Stroke.Quya-Ping; Song Wei-Qun.

Objective: To explore the effects of Biodex system assisted by task-specific walking training on motor function of lower limbs after stroke.Methods: Selection method of balance and lower limb movementdysfunction after stroke patients with hemiplegia: 40 cases with randomnumber table method are divided into the experimental group and controlgroup: 20 patients in each group. The control group used conventionalrehabilitation treatment and the experimental group had routine rehabili-tation treatment application with Biodex training system auxiliary task-specific walking training. Two groups of before and after treatment,respectively, for stability index, BBS, TUGT, most step speed, stride length,FMA, MBI, FAC for patients with balance and lower limb motor func-tion were assessed. Results: Before treatment, the difference in indicatorsbetween the two groups of patients was not statistically significant (p>0.05); after treatment BBS from 22.42 � 4.13 increased to 49.37 � 3.96;step from 30.31 � 11.10 increased to 53.70 � 12.13; FMA from 15.43 �5.71 increased to 30.50 � 4.25; MBI from 56.78 � 10.32 up to 80.87 �13.75. Experimental Group (p <0.05) than before treatment wasstatistically significant between groups (p <0.01) were significant.Conclusion: Biodex system assisted by task-specific walking training hasa good effect on balance and lower limb motor function after stroke.

No. 146 A Comparison Regarding ADL Recovery BetweenPercutaneous Endoscopic Gastrostomy and NasogastricTube Feeding in Patients With Dysphagic Stroke ina Convalescent Rehabilitation Ward.Ikenaga Yasunori; Nakayama Sayaka; Taniguchi Hiroki;Nahoko Komatsu.

Objective: To compare percutaneous endoscopic gastrostomy (PEG)with nasogastric tube feeding (NGT) after dysphagic stroke in terms of ADLrecovery. Design: Retrospective cohort study. Setting: A convalescentrehabilitation ward. Participants: A total of 67 patients with PEG or NGTfrom November 1, 2008, to October 31, 2013, were included. All patientswere diagnosed with stroke in an acute-care hospital and went to theconvalescent rehabilitation ward within two months. Patients were dividedinto the PEG group (n¼25) and NGT (n¼42) group. Two groups werecompared to existing demographic data, GCS, swallowing severity, NIHSS,FIM instrument scores on admission. Length of hospital stay, training time,FIM efficiency, and the rate of complete oral intake were compared betweenthe two groups. Logistic regression analysis and multiple regression analysiswere used to show the factors for complete oral intake and FIM gains duringhospital stay. Ethical committee in the hospital approved this study.Interventions: Not applicable. Main Outcome Measures: FIMinstrument scores, dysphagia severity scale (DSS), functional oral intakescale (FOIS), length of hospital stay, FIM efficiency score, and the rate ofcomplete oral intake. Results: Demographic data were similar between thetwo groups. No significant differences were found in GCS, NIHSS, DSS-FOIS and FIM instrument scores on admission. No significant differenceswere found in length of hospital stay and training time. Significant differ-ences were found as follows: the rate of complete oral intake (PEG: 20.0%vs. NGT: 64.3% p<0.01); FIM efficiency (PEG: 0.093�0.13 vs. NGT:0.199�0.28 p¼0.17). Logistic regression analysis showed that cognitiveFIM scores, DSS, and the method of tube feeding (PEG or NGT) contributedto the higher recovery rate of complete oral intake (hr: 1.23 95% CI: 1.07-1.38 hr: 4.56 95% CI: 1.51-13.79 and hr: 12.3 95% CI: 2.27-66.76,respectively). Multiple regression analysis indicated that GCS and themethod of tube feeding contributed to FIM gains during hospitalization(p<0.01 and p¼0.04, respectively).