Stroke e17

Poster 20

Concurrent Validity of the Stroke Upper Limb Capacity Scale (SULCS)

Daniel C. Tufaro (New York Presbyterian Hospital), Joan Toglia,Michael O’Dell, Mark Villanueva

Objective: The SULCS is a new measure of upper limb capacity. We

examine the relationship between the SULCS and measures of impairment

(Upper Extremity Motricity Index, UE-MI) and activity limitation

(Functional Independence Measure-Self Care, FIMsc).

Design: Criterion standard, descriptive.

Setting: Inpatient Rehabilitation Unit.

Participants: Inpatients with stroke (nZ74) with a mean ageZ71(�14)

years, National Institutes of Health Stroke ScaleZ 9(�7), median days

post strokeZ 7, and 38% with left brain lesion.

Interventions: Not applicable.Main Outcome Measure(s): All measures were performed at admission.

Frequency distributions of assessment scores and correlations with the

SULCS were analyzed.

Results: The SULCS held strong relationships with the UE-MI (rhoZ.90,

pZ.000) and FIMsc (rhoZ.77, pZ.000).Eleven and 12% of SULCS scores

were at the highest and lowest values, respectivelywhile 30% and 19%of the

UE-MI scores were at the highest and lowest value, respectively.

Conclusions: The SULCS is strongly related to measures of impairment

and activity limitations supporting its concurrent validity. Although both

are brief and easy to administer, the UE-MI demonstrated a ceiling and

floor effect compared to the SULCS. Results suggest the SULCS may be

useful as a brief measure of upper extremity capacity for persons with

stroke in the acute rehabilitation phase.

Key Words: assessment, stroke, upper extremity rehab

Disclosure(s): None Disclosed.

Poster 21

The Reality of Virtual Reality In Stroke Rehabilitation

Jocelyn Harris (School of Rehabilitation Science, McMaster University),Heidi Sveistrup, Stephanie M N Glegg, Heather Colquhoun,Hillel Finestone, Pat Miller, Vincent DePaul, Laurie Wishart, Marie Brien

Objective: To design, implement and evaluate the effectiveness of a

knowledge translation (KT) strategy to support therapists in acquiring

proficiency with the Interactive Rehabilitation Exercise System (IREX;

GestureTek) while emphasizing integration of motor learning strategies

(MLS) during virtual reality (VR) interventions. VR systems are promising

treatment options in stroke rehabilitation because they can incorporate

MLS supporting motivating task-oriented practice.

Design: Before-after trial.Setting: Stroke rehabilitation unit.

Participants: Four physical therapists and 3 occupational therapists partici-

pated in the KT strategy and provided VR-based therapy to 24 clients

with stroke.

Interventions: The KT strategy included e-learning modules, group and

individual practice, and audit and feedback. Content included practicalities

of VR system operation with a focus on clinical application of MLS.

Main Outcome Measure(s): Standardized instruments were used to evaluate

changes in therapists’ VR knowledge, attitudes and behaviors; use of MLS

(videotaped sessions), and decision-making related to integratingMLS during

VR use. Professional experiences were captured through a focus group.

Results: Significant pre-post changes in therapist self-efficacy (pZ0.041)

were observed. However, therapists used few MLS, with no significant

improvement in MLS use over time. While therapists reported increased

knowledge about motor learning and understanding of the VR system,

difficulties with IREX operation appeared to lead to challenges assimi-

lating learning in the two domains. Integration of MLS seemed to take a

backseat to managing technical VR issues.

Conclusions: Future KT strategies should consider a phased approach

whereby proficiency in VR system operation precedes integration of a

theoretical approach to treatment.

www.archives-pmr.org

Key Words: Knowledge translation, Virtual reality therapy, Stroke,

Rehabilitation

Disclosure(s): None disclosed.

Poster 22

Comparing the Evidence for Interventions for CommunicationDeficits in Stroke and Acquired Brain Injuries

Danielle Brittany Rice (Lawson Health Research Institute),Laura Allen, Robert William Teasell

Objective: To compare and contrast the stroke and acquired brain injury

(ABI) rehabilitation literature for communication deficits.

Data Sources: Using the Evidence Based Review of Stroke Rehabilitation

(EBRSR) and the Evidence Based Review of Acquired Brain Injury

(ERABI) databases, we extracted all randomized control trials (RCTs)

from 1970 to 2013. Articles were identified through a literature search of

multiple databases (e.g. Psychinfo, Scopus, PubMed).

Study Selection: Studies were included if the sample population included

patients � 18 years old post ABI (moderate to severe) or stroke receiving

an intervention for a communication disorder.

Data Extraction: The sample size, year of publication and type of inter-

vention were extracted from each study that met inclusion criteria.

Data Synthesis: The literature for communication disorders revealed more

RCTs for stroke interventions (nZ50) than RCTs for ABI interventions

(nZ31). There was overlap in many interventions used in both populations

such as training communication partners, pharmaceuticals and group

therapy. Speech language therapy was an effective and common inter-

vention for aphasia post stroke (8 RCTs); however, for ABI there were no

RCTs looking at speech language therapy. The prevalence of aphasia in

ABI patients has been reported as high as 30% suggesting that in the case

of speech language therapy for aphasia in ABI, evidence-based practice

may need to rely on stroke rehabilitation evidence.

Conclusions: Considering the commonalities of communication deficits

within stroke and ABI, when supporting evidence for interventions is weak

in one population, such as aphasia treatment after ABI, it may be beneficial

to rely on strong evidence within the other area, i.e. stroke rehabilitation.

Key Words: Aphasia, Communication deficits, Stroke, Acquired

Brain Injury

Disclosure(s): None Disclosed.

Poster 23

Interventions for Depression: Combining the Stroke and AcquiredBrain Injury Rehabilitation Literature

Danielle Brittany Rice (Lawson Health Research Institute),Mona Madady, Marina Richardson, Swati Mehta, Robert William Teasell

Objective: To compare and contrast the stroke and acquired brain injury

(ABI) rehabilitation literature of depression.

Data Sources: Using the Evidence Based Review of Stroke Rehabilitation

(EBRSR) and the Evidence Based Review of Acquired Brain Injury

(ERABI) databases we extracted all randomized control trials (RCTs) from

1970 to 2013. These databases include articles identified through a sys-

tematic search of the research literature from databases such as PsychInfo

and Scopus.

Study Selection: Studies were included if the sample population included

patients � 18 years old post ABI (moderate to severe) or stroke, receiving

an intervention for depression.

Data Extraction: The sample size, year of publication and type of inter-

vention were extracted from each study that met inclusion criteria.

Data Synthesis: Each RCT was categorized according to type of interven-

tion, and was further classified as pharmacological or non-pharmacological

interventions. The numbers of RCTs, sample sizes, and publication dates

were compared between stroke and ABI. Both pharmacological and non-

pharmacological intervention data sets were dominated by stroke RCTs.

There were over 3 times as many pharmacological RCTs in stroke compared

to ABI, and over 4 times as many non-pharmacological RCTs. The