Poster 87 Activity Changes Following Treatment of Lumbar Spinal Stenosis

Results: Data were tested for normality. No statistical differenceswere found in any variable between males and females (all P�.05),and hence males and females were combined for the analysis. Therewere far fewer significant correlations in the s/e pain severity group,even though there was a larger number of them in the sample. RMQwas not correlated with any measure in the s/e group, but wascorrelated with several measures in the m/m group: PDQ-Total(r�.529, P�.024); MODQ (r�.590, P�.010); PF (r��.579,P�.012); and, PI (r�.628, P�.005). MODQ was not correlatedwith any measure in the s/e group, but was correlated in m/m withboth PI (r�.546, P�.019) and RMQ (r�.590, P�.010). PDQ-Totalscores were correlated with PI and PF in the mild/moderate group,but not in the s/e group.Conclusions: Disability was driven primarily by measures ofpain and global health and not by their multi-morbidity burden.Because the PDQ is a simple and useful clinical tool, we suggest thatphysicians should make a routine attempt to characterize the func-tional status of patients due to LBP-related impairments. We believethat identifying potentially modifiable disability determinants inLBP patients provides an opportunity to broaden strategies to re-duce its socioeconomic burden.

Poster 87Activity Changes Following Treatment of LumbarSpinal Stenosis.Matthew Smuck, MD (Stanford University, RedwoodCity, CA, United States); Matthew Buman, PhD; WilliamHaskell, PhD; Ma Agnes Ith; Bonny Masters, MD.

Disclosures: M. Smuck, Research grants: NASS, Other ISIS, Cy-tonics Inc., Consulting fees: Arthrocare Inc., EMKinetics Inc.Objective: To assess changes in physical activity (objective andself-report) in patients with lumbar spinal stenosis undergoingdecompression surgery.Design: Prospective observational cohort study.Setting: Laboratory; outpatient spine center.Participants: 14 subjects scheduled for surgical decompressionof lumbar spinal stenosis.Interventions: Patients wore an accelerometer for 7 consecutivedays (Actigraph GT3x�), performed a self-paced walking test(SPWT), completed a battery of validated disease-specific functionaloutcomes questionnaires and a self-reported 7-day activity ques-tionnaire at baseline, 1-month post-operation, and 3-months post-operation. Moderate-vigorous physical activity (MVPA) was definedusing published thresholds (�1952cts/min) for accelerometer dataand standard metabolic equivalents (�3.0 METS) for reportedactivities. Mixed-effects models were fitted to examine within-groupchanges in these variables.Main Outcome Measures: Activity levels provided by accel-erometry; Swiss Spinal Stenosis Questionnaire, Neurogenic Claudi-cation Outcome Score, Oswestry Disability Index, and SF-36.Results: Patients (N�14) were 57% female, 43% Caucasian, over-weight (27.6�5.1kg/m2), and of older age (73.4�8.1 years). The1-month and 3-month measures demonstrated statistically signifi-cant (P�.05) improvements in the SPWT and all functional out-comes questionnaires (Swiss Spinal Stenosis Questionnaire, Neuro-genic Claudication Outcome Score, Oswestry Disability Index, andSF-36 subscales: physical function, role physical, bodily pain andsocial functioning). Improvements in accelerometer MVPA were notsignificant (P�.05); however, effect sizes were moderate to large for

accelerometer-derived MVPA at 1 month (diff�9.6mins, d�0.98)and 3 months (diff�8.0mins, d�0.4), and small for self-reportedPA at 1 month (diff�5.3mins,d�.01) and 3 months (diff�99.2mins, d�0.3).Conclusions: Future research is needed to confirm these resultsin a larger sample, with longer-term follow-up and with comparisonto controls.

Poster 88Effect of Post-Acute Rehabilitation Setting onFunctional Outcomes of Persons UndergoingDysvascular Lower Extremity Amputations.Carley N. Sauter, MD (Medical College of WisconsinAffiliated Hospitals, Milwaukee, WI, United States); Tim-othy R. Dillingham, MD; Liliana E. Pezzin, PhD.

Disclosures: C. N. Sauter, No Disclosures.Objective: To examine the effect of post-acute rehabilitationsetting on functional outcomes in patients undergoing major lowerextremity dysvascular amputations.Setting: A population-based, prospective cohort study conductedin Maryland and Wisconsin. Data were collected from medicalrecords and patient interviews during acute hospitalization follow-ing amputation and a 6-month follow-up survey.Results: There were 297 patients analyzed based on post-acutecare rehabilitation setting: acute inpatient rehabilitation (IRF),skilled nursing facility (SNF), or home. The majority (43.4%) re-ceived care in IRF, 32% in SNF, and 24.6% at home. On SF-36subscales, significantly improved outcomes were seen with IRFcompared to SNF in physical function (PF), role physical (RF) andphysical component score (PCS). IRFs yielded better RF and PCSoutcomes compared to home. Subanalysis showed higher likeli-hood of patients being in top quartile for general health in IRFcompared to SNF or home and less likelihood of being in bottomquartile for PF, RF and PCS in IRF compared to SNF. Less ADLimpairment was observed in IRF compared to SNF.Conclusions: Among patients with dysvascular lower limb am-putations, receiving interdisciplinary rehabilitation services in IRFsfollowing acute hospitalization demonstrated improved functionaloutcomes 6 months after amputation compared to SNFs or home.

Poster 89Severity of Cervical Dystonia: BaselineCharacteristics from the Cervical Dystonia PatientRegistry for Observation of OnabotulinumtoxinAEfficacy (CD PROBE).David Charles, MD (Vanderbilt University Medical Cen-ter, Nashville, TN, United States); Charles H. Adler, MD,PhD; Mitchell F. Brin, MD; Joseph Jankovic; SpyridonPapapetropoulos, MD, PhD; Marc Schwartz, BS; MarkStacy, MD.

Disclosures: D. Charles, Research grants: Allergan, Ipsen, Merz,Medtronic; Consulting fees: Allergan, Ipsen, Medtronic.Objective: To evaluate the relation between physician assess-ment of CD severity, patient demographics, disease characteristics,and treatment approaches in a large sample of CD patients.Design: CD-PROBE is a prospective, open-label, multi-center,observational, longitudinal registry evaluating the treatment of CDwith onabotulinumtoxinA (Botox®) in differing clinical settings(NCT00836017).

S219PM&R Vol. 4, Iss. 10S, 2012