Conclusions: Based on preliminary analysis it appears that BW-STT can improve functional abilities and gait in individuals livingwith a LLA. However, the results suggest the use of a safety harnessduring treadmill training may be as effective as BWSTT at improvingwalking endurance and functional gait speed.

Poster 465Functional Gains of Physical Therapy FollowingProsthetic Component Changes: A Case Report.Helena Lax, MD (Magee Rehabilitation Hosp, Philadel-phia, PA, United States); Lynn Cunningham, DPT; MarkNielsen, CP; Kevin Towers, BS.

Disclosures: H. Lax, No Disclosures.Case Description: The objective of this case study was to reportthe functional gains found following physical therapy interventionin an independent individual who received new prosthetic compo-nents. The subject was a 54-year-old man with a 32-year history ofleft hip disarticulation secondary to trauma. The subject had utilizedhis previous prosthesis at a K3 modified independent level. Thecomponents were as follows: Canadian hip disarticulation hardsocket, Otto Bock 7E7 hip joint, Otto Bock 3R60 knee joint, andOtto Bock Axtion LP energy storing foot. The subject was deemedappropriate for, prescribed, and issued a new prosthesis consistingof the following components: Ischial containment hip disarticula-tion socket with a flexible inner liner and micro carbon fiber frame,Otto Bock Helix hip joint, Otto Bock C-Leg knee joint with OttoBock 4R57 axial rotator, and Ossur LP Variflex foot.Setting: Hospital based outpatient rehabilitation center.Interventions: The subject underwent 11 physical therapy treat-ment sessions focusing on prosthetic training.Main Outcome Measures: Subjective and objective measure-ments were recorded on initial evaluation and at discharge. Subjec-tive measurements included: pain, Activities-Specific Balance Scale(ABC), and RAND medical outcomes study: 36-item short formsurvey instrument (SF-36). Objective measurements included: gaitanalysis, standing balance (single limb stance and Sharpened Rom-berg positions), 6 and 12 minute walk tests, and timed stair mobil-ity.Results or Clinical Course: By discharge, pain was eliminated,the ABC score was improved, the SF-36 score was improved,standing balance was improved, the 6 and 12 minute walk testdistances were improved, and the time to ascend and descend stepswas decreased.Discussion: This case study justifies the need for physical therapyinterventions throughout an amputee patient’s life.Conclusions: While a good prosthetic design is essential, physi-cal therapy treatment may be required to help the amputee patientlearn to utilize the components appropriately and help the patientachieve their highest functional and social outcomes.

Poster 466Hyperhidrosis in Amputee Populations: Self-Reported Incidence and Impact on Prosthetic Useand Function.Jody Q. Wixom, MD (University of Utah, Salt Lake City,UT, United States); Bradeigh S. Godfrey, DO; Colby R.Hansen, MD.

Disclosures: J. Q. Wixom, No Disclosures.Objective: To assess the incidence and severity of self-reported

hyperhidrosis in patients with amputation. To understand the ef-fects of self-reported hyperhidrosis on prosthetic fit or function.Design: Cross-sectional survey.Setting: Outpatient amputee clinics at an academic medical centerand Veterans Affairs medical center (VAMC).Participants: 86 subjects who responded to a mail survey. Sub-jects included had their amputation at least 6 months prior to thetime of completing the survey.Interventions: Not applicable.Main Outcome Measures: Self-reported severity of hyperhi-drosis as it affects daily activities, prosthetic fit, and function on a6-point Likert scale.Results: 86 subjects (65 M, 21 F) responded to the survey. Themajority of the subjects had a below the knee amputation (67.4%)or above the knee amputation (18%). 51.7% of subjects reportedtolerable sweating, with 4.6% reporting intolerable sweating. 54.1%of subjects reported that sweating interfered mildly with prosthesisfit, while 15.3% reported sweating interfered severely with prosthe-sis fit. 21.8% of subjects reported severe interference with prostheticfunction and 24.1 % reported moderate interference with prosthesisfunction. 33% of subjects had not tried any interventions for sweat-ing, while common treatment approaches included socks (36%)and anti-perspirants (58%).Conclusions: Hyperhidrosis is a common problem in amputa-tion and varies in severity. Patients with amputations may tryvarious interventions to manage sweating. Prosthetic fit and func-tion may be impaired, which can negatively impact overall function.Future analysis will entail correlations of self-reported hyperhidro-sis, prosthetic use, and functional mobility using the LocomotorCapabilities Index. Attempts will be made to delineate factors suchas age, level of amputation, or etiology, which may correlate withgreater risk of moderate to severe hyperhidrosis.

