ttifiaitwaad(arstftcfqWd

PMaC

Dt

E50 2012 ACRM–ASNR Annual Conference Abstracts

A

Poster 123Application of Routine Outcome Measurement to Improve Qual-ity of Inpatient Rehabilitation. Marcel W. Post (De Hoogstraat,Utrecht, the Netherlands), Mia Willems.

Disclosure: None disclosed.Objective: To demonstrate the application of routine outcome

measurement (ROM) with the Utrecht Scale for Evaluation of Reha-bilitation (USER) in a freestanding Dutch rehabilitation facility. In theNetherlands, ROM of functional outcomes is not required by payors todate, but an initiative of the providers themselves. Design: Implemen-ation project. Setting: Rehabilitation center De Hoogstraat, Utrecht,he Netherlands. Participants: All multidisciplinary teams of thenpatient clinic. Intervention: In 2008, De Hoogstraat was among therst centers to implement administration of the USER at admissionnd discharge in all rehabilitation inpatients. Administration was mon-tored, support was provided to teams that were interested in applica-ion of the USER in daily practice, and feedback on the yearly resultsas given in 2010 and 2011. Main Outcome Measures: Not

pplicable. Results: Monitoring showed about 80% completeness ofdministration during 2009-2011. Yearly reports at group level wereistributed and discussed with managers and treatment coordinatorsphysiatrists). Effectiveness was expressed in various ways, and devi-ted between Departments and diagnostic groups. Individual USEResults related to length of admission were also discussed. Four teamstarted to use the USER as input for regular team meetings. In two ofhese USER results provided also feedback to patients and theiramilies. Some other teams were less enthusiastic. Several challengeso ROM in general were identified, including accuracy of scoring andongruence with rehabilitation goals. Conclusion: ROM was success-ully implemented in De Hoogstraat and is a potentially useful tool foruality improvement, but some restrictions were identified. Key

ords: Diagnosis-independent; Function and impairment-indepen-ent; Clinical practice; Rehabilitation.

oster 124utual Support Groups: Social Rehabilitation in Residential Care

nd in the Community. Kristine A. Theurer (University of Britisholumbia, Vancouver, BC, Canada).

isclosure: Java Music Club - Applied Research (Program Implemen-ation and Training): Principal.

Objective: The challenges engendered by illness are a social ex-perience and often include loss, struggle and uncertainty. There is anemerging body of research that documents the effectiveness of mutualsupport groups in alleviating loneliness and depression in the commu-nity, yet this type of non-pharmacological intervention is underuti-lized, particularly within supportive living settings such as long-termcare homes (LTCH). This paper describes the development of a mutualsupport group in LTCH, evaluates the processes, structure, and contentof the intervention, and addresses replication and sustainability. In-tervention and Design: Kitwood’s personhood model is used as thebasis for developing a weekly discussion group using themes chosenby participants and theme-associated music, readings, and photo-graphs. A mixed methods qualitative process evaluation design de-scribes the study participant’s assessment of the program andimplementation. Setting and Participants: The paper includes focusgroups, systematic observation of six resident groups, individual res-ident interviews (N�65), and staff interviews (N�7) in three LTCH inBritish Columbia, Canada. Results: Resident reports and observationsindicate positive benefits including a decrease in loneliness, the de-velopment of friendships, increased coping skills, understanding andsupport. Participating staff reported numerous benefits and describedhow the unique group structure fosters active participation of residentswith moderate-severe cognitive impairment. Conclusions: This pre-liminary qualitative study suggests that mutual support groups havepotential to offset loneliness, helplessness and depression in supportive

living settings. Implications for a future outcome evaluation of theprogram will be presented including the current translation into day

rch Phys Med Rehabil Vol 93, October 2012

programs in the community. Key Words: Diagnosis-independent;Mental health; Clinical practice; Rehabilitation.

Poster 125Urinary Incontinence in Geriatrics, a Retrospective Study of Diag-nosis and Management at Nursing Level. Hubert B. Vuagnat (Ge-neva University Hospitals, Bernex Geneva), Diane Morin, Marie-Chantal Regat.

Disclosure: None disclosed.Urinary incontinence (UI) is a major burden, especially in geriatrics.

Nurses are at the best place to assess for IU and propose furtherreferral. Better awareness is certainly a first step towards rehabilita-tion. Out of 100 patients’ records in a long-term geriatric setting, wesearched for three logical steps: (1) UI assessment out of the initialFIM bladder management item (UI if score 6 or under). 2) Presence ofa UI nursing diagnosis. 3) Nursing intervention. Mean age was 84�/� 8 years, 62% female. 71% presented UI. Only one out of 71 wasattributed a nursing diagnosis of UI. Seventy-five percent of UI pa-tients had a written record of nursing intervention directed at UI,mostly of palliative type. This study shows the usual high rate of UI.Surprisingly, the step towards a nursing diagnosis of IU is very low.Hopefully daily actions toward UI are taken. Our hypothesis is that UIis so widespread, especially at old age that it becomes routine dailycare, without any action taken toward a precise diagnosis and activetreatment plan such as rehabilitation. The results of this study shouldserve at implementing a screening program aimed at better diagnosisand treatment of IU. Key Words: Diagnosis-independent; Lifespanissues; Clinical practice; Rehabilitation.

Poster 126The Absence of Electromagnetic Fields and Mirror Therapy, toReduce Vascular Amputee Phantom Limb Pain. Helen Houston(Vidant Medical Center, Greenville, NC), Erwin Manalo, ClintonFaulk, Shane Coltrain, Anne E. Dickerson.

Disclosure: None disclosed.This presentation will describe the results of a study to investigate

the effectiveness of combining an intervention to eliminate electro-magnetic fields and mirror therapy to decrease phantom limb pain.Fourteen adults with a unilateral vascular amputation (nine acute)wore a Farabloc limb cover and performed mirror therapy exercises forfour weeks. Measures were completed at three points (pre and posttreatment and four weeks after the end of therapy) and includedresidual limb measures, pain, functional, and quality of life compo-nents. Results from ANOVAs showed a decrease in phantom limb painfor intensity (F(1, 14)�8.83, p. Key Words: Diagnosis-independent;Vascular amputees; Diabetics; Health and wellness; Research meth-ods; Rehabilitation.

Poster 127Body Coordination in Children: How Development and WeightClassification Affect Adaptation. Simone V. Gill (Boston Univer-sity, Boston, MA), Ya-Ching Hung.

Disclosure: None disclosed.Objectives: In two studies, we examined how development and

weight classification affected children’s ability to adapt movements.Design: Cross-sectional designs were used. Setting: Queens Collegeand Boston University. Participants: In study 1, participants included24 children divided into young (four to six years old), middle (sevento nine years old), or older (10 to 13 years old), age groups. In studytwo, participants were four- to 13-year olds with normal (n�12) oroverweight/obese (n�12) body mass index scores. All children weretypically developing. Interventions: Not applicable. Main OutcomeMeasures: Main dependent variables in study 1 were shoulder jointexcursion, stride length, and foot force while carrying a box. Main

dependent variables in study two were time taken to achieve maximumknee height and foot contact and ankle position during landing after