1
p0.012) and mFIM (r0.381, p0.014) at baseline. After inpa- tient rehabilitation, improvement rate (IR: %gain/baseline) of SARA at 0 week was 19.021.3%, which declined to baseline level within 24 weeks [F(1,40)9.44, p0.004]. CV of tapping amplitude performed by non-dominant hand without VI at baseline significantly correlated with IR at 0 week (r0.409, p0.007), 12 weeks (r0.332, p0.032) and 24 weeks (r0.321, p0.041). Conclusion: Tempo- ral and spatial variability of finger tapping is a potential marker for severity of ataxia and response to rehabilitative intervention in patients with degenerative cerebellar disease. Further studies are necessary to determine optimal condition for tapping task. Key Words: Neurode- generative disorder; Motor function; Clinical practice; Rehabilitation. Poster 132 Comparison of Individual, Group and Home Agility Boot Camp (ABC) Exercise Program for People with Parkinson’s Disease. Laurie A. King (Oregon Health & Science University, Portland, OR), Fay B. Horak. Disclosure: Laurie A. King disclosed that she will be discussing the inertial sensors and system of mobility analysis which is not FDA approved. Fay B. Horak disclosed that she is the Chief Scientific Officer for APDM. Objective: To investigate the most successful manner of delivery of physical rehabilitation (individual, group session or home exercise program) for people with Parkinson’s disease (PD). Design: A ran- domized intervention study. Setting: The study was conducted at a university outpatient balance disorders laboratory. Participants: Twenty-eight people (mean age 64 8 years; UPDRS motor 34 11) with PD were included in this pilot study. Interventions: People were randomized into one of three modes of delivery of the same exercise program. The ABC program 1 is based on a previously published protocol for improving mobility in people with PD. Intervention was one hour long, three times/week for four weeks. Pre-and-post exercise testing was administered by a blinded examiner. Main Outcome Measures: The primary outcome was balance performance for mini- BESTest. Secondary measures include Activities of Balance Confi- dence (ABC), Self-Efficacy for Exercise (SEE) and Geriatric Depres- sion Scale (GDS). Results: We found significant improvement in the mini-BESTest for the individual instruction only, (t4.1; p0.003) with no significant improvement in the home or group class. However, we found significant improvements in perceived balance confidence (ABC: t 3.1; p0.007), self-efficacy for exercise (SEE: t3.1; p0.02;) and depression (GDS: t2.3; p0.05) in the group exercise class only. Conclusions: The data from this pilot study suggests that individual exercise instruction may be more beneficial than the current standard of care (home exercise) or a group class for improving balance but a group class may be better for patient reported improve- ments. King LA and Horak FB. (2009) Delaying Mobility disability in Parkinson’s disease with a sensorimotor agility exercise program. Physical Therapy 89(4):384-393. Key Words: Neurodegenerative disorder; Motor function; Clinical practice; Rehabilitation. Poster 133 ISWAY: An Objective Test of Balance Control. Martina Mancini (Oregon Health & Science University, Portland, OR), Laurie King, Fay Horak. Disclosure: Fay Horak is APDM: Chief Scientific Officer. All authors disclose that they will discuss and do a demonstration of the mobility system using inertial sensors which are not FDA approved. Purpose: To measure test-retest reliability, clinical validity, and sensitivity to rehabilitation intervention of body-worn sensor measure- ments of postural sway while standing. Design: Study I: Postural sway in stance was acquired with accelerometers near the body center of mass (ISWAY). For validity, sway metrics were compared with clin- ical balance tests. For reliability, sway was measured twice, after removing and replacing the accelerometer. Study II: A different set of participants took part in an agility boot camp (ABC) rehabilitation program for prevention of mobility disability in Parkinson’s disease, with balance testing before and