Stroke e19

Compare whether voluntary versus involuntary termination differs, for

employees that fail to maintain post-stroke employment, based on

employer type.

Design: Online convenience sample survey of a pertinent group of working

age stroke survivors.

Setting: Stroke support group on Facebook. Members were invited to an

event, lasting for a 90-day period, and providing the survey link within the

confines of the closed group on Facebook.

Participants: 71 stroke survivors between the ages of 18 and 65, 12

months post stroke, diagnosed with one incidence of stroke, having

participated in an inpatient rehabilitation program along with residing in

US and working at time of stroke.

Interventions: Not applicable.Main Outcome Measure(s): Measure the post-stroke return rate to the

same employer compared to a different employer and the resulting voca-

tional outcome.

Results: Of the respondents, 40.8% returned to work at their same

employer and 11.3% returned to a different employer, and 46.9% did not

return to work. 16.9% of the population was unable to maintain their post-

stroke employment. Of the terminated same employer employees, 75.0%

were terminated involuntarily and of the different employer terminations,

75.0% were voluntary.

Conclusions: Our results suggest that different challenges are faced by

stroke survivors when attempting to return to work in these two different

work environments; demonstrating that the need for vocational rehabili-

tation assistance, and supported employment, remains even when returning

to the same employer.

Key Words: Rehabilitation, Vocational, Stroke, Employment, Supported,

Disabled Persons

Disclosure(s): None Disclosed.

Poster 28

Inpatient Rehabilitation Facility Admission Outcomes Specific forPatients with Stroke Predict Community Discharge

Emily Rosario (Casa Colina Centers for Rehabilitation),Stephanie Kaplan

Objective: To use IRF admission outcomes specific for patients with stroke

to predict community discharge.

Design: Retrospective study.

Setting: Inpatient Rehabilitation Hospital.

Participants: Patients hospitalized for a stroke.

Interventions: N/A.Main Outcome Measure(s): Admission data from the Functional Inde-

pendence Measure (FIM) and Stroke Rehabilitation Assessment of

Movement (STREAM) were used to determine predictive factors for a

community discharge and FIM walk/wheelchair score of 5 or above. A

discriminant analysis, logistic regression, and chi-square analysis were

used to identify admission variables.

Results: 296 subjects were included in this retrospective analysis; 24% of

subjects did not have a community discharge and 54% did not discharge

with a FIM walk / wheelchair score of 5 or above. Five admission factors

were identified as predictive for a community discharge or a walk/

wheelchair FIM score of 5 or above; the Stream, Motor FIM, Total FIM,

FIM Bladder control, and FIM social interaction. The sensitivity for each

variable ranged from 61% e 94% while the specificity was between 40%

and 65%. When all five variables were combined 83% of non-community

discharges were identified (77% of patients with a walk wheelchair score

of below 5).

Conclusions: By using admission outcomes, community discharge can be

predicted with significant sensitivity. Patients identified as at risk for a non-

community discharge may be targeted for specialized interventions. Pro-

spective evaluation of the predictive ability of the above-identified factors

is warranted.

www.archives-pmr.org

Key Words: outcome measures, stroke, community discharge, Inpatient

rehabilitation facility, Functional Independence measure

Disclosure(s): None Disclosed.

Poster 29

WITHDRAWN

Poster 30

The Effects of Playing Electronic Musical Instruments During At-Home Rehabilitation on Hemiplegic Upper Limb Function

Fumihito Kasai (Showa University Kohtohtoyosu Hospital),Shinichi Wada, Masazumi Mizuma

Objective: To investigate the effects of at-home rehabilitation on the

functional improvement of hemiplegic upper limbs by playing electronic

musical instruments in stroke patients.

Design: Before-and-after trial, Experimental clinical research.

Setting: Visiting a university hospital as an outpatient.

Participants: Twelve cases of hemiplegic patients, averaging 56�6.4

years old, having suffered brain stroke and living at home in which 8 to

270 months have passed since onset.

Interventions: An guitar type electrophone and electronic drumwere rented

out to the homes of the patients as electronic musical instruments; in-

structions were given to play these instruments once a week as an outpatient

for 3 weeks each for a total of 6 weeks, and patients were trained to play the

instruments using their paralyzed upper limbs. A set piece was specified

weekly, and practice at home of at least 30 minutes a day was imposed. On

that basis, changes in motor function and muscle spasms were evaluated.

Main Outcome Measure(s): Fugl-Meyer Assessment of motor function

items of the upper limb (on a scale of 0 to 66) and Modified Ashworth

Scale (MAS).

Results: The Fugl-Meyer Assessment of motor function items of the upper

limb improved from an average of 36.17 prior to the experiment to 41.67

following the experiment (p<0.01). Although temporal improvement was

confirmed in muscle spasms following the experiment, there was no

change in MAS throughout the entire training period.

Conclusions: Rehabilitation of the paralyzed upper limbs by playing music

have a good effect for the paralytic improvement of the stroke patients at home.

Key Words: Music therapy, Stroke patients, At-home rehabilitation,

Hemiplegic upper limb

Disclosure(s): None Disclosed.

Poster 31

A Systematic Literature Review of the Effects of Attentional FocusDuring Motor Training

Grace J. Kim (NewYork Presbyterian Hospital-Weill Cornell MedicalCenter)

Objective: To understand the current literature for the effects of attentionalfocus instructions during motor skill training after stroke and for healthy

individuals.

To identify future areas of research in this area.

Design: A systematic literature review on the effects of attentional focus

for motor training was conducted in the following databases: PubMed,

MEDLINE, CINAHL, OTSeeker, and PEDro. Key search terms included:

attentional focus, external focus of attention, internal focus of attention,

motor learning, stroke, motor rehabilitation, motor recovery, upper limb,

upper extremity. Studies with healthy populations and individuals with

stroke were reviewed and analyzed.

Setting: NA.Participants: NA.Interventions: NA.Main Outcome Measure(s): NA.