e80 Spinal Cord Injury

nervous system, with or without coincident somatosensory input (Backus

2008). AB programs can include interventions such as weight bearing,

somatosensory augmentation, massed practice, functional electrical stim-

ulation, and/or locomotor training.

This AB program utilizes a multi-faceted treatment approach in an

effort to increase neuroplasticity, enhance sensorimotor recovery, increase

cortical neurotrophic up-regulation, and improve movement patterns. By

incorporating this approach into the acute rehabilitation environment,

goals pertinent to the acute SCI population, such as increasing function,

improving overall health, and preventing secondary conditions, can also be

addressed. Although advanced technology and specialized equipment can

assist in the application of these neuroplastic principles, there are also less

costly options that may be more readily available to clinicians.

Main Outcome Measure(s): Not applicable.Results: Not applicable.Conclusions: It is feasible to safely implement an activity-based program

into an acute rehabilitation settingwith thegoal of facilitating neuroplasticity

and increasing functional recovery. Though prospective studies are neces-

sary to determine effectiveness, therapists and patients have both responded

positively to the addition of early AB interventions. Additional future goals

include developing clinical decision making paradigms to enable clinicians

to easily translate the current evidence into reasonable daily practice.

Key Words: Inpatient Rehabilitation, Spinal Cord Injury, Activity-

Based Therapy

Disclosure(s): None disclosed.

Poster 244

Mobility Assistance Dog Reduces Upper Limb Efforts DuringWheelchair Propulsion on Tiled and Carpeted Floors

Dany H. Gagnon (Universite de Montreal), Valerie Martin-Lemoyne,Claude Vincent, Francois Routhier

Objective: To compare upper limb efforts when propelling a wheelchair on

a tiled and carpeted floors with and without using the traction provided by

a mobility assistance dog (ADMob).

Design: Single-group quasi-experimental analysis of differences.

Setting: Pathokinesiology laboratory.

Participants: Thirteen adults with a spinal cord injury (SCI) who use a

manual wheelchair as their primary source of mobility and own a ADMob.

Interventions: Participants randomly propelled their wheelchair at natural

speed on a 10-meter distance over a tiled abrasive and a medium pile

padded carpet floors with and without their own ADMob.

Main Outcome Measure(s): The spatiotemporal parameters and the han-

drim forces were computed with instrumented wheels whereas the

muscular demand of the anterior deltoid, pectoralis major, biceps and

triceps was recorded using surface electromyography.

Results: The traction provided by the ADMob when propelling on a tiled

(-38.2%) and carpeted (-71.5%) floors reduced the total amount of force

applied at the handrim in comparison to doing so without the ADMob. The

traction provided by the ADMob significant reduced the muscular demands

of the anterior deltoid (-65.6% and -43.6%), the pectoralis major (-52.4%

and -33.4%), and the triceps (-46.9% only for carpeted floor) when pro-

pelling on the tiled and carpeted floors, respectively, in comparison to

doing so without the ADMob. No significant effect was found at the biceps.

Conclusions: The provision of ADMob represents a therapeutic alternative

that minimizes upper limb risk exposure and optimizes functional capacity.

Key Words: self-help devices, wheelchair, assistive technology, spinal

cord injury

Disclosure(s): None disclosed.

Poster 245

Cluster Analysis of Functional Outcomes using the Spinal CordInjury: Functional Index (SCI-FI)

Denise Fyffe (Kessler Foundation Research Center), Claire Kalpakjian,Mary Slavin, Pamela Kisala, Steven Kirshblum, Alan Jette,David S. Tulsky

Objective: To determine the injury and demographic characteristics that

distinguish groups of persons with SCI based on their self-reported func-

tional activities.

Design: Cross-sectional cluster analysis.Setting: Inpatient rehabilitation hospital and long-term care settings.

Participants: A sample of 800 individuals with traumatic spinal cord

injury enrolled in 6 rehabilitation centers participating in the 2006-2011

Spinal Cord Injury Model Systems.

Interventions: Not Applicable.Main Outcome Measure(s): SpinalCord Injurye Functional Index (SCI-FI).

Results: Cluster analyses identified three distinct groups that represent

low, average and high scores on the SCI-FI. Comparison of clusters on

personal and other injury characteristics suggested some significant dif-

ferences between groups. In general, injuries in the cervical region were

more heterogeneous than those in the thoracic and lumbar regions in terms

of SCI-FI score clusters.

Conclusions: Results of the analysis suggest that the SCI-FI captures

function by injury level as well as AIS grade. Heterogeneity of clustering

within levels of injury was influenced by AIS grade as well as additional

factors that warrant further investigation to better understand self-reported

physical functioning in individuals with SCI. These results strongly support

the use of SCI-FI domains to measure physical function in persons with SCI.

Key Words: Spinal Cord Injuries, Cluster analysis, Motor Activities

Disclosure(s): None Disclosed.

Poster 246

Repetitions in Physical and Occupational Therapy During Spinal CordInjury Rehabilitation

Dominik Zbogar (University of British Columbia), Janice Eng,William Miller, Andrei Krassioukov, Molly C. Verrier

Objective: To quantify the amount of lower extremity and upper extremity

movement repetitions that occur during inpatient SCI rehabilitation, and

examine how repetitions change from admission to discharge.

Design: Longitudinal observational study.Setting: Two Canadian inpatient SCI rehabilitation centres.

Participants: The 105 patients in this investigation were consecutive ad-

missions. They were 49�17 years old. Average time in rehabilitation was

96�46 days. Fifty-five patients had paraplegia and 50 tetraplegia. Forty-

seven were ambulatory at discharge.

Interventions: Two days of therapy were observed and averaged for

admission and discharge. Observers recorded the time and repetitions for

all activities. For analyses, we split patients into those with paraplegia or

tetraplegia, and a subgroup of those able to ambulate at discharge. T-tests

(admission vs. discharge) were used for therapy time and upper and lower

extremity repetitions.

Main Outcome Measure(s): Repetitions of upper and lower extremity

movements and change from admission to discharge.

Results: Therapeutic time composed between 56-67% of total therapy

time. The highest repetitions for upper extremity movements were seen

with patients with tetraplegia in OT (111.9�170.2) and there was a sig-

nificant decrease by discharge (56.1�127.9, pZ0.003). The highest value

for hand repetitions was also seen in OT (67.9�122.4). The highest

repetition values for the lower extremity (291.7�303.8) and steps

(128.3�188.2) were seen in PT with ambulatory patients.

Conclusions: It appears that repetitions of upper extremity and lower ex-

tremity movement fall far below what the motor learning literature shows

may be optimal to drive the neural reorganization needed to promote

optimal function after SCI.

Key Words: occupational therapy, physical therapy, repetitions, spinal

cord injury

Disclosure(s): None Disclosed.

Poster 247

WITHDRAWN

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