**Poster 467Long-Term Prosthetic Outcome of Bilateral LowerLimb Amputees: A Case Series.Maria Lucia Guarita, MD (AACD - Association of Assi-tance to the Disabled Child, San Paulo, Brazil); Alexan-dra P. Gaspar, MD; Sheila Inghan, MD.

Disclosures: M. Guarita, No Disclosures.Objective: The first aim of this study was to determine thepercentage of patients with bilateral lower limb amputations whocontinued to use prostheses after successfully prosthetic rehabilita-tion discharge. The second aim of this study was to investigatepossible predictive factors related to continued prosthetic lowerlimb use.Design: Retrospective and sectional study.Setting: Tertiary care rehabilitation institute.Participants: Data were collected from 113 patients with bilaterallower limb amputations; 59 of these had complete data, successfully com-pleted prosthetic rehabilitation and could be contacted by telephone.Interventions: First, this study collected data (gender, age, num-ber of complications, etiology of the amputation, amputation level,presence of diabetes, hypertension, visual deficit, depression andobesity) from patients who had undergone bilateral lower limbamputation and that received prostheses between December of1999 and December of 2009 at our institution. Second, thesepatients were contacted by telephone and questioned about pros-thetic use. Data from these patients were analyzed together and

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divided into two categories depending on the nature of their ampu-tation into vascular and non-vascular etiologies. Partial foot andSyme amputations were excluded. In order to verify possible pre-dictive factors related to continued prosthetic lower limb use, Fish-er‘s exact test and regression test were performed.Main Outcome Measures: 1. Prosthetic use or abandonment;2. Prosthetic use x collected data (gender, age, number of compli-cations, etiology of the amputation, amputation level, presence ofdiabetes, hypertension, visual deficit, depression and obesity).Results: The percentage of bilateral lower limb amputees who con-tinue to use prostheses is 37.28% (17.64% among the vascular groupand 64% among non-vascular amputees group). The total mean periodof prosthesis use was 6.20 years (3.24 years in the vascular group and10.12 years in non-vascular group). A correlation between abandoningthe prosthesis and the presence of DM, hypertension, depression,visual deficit, obesity, number of complications, etiology of the ampu-tation, amputation level and age was found. However, after a regressionwas performed, only age and the number of residual limb complica-tions were correlated with the use of prostheses.Conclusions: The percentage of bilateral lower limb amputeeswho continue to use prostheses is 37.28%. The factors that corre-lated with long-term prosthetic abandonment were age and numberof residual limb complications. Younger individuals, with less re-sidual limb complications were more likely to continue using theprostheses.

Poster 468The Effects of Two Different Ankle-Foot Orthoses onthe Gait of Acute Stroke Patients With Hemiplegia.Noel Rao, MD (Marianjoy Rehabilitation Hospital,Wheaton, IL, United States); Alexander S. Aruin, PhD;Daniel Hasso, CPO; Priyan Perera, MD; Jason Wening,MS, CPO.

