e22 Spinal Cord Injury (SCI) Diagnosis

Interventions: Subjects used the prototype pressure mapping system at

home for 5-7 days. They were required to take at least 5 recordings

throughout the day. A daily log was maintained to describe length of time

in chair, skin check frequency and identification of any red areas. At the

end of the study they returned to answer questionnaires related to usability

and satisfaction with use of the device. A therapist visually examined the

subject’s skin at start and end of the study period.

Main Outcome Measure(s):1. Quebec User Evaluation of Satisfaction with Assistive Technology

(QUEST)

2. Psychosocial Impact of Assistive Devices Scale (PIADS)

3. Qualitative report via interview from subjects regarding perception of

usefulness of pressure mapping data available to them in their home

environment.

4. Saved pressure map files for each subject will be available for access by

researcher in the secure data base designated to contain the pressure

map sessions.

5. Visual skin examination by research investigator at start and end of

study period.

Results: Users reported satisfaction with use of the device. They were able

to access the map from their smartphones to take recordings consistently.

Users provided excellent and useful feedback regarding usability of the

web application and placement of the pressure mat on their cushion. There

were no adverse skin problems identified following use of the pressure

mapping system at home.

Conclusions: Interface pressure mapping in the home environment, with

ability to view it on a smartphone, allows people who use wheelchairs and

are at risk for pressure ulcer development to have access to important

feedback that can help them make positioning changes. The system tested

is a prototype and there are plans to incorporate the user’s feedback into

the next iteration of software for improved indivualized customization of

the interface for each user.

Key Words: Pressure mapping, wheelchair seating, pressure ulcer

prevention.

Disclosure: Tamara Vos-Draper has the following disclosures: Vista

Medical: Use of the BodyTrak stretch pressure mat in prototype.

Poster 30

Pressure Ulcer Risk Assessment in an Inpatient Spinal Cord Injury(SCI) Rehabilitation Program: Implementation Science

Carol Scovil (Toronto Rehab - UHN), Heather Margaret Flett,Lan McMillian, Diane J. Leber, Jacquie Brown, Anthony Scott Burns

Objective: Implement systematic risk assessment for pressure ulcers (PU)

in individuals with SCI.

Design: Quality Improvement

Setting: Inpatient SCI Rehabilitation Program (SCRP)

Participants: SCRP staff

Interventions: The 57-bed SCRP is one of 6-sites participating in the

pan-Canadian SCI Knowledge Mobilization Network (SCI KMN)

addressing Best Practice Implementation (BPI) for the care and reha-

bilitation of SCI. The National Implementation Research Network

(NIRN), University of North Carolina-Chapel Hill, provided methodo-

logical expertise. Each centre has a Site Implementation Team (SIT) and

Implementation Science (IS) is employed for the coordinated imple-

mentation of identified best practices (fidelity). Inpatient PU risk

assessment was selected for initial BPI. Previously, the SCRP utilized the

Braden Scale for PU risk assessment. Completion rates were poor, and it

became apparent through staff feedback that the Braden was viewed as

non SCI-specific and of questionable utility. Audit results were used to

engage staff and justify replacing the Braden with the SCI pressure ulcer

scale (SCIPUS). Using Driver Analysis tools, the SIT developed strate-

gies to address key implementation drivers (staff competency,

organizational supports, effective leadership). Implementation thereafter

involved a systematic progression through the Stages of Implementation:

pre-exploration / exploration / installation / initial implementation

/ full implementation.

Main Outcome Measure(s): PU risk assessment completion rates.

Results: Completion rates - Braden pre-implementation (29%); SCIPUS

initial implementation - first 12 weeks (68%); SCIPUS 6 months post-

implementation (94%).

Conclusions: Implementation Science can be utilized in a rehabilitation

setting. Future BPI will address (1) Development of PU Prevention Plans

and (2) Delivery of Patient Education for PUs.

Key Words: Spinal Cord Injury rehabilitation, Pressure Ulcer, Risk

Assessment, Implementation Science.

Disclosure: Carol Scovil has nothing to disclose.

Poster 31

Newly Developed Wearable Robot Facilitated Waking Rehabilitationfor Patient with Spinal Surgery: A Case Study

Harutoshi Sakakima (School of Health Sciences, Faculty of Medicine,Kagoshima University), Kosei Ijiri, Fumiyo Matsuda, Kazunori Yone

Objective: Hybrid assistive limb (HAL) is a new robot suit voluntary

controlling knee and hip joint motion by detecting very weak bioelectric

signals on the surface of the skin, which developed by Prof. Yoshiyuki

Sankai of Tsukuba University, Japan. The aim of this study is to report the

feasibility of patient-assistive HAL waking rehabilitation for facilitating

locomotor function after patient with spinal surgery.

Design: Single case study.

Setting: Performed in hospitalized care setting.

Participants: A 60-year-old women with thoracic ossification of the

posterior longitudinal ligament (OPLL) was recruited in this study. The

baseline lower-extremity MMT score of the subject was 1-2, ASIA clas-

sification was C, lower-extremity ASIA score was 12/11(Rt/Lt), Walking

index for spinal cord injury (WISCI) II was 0, which represented severe

impairment in the paretic legs.

Interventions: The subject underwent 2-3 times per week for 8 weeks of

HAL, which consisted of a standing and sitting exercise, and walking on

the ground with HAL. The subject was assisted the torque in each joint by

support her voluntary motion according to the voluntary muscle activity.

Main Outcome Measure(s): Clinical outcomes (MMT, ASIA classifica-

tion, lower-extremity ASIA score, WISCI II, FIM motor score) were

evaluated before the start of the intervention, immediately after 8 weeks of

HAL training, and 1 year after surgery.

Results: The subject improved considerably by intervention of HAL

training, subsequently, the walking ability recovered rapidly, who got the

independence walking half year after surgery.

Conclusions: This case study suggests that HAL training is a feasible

option to facilitating locomotor function of patients with residual paralysis

after surgery. A larger trail might be required to verify the efficacy of this

advanced HAL training strategy for spinal paralysis.

Key Words: spinal surgery, spinal paralysis, robotics, locomotor functions,

rehabilitation

Disclosure: Harutoshi Sakakima has nothing to disclose.

Poster 32

eIF-5A1 is a Crucial Molecule Promote Locomotor Function in Rat’sGastrocnemius After Spinal Cord Transection

Shang Fei-fei (the State Key Laboratory of Biotherapy), Luo li, He Mu

Objective: Spinal cord injury (SCI) can lead to paraplegia or quadriplegia,

and exhibit significant spontaneous functional recovery. The underlying

mechanisms remain elusive.

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