e34 Stroke Diagnosis

Results: Percent change scores per assessment before and after the 6

week home program. FMA-UE: subjects 1 and 4 had no change,

subject 2 had a 33% increase, subject 3 had a 25% decrease. AMAT:

Subject 1, 2, 4 had increases, 14.9%, 8.3%, 23.1% respectively.

Subject 3 had no change. MAL (amount of use scale): subject 1, 2, 3, 4

experienced increased scores, 1360%, 280%, 45.2%, and 170%

respectively.

Conclusions: All subjects were successfully trained with the Myomo in the

clinic and used the device at home independently for a 6 week period,

indicating the feasibility of our study design. The FMA-UE, an impairment

level outcome measure, showed the least improvement. However, most

subjects experienced improvements on the AMAT and the MAL, both

activity level assessments. Despite minimal improvements in motor

impairments, the improvements in MAL suggest that subjects increased

integration their affected arm in functional tasks during the 6

week program.

Key Words: elbow exoskeleton, upper extremity robotics, home training

program, activity monitor

Disclosure: Grace Kim has nothing to disclose; Lisa Rivera has nothing to

disclose.

Poster 65

Exercise After Stroke: Patient Adherence and Beliefs After DischargeFrom Physical Rehabilitation

Kristine Miller (Roudebush VAMC), Rebecca Porter,Erin Louise DeBaun, Marieke Van Puymbroeck, Arlene A. Schmid

Objective: Determine the proportion of people who received and adhered

to a prescribed home exercise program (HEP); describe perceived benefits

of exercise after a stroke.

Design: Cross-sectional mixed methods study

Setting: Seven stroke support group meetings

Participants: Adults (nZ55) with stroke discharged from physical reha-

bilitation within the previous 1-6 months and in attendance at a local stroke

support group meeting.

Interventions: No intervention: The participants completed a one time

survey at a stroke support group meeting

Main Outcome Measure(s): Data were collected through a written survey

which included demographics, receipt of a HEP (yes/no), adherence with

HEP (yes/no), and perceived benefits of exercise after stroke (open

ended question).

Results: The average age of participants was 67 years, and the

majority were male (67%). Forty-nine (89%) reported receiving a HEP,

and of those 49 participants, 32 (65%) reported adherence with the HEP.

Qualitative data support that exercise is perceived as beneficial after

stroke. Comments on perceived benefits fell into 4 categories: 1) general/

overall impact “Exercise is hope. Hope is vital to continue life at any

level,” 2) impairment-based improvements “Exercise made me stronger,”

3) functional/daily task-based improvements “I think the exercise I do has

really made a difference in my daily activities. I believe I wouldn’t be

where I am today If I hadn’t exercised,” and 4) maintenance/preventative

benefit “Keeps me from getting stiff.”

Conclusions: Adults with stroke perceive exercise as beneficial, but only

65% report adherence with a prescribed HEP. These findings suggest that

better understanding of how to educate and engage people with stroke in

appropriate post-rehabilitation exercise is needed.

Key Words: Stroke, Exercise Adherence, Exercise Barriers

Disclosure: Kristine Miller has nothing to disclose.

Poster 66

Trials and Tribulations of Establishing a Stroke Outcomes ClinicalDatabase

Andrea Mastrogiovanni (New York Presbyterian), Kerri Ann Fitzgerald,Joan Toglia, Michael O’Dell

Objective: To establish an interdisciplinary stroke outcome database

integrated into routine inpatient clinical care providing the infrastructure

and foundation for current and future research.

To select and implement a common set of clinical assessments for

inpatient stroke rehabilitation.

To characterize recovery patterns and rehabilitation outcomes and

assist in guiding future clinical decisions.

Design: DescriptiveSetting: Inpatient Rehabilitation Unit (IRU), New York-Presbyterian

Hospital/Weill Cornell Medical Center.

Participants: Patients admitted to the IRU with a primary diagnosis of

stroke and ability to complete core assessments.

Interventions: N/AMain Outcome Measure(s): Interdisciplinary outcome measures were

selected to represent the breadth of the International Classification of

Function as well as to be psychometrically sound, feasibile, and brief.

Motricity Index, Montreal Cognitive Assessment, Patient Health

Questionnaire (Depression)

Stroke Upper Limb Capacity Scale, Ten Meter Walk Test, Activity

Measure for Post Acute Care

Community Participation Index, Stroke Impact Scale

Results: Seamlessly integrating research into clinical care was extremely

challenging and required overcoming multiple obstacles and navigating the

hospital/academic medical center matrix structure. Systematic, clinical and

staff level challenges emerged:

A core set of domain specific assessment measures were chosen after

thorough review addressing all areas within the ICF classification.

Navigating Hospital Policies & Procedures, Unit Regulations and

MedicalCollege practices. (finances to obtain security clearance for data-

base, data management and software interface, electronic documentation

manipulation, privacy issues)

Educated staff, achieved staff by-in and understanding of need for

evidence-based outcomes and research in a clinical setting.

Conclusions: In the current healthcare environment there is an increasing need

for outcomes driven practice/data. Research and clinical care are often separated.

This project serves as a model for integrating clinical research into routine care.

Key Words: Stroke, Outcome, Assessments, Database

Disclosure: Andrea Mastrogiovanni has nothing to disclose; Kerri Fitz-

gerald has nothing to disclose.

Poster 67

Therapeutic-Yoga after Stroke: Effect on Walking Recovery

Kristine Miller (Roudebush VAMC), Rebecca Porter,Stephanie A. Combs, Peter Altenburger, Tracy A. Dierks, Marieke VanPuymbroeck, Arlene A. Schmid, Erin Louise DeBaun

Objective: Explore the effect of group therapeutic-yoga on walking

recovery after stroke.

Design: Secondary data analysis of randomized pilot study.

Setting: University-based rehabilitation research lab.

Participants: People with stroke (> 18 years of age), discharged from

stroke rehabilitation and who have persistent physical impairments.

Interventions: Group therapeutic-yoga lead by a certified yoga therapist

delivered 2 times per week for 12 weeks. The therapeutic-yoga interven-

tion emphasized breathing, postures, and meditation.

Main Outcome Measure(s): Demographic data were collected at base-

line and all other data were collected at baseline and 12-weeks. Outcome

data included fast walking speed (10 meter walk test), walking distance

(6 minute walk test), and spatiotemporal step parameter symmetry

(GAITRite mat).

Results: Twelve people enrolled and 9 completed the study. Paired t-tests

(Wilcoxon for non-normal data) were used to compare means between

baseline and 12-weeks. Fast walking speed was unchanged, but walking

distance improved (279 e 299 meters, pZ0.064) between baseline and

12-weeks. Step length symmetry demonstrated a significant change

(pZ0.05), but in a negative direction, indicating more asymmetry.

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