Barefoot Technology® (MBT) to a New Balance® walking shoe(NB).Design: A within-subject study-design was used to compare NBwalking shoe and SK and MBT commercial “unstable” shoes.Setting: Healthy subjects underwent 3D gait analysis with simul-taneous collection of surface electromyography from selected legmuscles. After collecting anthropometric measures, active markerswere placed at specifically determined anatomical sites on thesubject skin following CODA protocol. Surface EMG (sEMG) re-cordings were obtained using Motion Lab System electrodes fromTibialis anterior (TA), Lateral Gastrocnemius (LG), Soleus, RectusFemoris (RF), Hip Adductors (Add), Medial Hamstring (MH), Glu-teus Medius (Gmed) and Gluteus Maximum (Gmax). The subjectswere asked to walk with SK, MBT and NB shoes at their self-selectedwalking velocity along a 12-meter walkway with 5 Bertec forceplatforms embedded in the floor. The order of shoe training andtesting was randomized. A minimum of 10 trials were recorded foreach condition.Participants: Ten healthy subjects (2 male and 8 female), aged 28to 52 (44.8�10.5 years), weight: (64.4�12.1 Kg) with no history orclinical evidence of orthopedic or neurological disease were en-rolled.Interventions: Subjects had 30 hours of training time with eachshoe prior to testing.Main Outcome Measures: 3D gait analysis with simultaneouscollection of surface electromyography from selected leg muscles.Results: Kinematic parameter results from base line condition(NB) of all 10 subjects were compared to the 2 “unstable” conditions(SK and MTB). There were no significant difference on walkingvelocity between conditions (NB 1.388�0.153 m/s, MBT1.375�0.151 m/s, SK 1.404�0.154 m/s) and cadence parameter(NB 119.7�9.63 steps/min, MBT 119.9�9.11 steps/min, SK120.6�10,23 steps/min). The periods of double support showed adecrease on SK condition (Right 9.00�2.00% and Left9.700�1.059%) when compared to NB and MBT. Kinematicchanges were evident with increase Ankle Eversion for SK in 70% ofsubject and increase in Hip Abduction in 30%. Ankle Dorsi-Plan-tarflexion changes were noted in 20% of the subject with a decreasein plantarflexion and in 30% an increase in dorsiflexion. Kineticparameter demonstrated changes for the recorder forces during gaitwith MBT and SK shoes. For SK, 40% of subjects had an increase invertical force application. Forty percent of subjects showed a de-crease in Hip Moment and a decrease in ankle power in 50%. ThesEMG signals of SK compared with NB condition showed a decreaseof TA activity in 50% of subjects and increase of Soleus activation in20%. A decrease of GMed activity was documented in 20% of them.For MBT the kinematic analysis showed 40% of the subjects to havea decrease in Ankle dorsiflexion, 60% had an increase in AnkleEversion and Hip Abduction increase in 30%. Kinetic data showeda decrease in Hip moment for 40% of subject and a decrease inAnkle power for 50%. An increase in vertical loading forces wasevident in 60% of subjects. The sEMG signals of MBT comparedwith NB showed a decrease in TA muscle activation in 40% ofsubjects and 20% increase for LG.Conclusions: Gait with these shoes may be less efficient andunstable forcing compensatory locomotor patterns. In healthy sub-jects, the biomechanical changes could result over time in neuro-muscular problems based on the reported changes. These “unsta-ble” shoes may have a role in persons with neurological and/or

orthopedic diseases but this requires further study. This study wassupported by MossRehab Orthotics & Gait Research Fund througha grant from Schachter, Hendy & Johnson PSC.

Poster 134Upper Extremity Nerve Entrapments in Individualswith Paraplegia: A Prospective Study in anOutpatient Setting.Renata Jarosz, DO (Stanford University, Stanford, CA,United States); Kazuko Shem, MD.

