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Age effect differences; 3. Effect of standing versus sitting in elderly adults.Setting: Geriatric rehabilitation center. Methods: The tasks involvedreaching to virtual balls appearing in random order on the left and right sideof TV screen connected to a computer. In the simple movement time (SMT)task, subjects were asked to touch each ball as soon as it appeared. In thego\no-go task the participants were asked to touch only the smooth lookingballs and avoid balls with spines. Total duration of each task was oneminute. For the reliability study 19 young healthy male and female subjectsperformed the tasks twice. To determine age effect, 18 young femalesubjects and 16 older female subjects performed the same tasks as in theprevious study. In the third study a group of 22 elderly participants per-formed both the SMT and go\no-go tasks while sitting and standing ina comfortable stance. Results: The interclass correlation coefficient (ICC)for the SMT and the go\no-go were 0.717 and 0.564, respectively. ANOVAresulted in significant age task and interaction effects. No differences werenoted in old subjects between performance while sitting or standing.Conclusions: The studied VR environment demonstrates moderate tohigh test retest reliability. Older adults respond more slowly particularlywhen faced with a go\no-go reaction. The need to maintain upward posturewhile maintaining a comfortable stance position does not challenge the oldersubjects sufficiently to effect movement time during stance.

No. 162 Role of a Foreign Non-Profit RehabilitationAssociation in a Large-Scale Natural Disaster: The PapaExperience in Typhoon Haiyan a Program Report.Rochelle Dymd; Ernesto Cruz, MD; Filipinas Ganchoon;Charles De Mesa, DO.

Setting: Tent city for displaced persons and a rural community in thetyphoon-affected area. Program: A relief/medical mission co-sponsoredby the Philippine American Physiatrist Association (PAPA). ProgramDescription: PAPA, a small group of US-based physiatrists of Filipinoheritage/descent partnered with the Philippine Academy of RehabilitationMedicine (PARM) a national rehabilitation society in conducting a relief andmedical mission to a tent city in San Jose Tacloban and the ruralcommunity of Burauen, Leyte, Philippines three months after typhoonHaiyan February 17-18, 2014. The group comprised of 8 physiatrists.Assessment/Results: 1200 and 300 hygiene kits were distributed at SanJose and Burauen, respectively. A basic need/medical screening survey wasadministered which identified basic needs as well as medical conditionsincluding disabilities. Free medical-rehabilitation consultations with limitedmedications were provided to residents in Burauen. Nearly half (46%) ofthe 283 patients served were pediatrics and 94 were males. Infections werethe most common diagnoses (143; 42%) followed by musculoskeletalconditions (62; 18%) of which 80% were degenerative joint disease.Seventeen neurological cases (5%) were evaluated. Discussion (rele-vance): At 3 months post-disaster primary care diagnoses includingsecondary injuries sustained during acquisition of basic provisions, relocation,and clean-up efforts were common in these two community populations.Physiatrists can effectively treat this range of conditions with specialized focuson musculoskeletal and neurological injuries as well as on persons withdisabilities. Medical follow-up of mission patients is a concern due to social,economical, and financial limitations. Conclusions: Physiatrists can playa significant role after a natural disaster. Through collaborations, a foreignnon-profit rehabilitation association and its members can provide valuabledirect support of local efforts in a large-scale natural disaster.

No. 163 Management Response in Post-TraumaticPseudarthrosis Scaphoid With Extracorporeal Shock WaveTherapy. A Case Report.Esquivia Carmen C., MD (Hospital Militar Central Bogotá, D.C.,Colombia); Pira Jo; Esquivia Pajaro Carmen;Pira Paredes Jose.

