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E352012 ACRM–ASNR Annual Conference Abstracts

tions that modify confidence in other areas of rehabilitation. KeyWords: Stroke; Function and impairment-independent; Clinical prac-tice; Rehabilitation.

Poster 71Development of a Classification Tool for Measuring Daily ArmUse After Stroke. Lisa A. Simpson (University of British Colum-bia, Vancouver, BC, Canada), Janice J. Eng, William C. Miller,Catherine L. Backman.

Disclosure: None disclosed.Objective: There is a lack of outcome measures that capture mean-

ingful use of the affected upper extremity in the daily lives of indi-viduals with stroke. The objective of this study was to develop andassess the content validity of a novel classification scale that captureseveryday use of the affected arm and hand following a stroke. Design:A two phase focus group design was used to develop scale items andassess the content validity of the scale. Setting: Community andoutpatient rehabilitation. Participants: Five focus groups (n�20)

ere conducted, with eight persons with stroke living in the commu-ity, two caregivers and ten healthcare providers (physiatrists, occu-ational and physical therapists, recreational therapists and nurses).nterventions: Not applicable. Main Outcome Measure: Thematicontent analysis of transcripts. Results: The focus groups revealed a

number of recurring characteristics considered important and relevantto classifying arm use. These included: frequency of use, ease of use,quality of movement, prime role of the arm during tasks and types oftasks performed. An ordinal scale was devised to capture these mul-tiple attributes of daily arm use and create a descriptive classificationtool. Conclusions: This was the first step to designing a quick,asy-to-use classification scale to enhance meaningful description ofaretic arm use following stroke. Further validation and assessment ofhe reliability of the scale will be conducted in a future study. Key

ords: Stroke; Function and impairment-independent; Clinical prac-ice; Rehabilitation.

oster 72euromuscular Electrical Stimulation (NMES) in Chronic Stroke:

Systematic Review of Upper Extremity Outcomes. Shelialahereira (St. Joseph’s Health Care, Lawson Health Research Insti-

ute, London, ON, Canada), Norine Foley, Liane Lobo, Swatiehta, Robert Teasell.

isclosure: Robert Teasell, Allergan: Speaker. Other authors have noisclosures.

Objectives: To determine if neuromuscular electrical stimulationNMES) results in improved upper extremity function in persons withhronic stroke. Data Sources: A literature search using Scopus,ubmed, CINAHL and EMBASE was conducted to identify English

anguage articles published between 1985 and February 2012. Studyelection: Randomized controlled trials (RCTs) evaluating the effectf NMES on upper extremity function within a chronic stroke popu-ation (i.e. �50% of the population had a stroke �6 months before

recruitment) were included. Data Extraction: Data extracted by twoeviewers included study design, population demographics, interven-ion and control conditions, outcomes assessed and results. RCTuality was assessed using the PEDro scale. Data Synthesis: FourteenCTs (PEDro scores 3-7) including a pooled sample size of 304hronic stroke survivors met criteria. Of these, 5 evaluated the effec-iveness of NMES alone, seven combined NMES with other therapynd two compared different forms of NMES. Ten of 12 studieseporting changes from baseline noted that NMES was associated withignificant improvements in upper extremity function. Five studieseported that NMES significantly improved upper extremity functionompared to control groups while six reported no significant between-roup differences on primary outcomes. Variability in interventionype and outcome measures used makes generalization of resultshallenging. Conclusions: There is evidence that the use of NMES can

mprove upper extremity function in chronic stroke. However, thevidence regarding the superiority of NMES over other interventions

uch as exercise programs is conflicting. Key Words: Electrical stim-lation; Functional electrical stimulation; Upper extremity; Stroke;ehabilitation.

oster 73ost Stroke Depression Symptoms: Therapeutic Interventions Ini-

iated More Than Six Months Post-Stroke. Swati Mehta (Lawsonealth Research Institute, London, ON, Canada), Liane Lobo,atherine Salter, Robert Teasell.

isclosure: Robert Teasell, Allergan: Speaker. Other authors have noisclosures.

Objective: To examine effectiveness of therapeutic interventionsimed to improve depressive symptoms in the chronic stage of stroke.ata Source: A literature search was conducted using the followingatabases: Medline, CINAHL, EMBASE and PsychInfo, for relevantrticles published from 1980 to February 2012. Study Selection:tudies were identified for inclusion if: (1) participants had a history oftroke; (2) time since stroke was � 6 months; (3) participants receivedn intervention aimed at improving depressive symptoms; (4) a ran-omized controlled trial (RCT) was conducted. Based on these criteriaix RCTs were identified. Data Extraction: Data extracted includedubject demographics, inclusion and exclusion criteria, method ofssessment and results related to change in depressive symptoms. Dataynthesis: Study methodology was assessed using the PEDro scale.trength of evidence was assessed using previously established guide-

ines developed for the Evidence-Based Review of Strokeehabilitation. Conclusion: There was strong evidence from twofair” quality RCTs that repetitive transcranial magnetic stimulationrTMS) applied over the left prefrontal cortex may be associated with

reduction in symptoms of depression. Based on results from oneCT of “fair” quality, there is moderate evidence that treatment withortriptyline, but not fluoxetine, may result in improvement of depres-ive symptoms. In addition, there is strong evidence, based on theesults of two RCTs of fair quality, that physical exercise and educa-ion interventions may not be effective in reducing symptoms ofepression. Key Words: Stroke; Mental health; Clinical practice;ehabilitation.

oster 74he Impact of a Sustained, Comprehensive and Freely-Availableesearch Synthesis in Stroke Rehabilitation. Robert W. Teasell

University of Western Ontario, London, ON, Canada).

isclosure: Robert Teasell, Allergan: Speaker.Objective: To review the impact of the Stroke Rehabilitation Ev-

idence-Based Review (www.ebrsr.com), a comprehensive, continuallyupdated, freely available review of the stroke rehabilitation literaturewhich has been actively sustained for over a decade. Methods: TheSREBR utilizes a well-validated methodology which includes an ex-tensive literature search, data extraction and analysis, study qualityassessment using the PEDro scale and development of levels ofevidence, with the focus on randomized controlled trials (RCTs).Results: The SREBR (2011) summarized 929 RCTs and 2,500 non-RCTs into 400 levels of evidence. The SREBR has served as a sourceof research evidence for provincial, national and international guide-lines, recommendations and models of care designed to improvepatient care. Through an integrated strategy of knowledge translationwe are beginning to see an acceleration of best evidence translated intoimplementation of clinical best practices. Conclusions: The SREBRhas played a pivotal role in attempts to promote evidence-based bestpractices within Canadian stroke rehabilitation and has become a rolemodel for other disease-specific rehabilitation groups outside of stroke.It points to the importance of not just supporting new research butensuring that there is infrastructure in place to summarize and promoteavailable research findings, particularly within a health care system

which is becoming more interdisciplinary in nature. The value offunding this type of infrastructure support, for what has been a rela-

Arch Phys Med Rehabil Vol 93, October 2012