after the intervention. Setting: Partic- ipants were assessed in the clinic of a university hospital. Partici- pants: Study I: 17 people with idiopathic Parkinson’s disease (PD) and 17 age-matched controls. Study II: 20 people with idiopathic PD. Interventions: The exercise program was based on a published ABC protocol with a physical therapist four times a week for four weeks. Main Outcome Measures: Thirteen objective measures of postural sway, UPDRS Motor part, PIGD subscore, and Berg Balance Scale. Results: ISAW measures showed good to excellent test-retest reliabil- ity with Intraclass Correlation Coefficients (ICC) from .55 to .86 in PD and from .53 to .85 in CTR). All, but one, time-domain measures were significantly correlated with PIGD and Berg (r ranged from 0.50 to 0.63, 0.01p. Conclusions: Postural sway can quickly and practically be measured in the clinic with accelerometers as a sensitive, valid and reliable measure of balance control. Key Words: Neurodegenerative disorder; Motor function; Research methods; Rehabilitation. Poster 134 Developing a Vision Based Gesture Recognition System to Control Assistive Technology in Neuro-Disability. Mohamed Sakel (East Kent University Foundation Hospitals NHS Trust, Canterbury, Kent, United Kingdom), Farzin Deravi, Konstantinos Sirlantzis, Matthew Pepper, Shivanand Prabhoolall Guness. Disclosure: None disclosed. Objective: To develop a low cost, reliable automatic gesture rec- ognition system - HeadTracker - that will enable the most severely disabled patients (retaining the ability to move facial/eye muscles only) to access electronic assistive technology (AT) e.g., communica- tion devices. Design: A novel vision based assistive device that incorporates a system for the detection and interpretation of facial gestures. The system combines face shape, skin color and motion detection techniques to enhance head tracking in visible light. The head-tracker in turn corrects for pose variations to facilitate the inter- pretation of facial gestures. A small “vocabulary” of simple gestures is learnt by the system including eye blink, eye-brow movements and tongue movements. The system combines face shape, skin color and motion detection techniques. This system is then compared with SmartNav and Camera Mouse for performance. Setting: Electronic Engineering department lab of a University in UK. Participants: One volunteer at stage one. Intervention: Not applicable. Main Outcome Measures: Fitt’s test. One Index of Difficulties (ID). Results: ID and movement time required varies between the three devices but varies with the task/ID. The Head tracker successfully monitors head move- ment, but at half the movement time of the other devices. Conclu- sions: The results indicate that robust head tracking and gesture recognition can be achieved using low-cost sensors in unconstraint capture environments. The device needs to fine tune to adapt the need of the individual patients before experimentation starts with patients. I.S. MacKenzie, “Fitts’ law as a research and design tool in human- computer interaction,” Human-Computer Interaction, vol. 7, no. 1, pp. 91-139, Mar. 1992. Key Words: Neurodegenerative disorder; Com- munication; Technology; Rehabilitation. Poster 135 A Multidisciplinary CBT Pain Management Group Program: Outcomes for Patients With Chronic Non-Cancer Pain. Kathryn Ann Boschen (University of Toronto, ON, Canada). Disclosure: None disclosed. Objectives: Bridgepoint Health’s 10-week 20 sessions Cognitive- Behavioural Treatment (CBT) program has been offered to 36 groups of chronic non-cancer pain (CNCP) patients. The primary aim of this study was to evaluate program effectiveness in decreasing pain and improving functioning and mood. The secondary aim was to investi- gate demographic factors that predicted these outcomes. Design: Pre- test posttest design. Setting: Bridgepoint Health Pain Management Group Program. Participants: 311 outpatients enrolled in and 214 completed the program from 2002 to 2011, attending at least 13/20 E52 2012 ACRM–ASNR Annual Conference Abstracts Arch Phys Med Rehabil Vol 93, October 2012

