e90 Diagnosis Independent

Poster 282

Factors Associated with Nursing Home Placement of PatientsAdmitted for Inpatient Rehabilitation in Singapore

Cynthia Chen (NUS SSHSPH)

Objective: To (1) identify social and rehabilitation predictors of nursing

home placement, (2) investigate the association between effectiveness and

efficiency in rehabilitation and nursing home placement of patients

admitted for inpatient rehabilitation from 1996 to 2005 by disease

in Singapore.

Design: case extraction.

Data Sources: National data were retrospectively extracted from medical

records of community hospital.

Participants: There were 12,506 first admissions for rehabilitation in four

community hospitals. Of which, 8,594 (90.3%) patients were discharged

home and 924 (9.7%) patients were discharged to a nursing home.

Interventions: Not applicable.Main Outcome Measure(s): Nursing home placement.

Results: Those who were discharged to nursing home had 33% lower

median rehabilitation effectiveness and 29% lower median rehabilitation

efficiency compared to those who were discharged to nursing homes.

Patients discharged to nursing homes were significantly older (mean age:

77 vs. 73 years), had lower mean Bathel Index scores (40 vs. 48), a longer

median length of stay (40 vs. 33 days) and a longer time to rehabilitation

(19 vs. 15 days), had a higher proportion without a caregiver (28 vs. 7%),

being single (21 vs. 7%) and had dementia (23 vs. 10%). Patients admitted

for lower limb amputation or falls had an increased odds of being dis-

charged to a nursing home by 175% (p,0.001) and 65% (p Z 0.043)

respectively compared to stroke patients.

Conclusions: In our study, the odds of nursing home placement was found

to be increased in Chinese, males, single or widowed or separated/

divorced, patients in high subsidy wards for hospital care, patients with

dementia, without caregivers, lower functional scores at admission, lower

rehabilitation effectiveness or efficiency at discharge and primary

diagnosis groups such as fractures, lower limb amputation and falls in

comparison to strokes.

Key Words: Inpatient rehabilitation, Nursing home, Functional recovery

Disclosure(s): None Disclosed.

Poster 283

Energy Expenditure During ADL in Korean Life Style Setting

Hee Song Lee (Department of Rehabilitation Medicine, CHA BundangMedical Center, CHA University), MinYoung Kim

Objective: To measure VO2, energy expenditure(EE) and metabolic

equivalent of task(MET) values of activities of daily living and to compare

each values between subjects and 11 activities.

Design: Cross-sectional study.Setting: General teaching hospital.

Participants: The subjects were normal adults with no specific medical

history. Total 10 subjects were included.

Interventions: We chose 11 daily activities that are relevant to Korean life

style and tested it to subjects according to protocol respectively: typing (typing

2500 words or 10 min), sleeping, folding laundry (folding uniform made of

wool), dish washing, cleaning the room (using a mop), studying (reading and

writing), walking (4km/hr), running (8 km/hr), stair-climbing, walking uphill,

and walking downhill. Duration of each activity was 10 minutes.

Main Outcome Measure(s): Energy expenditure (EE) and metabolic

equivalent of task (MET).

Results: There were high internal consistency among the subjects for

identical activities (Cronbach a Z 0.89). We obtained mean MET values

of each activity: sleeping (0.77), typing (1.33), folding the laundry (0.85),

washing the dish (2.76), cleaning the room (2.78), studying (2.30), walking

(4.23), running (7.83), stair-climbing (6.89), walking uphill(5.70), and

walking downhill(3.20). VO2 values were proportional to EE value

(rZ0.997, pZ0.00).

Conclusions: We identified intensity level of each activity according to the

amount of EE and MET. We intend to provide a baseline for physical

activity guideline development of normal adults. By integrating body

weight, height, BMI in comparison to MET scores of different occupation

groups in future studies.

Key Words: Energy expenditure, Activity of daily living, Metabolic

equivalents

Disclosure(s): None Disclosed.

Poster 284

Daily Activity Positively Impacts Motor Performance in Older Adults

Jeanne Langan (University at Buffalo)

Objective: Examine if meeting the steps/day recommendation for older

adults, 7100 (Tudor-Locke et al., 2011), influenced performance on a

computer-based cognitive/motor assessment.

Design: Cross sectional.Setting: Computer assessments completed in a research lab, steps

measured in home/community.

Participants: 24 older adults 65-78 years (mean 70.3 +3.9 years, 11 male)

with � 3 years experience using a computer and who lived independently

in the community.

Interventions: Each participant underwent two computer-based cogni-

tive/motor assessments, one as an orientation, the second representing

the actual test. The assessment consisted of response time, verbal

memory, spatial memory and motor performance (chase target using a

mouse) tasks. Daily steps taken were measured using a Fitbit, an

accelerometer device.

Main Outcome Measure(s): Time and accuracy reported for computer-

based assessment. The average number of steps was based on four

weekdays and one weekend. Fitbit activity graphs were visually inspected

and the number of days in which participants had � 30 minutes of sus-

tained activity was recorded. Using 7100 average steps/day as a cut point,

participants were divided into two groups.

Results: 10 participants, primarily women, fell below the recommended

7100 steps. They also had fewer days with � 30 minutes of sustained

activity. Despite the discrepancy in activity levels, the two groups per-

formed similarly on the reaction time, verbal memory and spatial

memory tasks. The more active group performed better on the

motor task.

Conclusions: Amount of daily activity impacted motor rather than

cognitive performance. Intensity of daily activity should be further

examined for influence on cognitive domains.

Key Words: cognitive, older adults, motor performance, activity

Disclosure(s): None disclosed.

Poster 285

Assessment of Gait Variability: Towards an Optimal Testing Protocol

Lutz Schega (Otto-von-Guericke University Magdeburg),Daniel Hamacher, Dennis Hamacher

Objective: Gait variability is frequently used to identify rehabilitation

progresses in orthopedic and neurologic diseases by means of repeated

testing. However, learning effects are a significant issue. This study

examined if the inter-day reliability of gait variability parameters improves

with an additional familiarization trial.

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