Disclosures: N. Rao, No Disclosures.Objective: To compare the effects of an off-the-shelf carbon-fiberankle-foot orthosis (CF-AFO) to a custom fabricated polymer ankle-foot orthosis (P-AFO) on the gait of acute stroke patients withhemiplegia.Design: Prospective, case-controlled study.Setting: Prosthetic/orthotics clinic in freestanding rehabilitationhospital.Participants: Acute stroke patients with hemiplegia (n�27) weretested with no ankle-foot orthosis (AFO), and then with an off-the-shelf carbon AFO (CF-AFO) and a custom polymer AFO (P-AFO) inrandom order at the time of initial orthosis fitting.Interventions: Gait parameters such as velocity, cadence, stridelength and step length were collected using an electronic walkwayunder the no-AFO, P-AFO, and CF-AFO conditions.Main Outcome Measures: All the data were subjected to aShapiro-Wilk test for normality. A one-way repeated measuresanalysis of variance (ANOVA) was performed with AFO factors (3levels: No AFO, CF-AFO, P-AFO) separately for velocity, cadenceand stride length. Split-Plot ANOVA was performed with AFOfactors (3 levels: No AFO, CF-AFO, P-AFO) and side (involved anduninvolved) to analyze the differences in step length. Pairwisecomparisons with Bonferroni corrections were used for furtheranalysis of significant effects. For all tests, statistical significance wasset at P�.05.Results: Subjects walked significantly faster, with a higher ca-

dence, longer stride and longer step length (involved and unin-volved side) when using either the P- AFO or CF-AFO as comparedto no AFO. Although the P-AFO did show more effect on allparameters than the CF-AFO, the difference between the two AFOswas never statistically significant.Conclusions: Acute stroke patients with hemiplegia will benefitfrom either a carbon or polymer AFO as opposed to no AFO. There is,however, no significant difference between the two AFOs in this pop-ulation.

**Poster 469Effect of Lower Limb End-Effector Robot-AssistedTherapy With Body Weight-Support vs TreadmillGait Training in Parkinson’s Patients.Patrizio Sale (IRCCS San Raffaele Pisana, Rome, Italy);Maria Francesca De Pandis, MD; Palma Enzo, MD;Marco Franceschini, MD; Vacca Laura, MD; Do-menica; Le Pera, MD; Franceschini Marco, MD; GrassiniPaola, MD; Fabrizio Stocchi, MD, PhD.

Disclosures: P. Sale, No Disclosures.Objective: PD is characterized by a progressive decline of locomo-tor abilities of lower limb so that gait rehabilitation is an essential, butoften frustrated, aim of the treatment. Recent studies demonstrated amajor efficacy of physical rehabilitation therapy associated with tread-mill training compared with physical therapy alone. The aim of thestudy is to validate the efficacy of a robotic system specific for lowerlimb (G-EO) compared with training on treadmill.Design: Randomized clinical trial.Setting: Gait analysis evaluation 3D-GA was conducted using thefollowing equipment: a 12-camera optoelectronic system with pas-sive markers (ELITE2002, BTS, Italy) to measure the kinematic ofmovement; 2 force platforms (Kistler, CH) to obtain the kinetic dataof movement (ie, ground reaction forces); and 2 TV camera videosystem (BTS, Italy) synchronized with the optoelectronic and forceplatform systems for videorecording. To evaluate the kinematics ofeach body segment, markers were positioned as described by Daviset al (Davis, 1991). Subjects were asked to walk barefoot at theirown natural pace (self-selected and comfortable speed) along a (10m long) walkway where the two force platforms were placed. Atleast seven trials were collected for each subject in order to ensurethe consistency of the data. All graphs obtained from GA werenormalized as % of gait cycle and kinetic data were normalized forindividual body weight. Using specific software (Smartanalyser,BTS, Italy) from these data some indices (time/distance parameters,angles joint values in specific gait cycle instant, peak values in anklepower graph) were calculated in order to quantify the gait pattern ofparticipants involved in this study.Participants: Diagnosis of idiopathic Parkinson’s Disease by UKBrain Bank criteria. Inclusion criteria: evidence of motor deficit inone lower limb, age between 18 and 79 years. Exclusion criteria:association of neurological, orthopaedic or cardiopulmonary pa-thologies. Psychiatric disorders reducing patient collaboration.Interventions: If eligible, the patients were assigned to one of thetwo study arms (GEO o TREADMILL) by means of a computedrandomization. Rehabilitation Treatment: 20 sessions of 45’. Tensubjects underwent lower limb rehabilitation consisting of a treat-ment cycle using the GE-O system device, according to individuallytailored exercise scheduling. The practice included an add-on ro-bot-assisted walking therapy at variable speeds for 40 min with a

S350 PRESENTATIONS