Poster 134 Developing a Vision Based Gesture Recognition System to Control Assistive Technology in Neuro-Disability

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Page 1: Poster 134 Developing a Vision Based Gesture Recognition System to Control Assistive Technology in Neuro-Disability

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p�0.012) and mFIM (r��0.381, p�0.014) at baseline. After inpa-tient rehabilitation, improvement rate (IR: %gain/baseline) of SARA at0 week was 19.0�21.3%, which declined to baseline level within 24weeks [F(1,40)�9.44, p�0.004]. CV of tapping amplitude performedby non-dominant hand without VI at baseline significantly correlatedwith IR at 0 week (r��0.409, p�0.007), 12 weeks (r��0.332,p�0.032) and 24 weeks (r��0.321, p�0.041). Conclusion: Tempo-al and spatial variability of finger tapping is a potential marker foreverity of ataxia and response to rehabilitative intervention in patientsith degenerative cerebellar disease. Further studies are necessary toetermine optimal condition for tapping task. Key Words: Neurode-enerative disorder; Motor function; Clinical practice; Rehabilitation.

oster 132omparison of Individual, Group and Home Agility Boot Camp

ABC) Exercise Program for People with Parkinson’sisease. Laurie A. King (Oregon Health & Science University,ortland, OR), Fay B. Horak.

isclosure: Laurie A. King disclosed that she will be discussing thenertial sensors and system of mobility analysis which is not FDApproved. Fay B. Horak disclosed that she is the Chief Scientificfficer for APDM.Objective: To investigate the most successful manner of delivery of

hysical rehabilitation (individual, group session or home exerciserogram) for people with Parkinson’s disease (PD). Design: A ran-omized intervention study. Setting: The study was conducted at aniversity outpatient balance disorders laboratory. Participants:wenty-eight people (mean age 64� 8 years; UPDRS motor 34� 11)ith PD were included in this pilot study. Interventions: People were

andomized into one of three modes of delivery of the same exerciserogram. The ABC program 1 is based on a previously publishedrotocol for improving mobility in people with PD. Intervention wasne hour long, three times/week for four weeks. Pre-and-post exerciseesting was administered by a blinded examiner. Main Outcome

easures: The primary outcome was balance performance for mini-ESTest. Secondary measures include Activities of Balance Confi-ence (ABC), Self-Efficacy for Exercise (SEE) and Geriatric Depres-ion Scale (GDS). Results: We found significant improvement in theini-BESTest for the individual instruction only, (t�4.1; p�0.003)ith no significant improvement in the home or group class. However,e found significant improvements in perceived balance confidence

ABC: t � 3.1; p�0.007), self-efficacy for exercise (SEE: t�3.1;�0.02;) and depression (GDS: t�2.3; p�0.05) in the group exerciselass only. Conclusions: The data from this pilot study suggests thatndividual exercise instruction may be more beneficial than the currenttandard of care (home exercise) or a group class for improvingalance but a group class may be better for patient reported improve-ents. King LA and Horak FB. (2009) Delaying Mobility disability inarkinson’s disease with a sensorimotor agility exercise program.hysical Therapy 89(4):384-393. Key Words: Neurodegenerativeisorder; Motor function; Clinical practice; Rehabilitation.

oster 133SWAY: An Objective Test of Balance Control. Martina

ancini (Oregon Health & Science University, Portland, OR),aurie King, Fay Horak.

isclosure: Fay Horak is APDM: Chief Scientific Officer. All authorsisclose that they will discuss and do a demonstration of the mobilityystem using inertial sensors which are not FDA approved.