Disclosure: None. Setting: Tertiary care military hospital. Patient: A17-year-old male with scaphoid pseudarthrosis before surgical management.Case Description: The initial management performed was osteosynthesis

on the scaphoid bone and a pelvic graft of the nonunion focus. Theprocedure was described as unremarkable. However in subsequent outpa-tient controls after two months patient reported persistent pain. Radio-graphic examination showed an altered consolidation. After which he wasreferred to our service. In our perspective patient had preserved musclestrength in both upper limbs. Sensitivity was preserved without signs ofactive synovitis levels in the right carpal region. Patient is then considereda candidate for shock wave therapy. The patient received 5 sessions of shockwaves at a frequency of 14 beats per second with an intensity of 2 airpressure at 5 bar for a total of 6000 shots. Assessment/Results: After 5sessions a new x-ray is taken where improvement was evident in consoli-dation level. The nonunion of the left hand also had a decrease of 4 pointson the subjective pain scale. Physical examination did not indicatea decrease in range of motion. Finally there was an improvement indicatoron the score of quick functional scale. Discussion: Treatment withextracorporeal shock waves has proven effective to accelerate bone healing.However to our knowledge this is one of the first reported cases of improvedresults with shock wave therapy. Conclusion: Scaphoid pseudarthrosisrefers to the failure to consolidate a fracture at a navicular bone level. Severaltypes of treatments have been used to improve this union alteration onebeing extracorporeal shockwave therapy as described in this case presen-tation which showed excellent results.

No. 164 Randomized Controlled Trial: Decreased Pain andImproved Functionality By Using Intraarticular Injection ofBotulinum Toxin Type A Vs Intraarticular Injection WithMethylprednisolone in Knee Osteoarthrosis.Ethel Fluchaire; María Del Carmen Mora.

Objective: To prove that knee intraarticular injection with botulinumtoxin type A (TBA) in patients with knee osteoarthrosis (KOA) is moreeffective than those with knee intraarticular injection with methylpredniso-lone (MP) for decreased pain and improvement in functionality.Design: Prospective randomized controlled study. Setting: Rehabilitationcenter. Third attention level. Participants: 35 subjects randomly assignedto TBA (n¼17) or MP (n¼ 18) groups; with a total of 53 knees TBA group(n¼22) and MP group (n¼31). Interventions: Intraarticular injectionwas performed in symptomatic knees of patients with KOA with subse-quent follow-up in 1, 2, 3, and 6 months after application. Descriptivestatistical analysis was made by using t Student and linear regressionanalysis. Main Outcome Measures: Visual analog scale (VAS) forpain intensity, Western Ontario and McMaster Universities OsteoarthritisIndex (WOMAC) for functionality. Level of Evidence: 2. Results: Asignificant difference with a p value¼0.01 was found for TBA group indecreased pain (VAS) and improvement in functionality (WOMAC) in thecategories of pain and function. With a longer duration of therapeuticeffect in the group of TBA. Conclusions: The use of the intraarticularinjection of botulinum toxin type A provides more effective therapeuticoption for pain reduction and improved function in patients with kneeosteoarthrosis with a longer duration of effect compared with the use ofmethylprednisolone.

No. 166 Does Sugar-Sweetened Beverage ConsumptionDetermine Metabolic Health Status in Adults: AnObservational Study.Katherine González-Ruíz; Robinson Ramírez-Vélez;Jorge Enrique Correa-Bautista.

Disclosure: None. Objective: The influence of sugar-sweetenedbeverages (SSBs) on metabolic health and body fatness has been extensivelyresearched and debated in the last few years. However this association hasnot been reported in Latin-American population. The aim was to examinethe relationships between the consumption of SSBs and metabolic healthdefinitions in adults. Setting: All subjects were from Bogota (Colombia)and belong to different universities (public and private). Participants: Atotal of 280 healthy men and women (age 23.3�2.3 years; weight61.2�11.3 kg; BMI 22.5�3.6 kg�m-1) were invited to participate in the

