Stroke e31

clinics completed: 3 English and 3 Spanish. 32 participants completed 6-

month follow up. Phase 2 (nZ59) and formative evaluation are in progress.

Conclusions: HEALS Phase 1 suggests that a six week lifestyle manage-

ment program consisting of a 2-hour small group format, healthy lifestyle

content, and led by an occupational therapist may be feasible for the

proposed population. Phase 2 will confirm these notions.

Key Words: lifestyle, stroke, behaviorDisclosure(s): None Disclosed.

Poster 70

Recollection Training in Stroke Survivors: A Pilot Study

Janine Jennings, Lisa Walker, Ves Stamenova (Rotman ResearchInstitute at Baycrest), Fu-Qiang Gao, Shaun P. Cook, Andra Smith,Patrick Davidson

Objective: To examine the feasibility and effectiveness of a recollection

memory training paradigm.

Design: A single-blind non-randomized trial.

Setting: Community setting.

Participants: Eighteen stroke patients and thirty healthy age-matched

control participants.

Interventions: All participants performed three self-adaptive training

sessions per week for two weeks. Each training day, they completed four

sessions (each session involved studying one word list and then performing

a recognition memory test).

Main Outcome Measure(s): Training task improvement was established

based on the number of levels each participant gained in the training. To

establish transfer effects, participants were assessed at baseline and

post-training on a series of neuropsychological measures of working

memory, verbal and visual long-term memory, and source memory.

Clinical MRI and CT scans were used to establish stroke lesion size

and location.

Results: A repeated measures ANOVA showed that the patients and

controls improved to similar degrees on the training task. Significant

transfer effects following training were observed only in backward digit

span. Changes in forward digit span, digit symbol, and spatial source

memory scores approached significance. These effects were observed in

both groups of participants. We found no obvious link between lesion

location and training gains.

Conclusions: Although we found that many stroke patients can improve on

the training task itself to the same degree as healthy controls, we found

little evidence for transfer of training.However, the trainingwas tolerated

by all the patients, including the most impaired ones, and should be further

explored in future work.

Key Words: memory, Stroke, rehabilitation

Disclosure(s): Nothing to disclose.

Poster 71

Independent Mobility and Physical ACtivity Training (IMPACT) on aStroke Rehabilitation Unit: A Pilot Study

Vincent DePaul (Toronto Rehabilitation Institute),Wieslaw Jan Oczkowski, Michaela Ferguson, Laurie Wishart

Objective: To test the feasibility of a novel program that aims to engage

inpatients with stroke in extra task-oriented walking-related practice

outside of supervised physical therapy sessions.

Design: Prospective cohort pilot study.

Setting: Inpatient stroke rehabilitation unit.

Participants: Convenient sample of 10 adults (mean age Z 62.3 years

[MIN 37, MAX 78]) admitted to a subacute inpatient stroke rehabilita-

tion unit.

Interventions: The IMPACT program is based in principles of motor

learning (abundant, task-oriented practice), self-management, and self-

www.archives-pmr.org

determination theory. Patients negotiated a walking-related goal, devel-

oped a plan to practice walking-related activities outside of therapy, and

implemented, monitored and progressed the plan with intermittent thera-

pist guidance.

Main Outcome Measure(s): Feasibility outcomes included successful goal

setting, practice plan development and completion, and change in gait

speed (GS), six minute walk test (SMWT), Functional Ambulation Clas-

sification (FAC), and Functional Independence Measure (FIM) over the 2

week intervention.

Results: Nine of 10 participants developed and initiated an independent

walking task-oriented activity plan. On 70% of study days, participants

completed or exceeded their negotiated practice. Eight of 10 participants

carried out the practice independently and reported that they would

continue beyond the study period. On average participants made mean-

ingful changes in FAC scores (Median 2, MIN 0 MAX 3), GS (Median

0.21 m/s [min 0.04 MAX 1.08]) m/s); FIM (Median Z 25 [MIN 4, MAX

54]); 6MWT (MedianZ 65 m [MIN 8, MAX 190]). There were no falls or

serious adverse events.

Conclusions: The IMPACT program was shown to be safe, feasible

method of engaging inpatients with stroke in additional task-oriented

practice. A randomized controlled cluster trial is planned to further eval-

uate this novel intervention.

Key Words: rehabilitation, stroke, walking, learningDisclosure(s): None disclosed.

Poster 72

Relationship Between Step Length, Cadence and Capacity to IncreaseGait Velocity After Recent Stroke

Vincent DePaul (Toronto Rehabilitation Institute - UHN),Kara Kathleen Patterson, Elizabeth L. Inness, Avril Mansfield,George Mochizuki, William McIlroy

Objective: 1) To quantify the capacity for individuals with recent stroke

to increase gait velocity from comfortable to maximum pace during

overground walking; 2) To describe the relationship between step length

[SL], cadence [Cad], the ratio of SL:Cad, and capacity to in-

crease velocity.

Design: Retrospective chart review.

Setting: Inpatient stroke rehabilitation

Participants: Consecutive sample of 245 ambulatory adults (age 67.6

years [SD 13.9]) admitted to an inpatient stroke rehabilitation unit.

Interventions: Not applicable.Main Outcome Measure(s): Gait parameters (velocity, step length [SL],

cadence [Cad] and the ratio of SL:Cad) at comfortable velocity (CV),

and maximal velocity (MV) were measured using the GAITRite System.

Increase in gait velocity was calculated as difference between MV

and CV.

Results: The mean difference between CV and MV gait velocity was 0.32

(SD 0 .19; 95% CI[4.6, 61.4]) m/s with only 0.04 % of participants

demonstrating no difference between MVand CV. Increase in gait velocity

was positively associated with SL (rZ0.48, p <0.0001), SL:Cad ratio

(rZ0.27, p <0.0001), and Cad (rZ0.26, p <0.0001). Participants with

greater increase in gait velocity (MV-CV) had a significantly greater

SL:Cad ratio during CV (F[3, 238]Z 7.23 , p < 0.0001) and MV walking

(F[3,238]Z 10.14, p<0.0001).

Conclusions: On average, this group of ambulatory inpatients with recent

stroke was able to substantially increase their overground gait velocity. A

strategy that favored increased step length over cadence was positively

associated with an increased differential between CVand MV. It is possible

that training targeted to increasing step length over cadence may help

patients adopt a more effective strategy to increase gait velocity

following stroke.

Key Words: gait, stroke, rehabilitation, physical therapy