PM&R Vol. 6, Iss. 9S, 2014 S233

standing on firm and foam bases, walk across, tandem walk, stepand quick turn); posture assessment (TWD, MST, chest expansion);pain (VAS); disease activity (Bath Ankylosing Spondylitis DiseaseActivity Index, BASDAI).Results or Clinical Course: The groups were similar in age,height, BMI. In AS group mean values were disease duration:8.6�8.4 years; VAS:5.9�2.1, BASDAI:4.7�2.6; TWD:17.7�5.6;MST:18.6�2.8. The AS group had significantly increased TWD anddecreased MST than the control group had (p¼0.001). The ASgroup had higher sway velocity in standing on firm base, lowerspeed in walk across and tandem walk tests (p<.030). AS patientswith decreased MST had higher sway velocity on foam base(p¼.001 r¼-0.558). AS patients with decreased MST and increasedTWD had larger step width in tandem walk (p¼.017 r¼-0.433;p¼.014 r¼0.443). As disease duration prolonged, MST decreasedand step width increased in AS (p¼.021 r¼-0.420, p¼.0420r¼0.433). VAS and BASDAI had no correlation with posture andbalance.Conclusions: In AS patients, restricted spine flexibility impaireddynamic and static balance, prolonged disease duration impairedonly the dynamic balance. We suggest assessment of posture andspine flexibilty should be inevitable part of AS follow-up to preventbalance disorders.

Poster 140Effect of Cardiac Rehabilitation Exercise onCardiopulmonary Function in Patients withAdvanced Heart Failure.Young Joon Lim (Sanggye Paik Hospital, Seoul, Korea,Republic of); Chul Kim, MD, PhD; Hee eun Choi, MD;Seong Hoon Kang, Dr.; Jaeki Ahn.

Disclosures: Y. Lim, No Disclosures: I Have No RelevantFinancial Relationships to Disclose.Objective: The objective of this study was to compare the ejec-tion fraction (EF) and maximal oxygen consumption (VO2 max)before and after completion of CR exercise and evaluate differencesbetween EF < 30% group and EF 30-50% group.Setting: Patients with heart failure (HF) of EF � 50% wereincluded as subjects. The patients were classified into 2 groupsof EF 30-50% (n ¼ 40) and EF < 30% (n ¼ 10), and all weresubjected to the CR exercise program. Patients underwent hourlyaerobic exercise training sessions 3 times a week for 6 weeks.Graded exercise test (GXT) and transthoracic echocardiogram(TTE) was performed on all study patients before and aftercompletion of the CR exercise program. After 6 weeks of CRexercise, both groups were evaluated and the results wereanalyzed.Results or Clinical Course: Demographic data were evaluatedand baseline characteristics of both group had no significantdifferences. After completion of the CR exercise program, bothgroup showed significant increases in EF and VO2 max. In EF 30-50% group, EF and VO2 max increased from 42.7% to 50.0%(p<.001), 22.7 to 26.3 (p<.001) respectively. In EF < 30% group,EF and VO2 max increased from 22.5% to 29.9% (p<.001), 17.0 to21.7 (p<.001) respectively. All results were statistically valid inboth groups (p<.05).Conclusions: Patients with ischemic heart failure who completeda 6-week supervised CR exercise program demonstrated sustained

improvements in EF and VO2 max, measures of increased cardio-pulmonary function, regardless of initial baseline EF values.

Poster 141Pulmonary Embolism Presenting as Seizures in anAcute Inpatient Rehabilitation Unit: A Case Report.David B. Essaff, DO (University of Rochester MedicalCenter, Rochester, NY, Rochester, NY, United States);Kanakadurga R. Poduri, MD; Jean L. Nickels, MD.

Disclosures: D. B. Essaff, No Disclosures: I Have No RelevantFinancial Relationships to Disclose.Case Description: Patient A is a 30-year-old man with nosignificant past medical history admitted for a pontine ischemicstroke in the setting of right vertebral artery dissection and basilarartery thrombus. Patient B is a 44-year-old man with a history ofCOPD admitted for a left middle cerebral artery ischemic stroke.After one week of an uncomplicated course in the inpatient reha-bilitation unit, both patients had isolated tonic-clonic seizureslasting less than 3 minutes with a short post-ictal period. Both weremedically stable and participating in therapies at the time ofseizures and prior vital signs were normal. Post-seizure, both hadtachypnea, low-oxygen saturation, hypotension, tachycardia anddiaphoresis. Patient A was somnolent but appropriately responsive.He was stabilized and transferred to an intensive care unit. Patient Bwas mildly obtunded and intermittently following commands,shortly after he demonstrated additional seizure activity followed byPEA arrest.Setting: Acute inpatient rehabilitation unit in a tertiary carehospital.Results or Clinical Course: Patient A had computed tomog-raphy angiogram that demonstrated right-heart strain and largesaddle pulmonary emboli (PE). Patient B expired within 45 minutesof seizure onset and autopsy demonstrated multiple acute bilateralPE. Hypercoagulable work-up for both patients was negative.Discussion: The presentation of PE is often variable andnonspecific, making diagnosis challenging. Diagnosis is furthercomplicated on rehabilitation units by the abundance of neuro-logical diseases and associated complications which includeseizures. Seizure frequency in acute rehabilitation units approaches14% and post-ictal changes in vitals and behavior may mimic ormask other pathology. While seizures represent < 1% of thosepresenting with PE, the high incidence of immobility on these unitswarrants consideration when formulating differentials for new-onset seizure.Conclusions: PE should be considered when isolated acute-onset seizures occur. Patients on the rehabilitation units are at highrisk for developing venous thromboembolism and PE.

Poster 142Patient Characteristics Associated with CaregiverBurden of Patients with Malignant Brain Tumors.Stacy McCarty, MD (Rehabilitation Institute of Chicago,Chicago, IL, United States); Alex Wong, PhD;Susan Keeshin, MD; Sarah M. Eickmeyer, MD;Samman Shahpar, MD; Michael O. Schmitt, BS;Patrick Semik, BA; Allen W. Heinemann, PhD.

Disclosures: S. McCarty, No Disclosures: I Have No RelevantFinancial Relationships to Disclose.