Disclosures: R. Jarosz, No Disclosures.Objective: Evaluate the incidence of upper extremity nerve en-trapments (UENE) in individuals with chronic paraplegia.Design: Prospective.Setting: SCI Clinic at a county hospital.Participants: 54 paraplegia subjects (14 females, 40 males).Interventions: Nerve conduction.Main Outcome Measures: Incidence of UENE.Results: Fifty-four subjects, aged between 22-74 years (mean42�13 years) were examined with mean time since injury of11.1�10.1 years. Five individuals (9.3%) showed abnormalities inulnar motor conduction velocities across the elbow. Of those withabnormalities, 80% demonstrated unilaterally positive findings. Nosubjects demonstrated sensory nerve slowing across the elbow.Twenty-one subjects (39.0%) demonstrated abnormal latencies ofsensory ulnar nerve responses at the wrist, defined as �3.6msec. Ofthose subjects with abnormal latencies, 57% were unilateral. Thirty-two subjects (59.3%) had sensory median nerve latency abnormal-ities at the wrist of � 3.7msec and 31 (57.4%) had motor mediannerve latency abnormalities at the wrist of �4.2msec, consistentwith carpal tunnel syndrome (CTS). Additionally, two of thesesubjects who had median mononeuropathy also had positive find-ings for UNE.Conclusions: In a sample of 54 subjects with chronic paraplegia,9.3% demonstrated electrodiagnostic findings consistent with UNEacross the elbow and 59.3% with CTS. This result may exemplify agreater propensity for median nerve neuropathy in individuals withparaplegia.

Poster 135Progressive Peripheral Neuropathy Secondary toChurg-Strauss Syndrome: A Case Report.Rodrigo Cayme, MD (North Shore Long Island JewishHealth System, Manhasset, NY, United States); MatthewM. Shatzer, DO; Murthy Vishnubhakat, MD.

Disclosures: R. Cayme, No Disclosures.Case Description: A 70-year-old woman with progressive righthand and bilateral lower extremity numbness/weakness.Program Description: A 70-year-old woman with past medicalhistory significant for asthma, chronic sinusitis, chronic ear infec-tions admitted to hospital on 6/2/11 with a 2-week history ofprogressive weakness, numbness, and tingling in her right arm andbilateral lower extremities causing difficulty ambulating. Her exam-ination was notable for wide based ataxic gait, bilateral dorsiflexor,plantar flexor, and toe extensor weakness with sensory deficit topinprick and diminished DTRs.Setting: Tertiary care university hospital.Results or Clinical Course: MRI, brain: incidental with 2 smallinfarcts in left basal ganglia; MRI, head and neck, normal; MRI,

S236 PRESENTATIONS

cervical/thoracic/lumbar spine, mild degenerative changes. CT,Chest, 0.3-cm nodule to right upper lobe without infiltrates; CT,Maxillofacial, evidence of chronic sinusitis. ECHO, normal LVfunction with aortic/mitral valve calcification. Laboratory: leuko-cytosis, eosinophilia, elevated CRP, C-ANCA�, myeloperoxi-dase antibody�, skin/muscle/sural nerve biopsy suggestive ofperipheral neuropathy. NCS/EMG: distal sensory motor axonalneuropathy with decreased recruitment, polyphasic potentials,and no active denervation. Hospital course: diagnosed withvasculitis and peripheral neuropathy, treated with steroids, de-veloped left radial nerve palsy, discharged to acute rehab withresolution of radial nerve palsy, and completed steroid taper.Patient readmitted on 10/15/11 with progressive bilateral lowerextremity weakness/numbness resulting in multiple falls. RepeatNCS/EMG: progressive symmetric distal sensory motor axonalneuropathy with active chronic denervation in most proximaland distal muscles tested. Patient diagnosed with Churg-StraussSyndrome using the American College of Rheumatology Diag-nostic Criteria and was treated with steroids.Discussion: Churg-Strauss is a rare cause of peripheral neuropa-thy. Pathophysiology not well understood. Lanham described theclinical evolution into 3 phases.Conclusions: Early diagnosis is pertinent due to possible sys-temic progression without treatment with steroids.

Poster 137Motor Axonal Neuropathy Associated withIdiopathic CD4� T-lymphocytopenia: A CaseReport.Taeim Yi, MD (Bundang Jesaeng General Hospital,Seongnam city, Korea, Republic of); Insoo Han, MD; BoKyoung Kim, MD; Bo Ra Kim, MD.