S128 PRESENTATIONS

study.Main OutcomeMeasures: Metabolic health status was definedusing 9 metabolic health definitions based on a range of cardiometabolicabnormalities (total cholesterol, triglycerides, C-HDL, C-LDL, glucose,waist circumference, body adiposity index, body mass index, and waistsize index). SSB consumption was measured with a previously validatedbrief questionnaire to assess habitual beverage intake (bevq-15). Therelationship between the frequency of consuming SSBs and metabolichealth was determined after controlling for age, sex, and otherconfounders by using multiple regression techniques. Results: Inde-pendent of other factors high consumption of SSBs (2 and 4 servings/day)vs. (non-consumers) showed higher values in total cholesterol (151 � 29vs. 144 � 32 mg/dl), triglycerides (86 � 50 vs. 80 � 44 mg/dl), glucose(87 � 9 vs. 83 � 10 mg/dl), C-LDL (92 � 8 vs. 83 � 6 mg/dl), and inwaist circumference (77 � 9 vs. 75 � 7 cm); p for trend <0.05. Besidesan inverse relationship was observed between high consumption ofSSBs and low levels of C-HDL (41 � 11 vs. 44 � 12 mg/dl p<0.05).Conclusions: In this cross-sectional analysis it is observed thatconsumers of SSBs were more likely to display metabolic abnormalitiescompared to non-consumers.

No. 167 Renovation of Rehabilitation Hospital for HomeReturn.Yasuko Hashimoto.

Disclosure: None. Introduction: Our hospital is the rehabilitationhospital devoting to the rehabilitation of patients with various neurologicalfractural/orthopedic and other medical conditions following stabilization oftheir acute medical issues. The goal for our hospital is to improve theactivities of daily living (ADL) of the inpatients aiming for home return.Objective: To test hypotheses that the home return rate of inpatientsincreased by renovated hospital in the style similar to the Japanesestyle from Western style. Setting: Rehabilitation hospital Japan.Participants: All inpatients in rehabilitation hospital on recovery stage in2013. Interventions: Our hospital has two type of rooms: generalWestern type of rooms and rooms renovated in the style similar tothe Japanese style at home from Western style. The living rooms werealso reformed from multiple-bed rooms to the private rooms. MainOutcome Measures: We examined the home return rate and FIM ofthe inpatient to compare with before and after the reform of the hospital.The secondary outcomes were the amount of activity in a multiple-bedsroom and the private room. Level of Evidence: Level 2 evidence.Results: Home return rate and FIM improved in comparison with beforeand after the reform of the hospital. The amount of activity e.g. area ofactivity and steps per day significantly increased living in the private roomcompared with in a multiple-bed room. Conclusions: We concludedthat considering environment for rehabilitation was important to improveADL and to return to home.

No. 169 Comprehensive Rehabilitation Improved TasteSensitivity in Patients With Overweight and Obesity.Kumiko Ito, Msc; Satoru Ebihara, MD PhD; Tamao Takahashi;Masahiro Kohzuki.

Disclosure: None. Objective: Obese patients have lower taste sensi-tivity than normal-weight controls. Comprehensive rehabilitation reducedweight and increased exercise tolerance in obese patients. However effects ofcomprehensive rehabilitation on taste sensitivity are still unknown. There-fore this study determined whether comprehensive rehabilitation improvedtaste sensitivity in obese patients. Design: Single-group intervention trial.Setting: Comprehensive rehabilitation. Patients: Forty-one patientsdiagnosed as overweight (body mass index; BMI > 25 kg/m2) or obesity(BMI > 30 kg/m2) and hospitalized for weight loss and treatment of com-plications. Interventions: Subjects participated in comprehensive reha-bilitation program including exercise therapy, diet therapy, and self-monitoring of weight and behavior and patients’ education for 4 weeks.Main Outcome Measures: BMI, body composition (fat mass index;FMI and fat free mass index; FFMI), exercise tolerance (6-minute walking

distance; 6MWD), and 5 taste sensitivity (salt, sweet, bitter, sour, andumami) measured by the filter-paper disc method. Results: The 4-weekprogram significantly decreased BMI from 35.9�11.8 to 34.6�8.8 kg/m2