Purpose: To measure test-retest reliability, clinical validity, andensitivity to rehabilitation intervention of body-worn sensor measure-ents of postural sway while standing. Design: Study I: Postural sway

n stance was acquired with accelerometers near the body center ofass (ISWAY). For validity, sway metrics were compared with clin-

cal balance tests. For reliability, sway was measured twice, afteremoving and replacing the accelerometer. Study II: A different set of

articipants took part in an agility boot camp (ABC) rehabilitationrogram for prevention of mobility disability in Parkinson’s disease,

Gc

rch Phys Med Rehabil Vol 93, October 2012

ith balance testing before and after the intervention. Setting: Partic-pants were assessed in the clinic of a university hospital. Partici-ants: Study I: 17 people with idiopathic Parkinson’s disease (PD)nd 17 age-matched controls. Study II: 20 people with idiopathic PD.nterventions: The exercise program was based on a published ABCrotocol with a physical therapist four times a week for four weeks.ain Outcome Measures: Thirteen objective measures of postural

way, UPDRS Motor part, PIGD subscore, and Berg Balance Scale.esults: ISAW measures showed good to excellent test-retest reliabil-

ty with Intraclass Correlation Coefficients (ICC) from .55 to .86 in PDnd from .53 to .85 in CTR). All, but one, time-domain measures wereignificantly correlated with PIGD and Berg (r ranged from 0.50 to.63, 0.01�p. Conclusions: Postural sway can quickly and practicallye measured in the clinic with accelerometers as a sensitive, valid andeliable measure of balance control. Key Words: Neurodegenerativeisorder; Motor function; Research methods; Rehabilitation.

oster 134eveloping a Vision Based Gesture Recognition System to Controlssistive Technology in Neuro-Disability. Mohamed Sakel (Eastent University Foundation Hospitals NHS Trust, Canterbury,ent, United Kingdom), Farzin Deravi, Konstantinos Sirlantzis,atthew Pepper, Shivanand Prabhoolall Guness.

isclosure: None disclosed.Objective: To develop a low cost, reliable automatic gesture rec-

gnition system - HeadTracker - that will enable the most severelyisabled patients (retaining the ability to move facial/eye musclesnly) to access electronic assistive technology (AT) e.g., communica-ion devices. Design: A novel vision based assistive device thatncorporates a system for the detection and interpretation of facialestures. The system combines face shape, skin color and motionetection techniques to enhance head tracking in visible light. Theead-tracker in turn corrects for pose variations to facilitate the inter-retation of facial gestures. A small “vocabulary” of simple gestures isearnt by the system including eye blink, eye-brow movements andongue movements. The system combines face shape, skin color andotion detection techniques. This system is then compared withmartNav and Camera Mouse for performance. Setting: Electronicngineering department lab of a University in UK. Participants: Oneolunteer at stage one. Intervention: Not applicable. Main Outcomeeasures: Fitt’s test. One Index of Difficulties (ID). Results: ID andovement time required varies between the three devices but variesith the task/ID. The Head tracker successfully monitors head move-ent, but at half the movement time of the other devices. Conclu-

ions: The results indicate that robust head tracking and gestureecognition can be achieved using low-cost sensors in unconstraintapture environments. The device needs to fine tune to adapt the needf the individual patients before experimentation starts with patients..S. MacKenzie, “Fitts’ law as a research and design tool in human-omputer interaction,” Human-Computer Interaction, vol. 7, no. 1, pp.1-139, Mar. 1992. Key Words: Neurodegenerative disorder; Com-unication; Technology; Rehabilitation.

oster 135Multidisciplinary CBT Pain Management Group Program:

utcomes for Patients With Chronic Non-Cancer Pain. Kathrynnn Boschen (University of Toronto, ON, Canada).

isclosure: None disclosed.Objectives: Bridgepoint Health’s 10-week 20 sessions Cognitive-

ehavioural Treatment (CBT) program has been offered to 36 groupsf chronic non-cancer pain (CNCP) patients. The primary aim of thistudy was to evaluate program effectiveness in decreasing pain andmproving functioning and mood. The secondary aim was to investi-ate demographic factors that predicted these outcomes. Design: Pre-est posttest design. Setting: Bridgepoint Health Pain Management

roup Program. Participants: 311 outpatients enrolled in and 214

ompleted the program from 2002 to 2011, attending at least 13/20