Disclosures: T. Yi, No Disclosures.Case Description: A 10-year-old boy was referred to the reha-bilitation unit for the work-up of progressive weakness involving alllimbs, which developed several months earlier. At the age of five, hewas diagnosed idiopathic CD4� T-lymphocytopenia with historyof recurrent infection, such as pneumonia and otitis media. Familyhistory was negative. Physical examination revealed severe atrophyof all the muscles: the Medical Research Council (MRC) scale wasgrade 2 for the shoulder flexor, grade 3 for the elbow flexor, grade 2for the hip flexor, and grade 2 for the knee flexor and extensormuscles. The sensory examination was normal. The deep tendonreflexes were normo-active in bilateral upper and lower limbs.There were no upper motor neuron signs. A nerve conduction studyand needle electromyography identified motor axonal neuropathy.Several laboratory investigations including muscle enzyme, CSFstudy, serum immunoglobulin, HIV Ag/Ab, chromosomal study etc.were performed for differential diagnosis of motor axonal neuropa-thy, but there was no abnormality except for decreased CD4�T-lymphocyte subset count.Setting: Rehabilitation center, general hospital.Results or Clinical Course: Functionally, he was able to rollover in bed independently, but needed moderate assistance to sit upfrom the supine position.Discussion: Motor axonal neuropathy is an unusual manifesta-tion of idiopathic CD4� T-lymphocytopenia, and probably associ-ated with an immune process.

Conclusions: We report a rare case of a 10-year-old boy whodeveloped weakness due to motor axonal neuropathy associatedwith idiopathic CD5� T-lymphocytopenia.

Poster 138Unusual Case of Isolated Dorsal Ulnar CutaneousNeuropathy in Dental Technician: A Case Report.Taras Ploskanych, MD (University of Texas SouthwesternMedical Center at Dallas, Dallas, TX, United States);Thiru M. Annaswamy, MD, MA.

Disclosures: T. Ploskanych, No Disclosures.Case Description: A 59-year-old male dental technician withdorsal ulnar cutaneous entrapment neuropathy. The patient pre-sented with complaints of numbness and tingling over the dorso-medial aspect of left hand and 4th-5th fingers that started gradually6 months ago and was gradually getting worse. He denied any pain,local weakness or other symptoms. He was working as a dentaltechnician and would rest his left hand on a special laboratory benchduring work. Physical examination revealed prominent styloid pro-cesses of left ulnar bone with callus and redness in the dorsalforearm area. Decreased sensation to light touch and pin prick overdorsal ulnar surface of left hand and 4th-5th fingers was also noted.Nerve conduction studies (NCS) of the left dorsal ulnar cutaneousnerve (DUCN) revealed significantly prolonged peak latency andborderline low amplitude. Right DUCN, bilateral ulnar and leftmedian NCS showed normal values.Setting: Hospital-based EMG clinic.Results or Clinical Course: Diagnosis of a demyelinating leftdorsal ulnar cutaneous neuropathy was made. The condition wasconsidered to be likely related to recurrent nerve compression fromprolonged pressure on distal posterior forearm area from resting hishand on the dental bench.Discussion: DUCN conduction study is useful as an additionaltest to distinguish between ulnar nerve entrapment at the elbowvs the wrist. This nerve branches off 5-8 cm proximal to wrist andpositioned superficially around distal ulnar end of the forearmwhich makes it susceptible to injury. DUCN neuropathy is oftenunderdiagnosed after acute trauma or chronic traumatization atwork place, during writing, wearing a tight wristwatch band etc.Electrodiagnostic evaluation is very important in diagnosing thisneuropathy so that appropriate management can be initiated.Conclusions: This is an unusual case of work-related, isolated dor-sal ulnar cutaneous entrapment neuropathy in a dental technician.

Poster 139A Novel Technique for Electrodiagnostic Testing ofthe Ulnar Motor Nerve.William S. Pease, MD (Wexner Medical Center at TheOhio State University, Columbus, OH, United States);Jonathan Pedrick, MD.

Disclosures: W. S. Pease: Receipt of royalties, Lippincott; Re-search grants, Innovative Neurotronics.Objective: Test the value of ulnar motor nerve conduction study(NCS) using a modified electrode montage.Design: Observational prospective study.Setting: Electromyographic laboratory at an academic medicalcenter.Participants: Adult volunteers (25 to 75 years) who had noindications of upper limb nerve dysfunction.

S237PM&R Vol. 4, Iss. 10S, 2012