(p <.001) and FMI from 17.6�10.8 to 15.2�9.3 % (p <.001) althoughthere was no significant change in FFMI. The program significantlyincreased 6MWD from 176.1�133.6 to 297.8�185.1 m (p <.001). Addi-tionally all the 5 taste sensitivity significantly improved after the program(salt: 2.6�0.9 to 2.1�0.8 units, sweet: 2.7�1.0 to 2.1�0.1 units, bitter:3.0�0.8 to 2.2�1.1 units, sour: 4.1�0.1 to 3.0�1.1 units, umami: 2.8�0.1to 2.1�1.1 units) (p <.001 for each taste). Level of Evidence: Level 1.Conclusions: The present study revealed that the comprehensive reha-bilitation improved not only body composition and exercise tolerance butalso taste sensitivity in overweight and obese patients.

No. 170 Effectiveness of Comprehensive Rehabilitation inPatients With Non-Alcoholic Fatty Liver Disease.Osamu Ito; Yoshiko Sakata, MD; Nobuyoshi Mori;Masahiro Kohzuki.

Disclosure: None. Objective: Non-alcoholic fatty liver disease(NAFLD) is a phenotype of metabolic syndrome. Paralleling the increasingprevalence of obesity NAFLD is becoming common and potentiallyserious all over the world. There are few reports of effective therapeuticintervention for NAFLD. Thus we examined effects of comprehensiverehabilitation in patients with NAFLD. Design: Hospitalized comprehen-sive rehabilitation subjects: seven adults (age 41.4�16.7 years male/female3/4) who were diagnosed NAFLD and resistant to regular outpatient treat-ment. Intervention: They were admitted to Tohoku University Hospitaland underwent exercise therapy with a bicycle ergometer and an underwatertreadmill and diet therapy of 25 kcal/day/kg standard body weight (1600-1200 kcal/day). After a guidance of life style modification they were dis-charged and followed at home for 6 months. Level of Evidence: Level 1.Results: On admission the body mass index (BMI) was 38.7�9.2 kg/m2.Serum asparatate transaminase (AST) and alanine transaminase (ALT) were98�48 IU/L and 143�90 IU/L. High triglyceride, high low-density lipo-protein cholesterol, and low high-density lipoprotein cholesterol in serumwere shown in 5, 5, and 4 cases, respectively. Diabetes mellitus andhypertension were shown in 5 and 5 cases. After 6 months, the BMIsignificantly decreased to 34.7�8.8 kg/m2 (p<0.01) and serum AST andALT decreased to 31�21 IU/L and 49�47 IU/L (p<0.01). Con-clusion: The clinical course of these cases indicates that the hospitalizedcomprehensive rehabilitation is an effective treatment in patients withNAFLD.

No. 171 The Treatment of Shoulder Pain After Stroke.Nur Kesiktas; Aysegul Ketenci; Dilsad Sindel; Melek Özarslan.

Objectives: A common sequela of stroke is hemiplegic shoulder painthat can effect functional recovery and lead to disability. Some of the mostfrequently suspected factors contributing to shoulder pain includesubluxation, contractures, complex regional pain syndrome (CRPS), rotatorcuff injury, and spastic muscle imbalance of the glenohumeral joint.Methods: We aimed to investigate the incidence and the type ofshoulder pain and the relationship between demographics, clinic, andtherapy. Of 100 consecutive hemiplegic patients who were examined, 62had shoulder pain. Computer generated random numbers were appliedfor the treatment of pain with gabapentin 800mg (2 times 400mg in a day)or paracetamol 1500mg (3 times 500 mg in a day). Patients’ measure-ments were recorded at the beginning and at the second week of thetherapy after a month. Range of shoulder external rotation, shoulder pain(VAS), Barthel index, Brunnstrom grading for upper extremity, modifiedAshworth scale. After a month gabapentin was given instead of non-steroid antiinflamatory. Both groups were evaluated at the end of secondmonth. Results: Both therapies had some improvements. Especiallygabapentin had the most significant results on shoulder pain VAS(p<0.01) at the first month. And at the end of second month gabapentinwas successful instead of 1500 mg paracetamol. Conclusion: Shoulder