William Zev Rymer. Objective: Acute intermittent hypoxia (AIH) facilitates neurological re- covery in chronic spinal cord injury (SCI), however circulating inflam-.
Spinal Cord Injury Poster 258 Motor Function in Chronic Spinal Cord Injury After Exposure to Ibuprofen and Intermittent Hypoxia Kelly Deatsch, Sudarshan Srivatsan, Meaghan Lynch, Lynsey Duffell, Allison Kessler (Rehabilitation Institute of Chicago), Arun Jayaraman, William Zev Rymer Objective: Acute intermittent hypoxia (AIH) facilitates neurological recovery in chronic spinal cord injury (SCI), however circulating inflammatory cytokines may limit AIH effects. We aim to determine if a single dose of ibuprofen augments the effects of AIH on motor strength in humans with SCI. Design: Double-blind, randomized placebo-crossover trial. Setting: Clinical laboratory in an academic rehabilitation hospital. Participants: 12 adults with chronic motor-incomplete SCI. Interventions: Administration of ibuprofen 800mg or placebo, followed by 30 minutes of rest, and then 45 minutes of exposure to AIH (alternating between FiO2 of 9% and 21% each minute) via respiratory mask. Main Outcome Measure(s): Maximum isometric ankle plantar flexion torque measured by a strength testing dynamometer. Agonist and antagonist muscle activity during ankle plantar flexion assessed with surface electromyography (EMG).Outcome measures were tested preintervention, and then immediately, 30 minutes, and 60 minutes postintervention. Results: Torque significantly increased with time after exposure to AIH for both ibuprofen and placebo groups (pZ0.004). There was no difference in improvement in torque between the ibuprofen and placebo groups. Increase in torque compared to baseline was significant at 30 minutes (pZ0.008) and 60 minutes (pZ0.011) after AIH. There was no correlation with EMG activity over time for either group. Conclusions: AIH systematically increased torque output in individuals with chronic SCI, but there was no differential effect with a single dose of ibuprofen 800mg. Further research is needed to investigate whether alternative ibuprofen dosing or timing of administration facilitates the effects of AIH in humans with SCI. Key Words: hypoxia, spinal cord injuries, muscle strength dynamometer, ibuprofen, rehabilitation Disclosure(s): None disclosed. Poster 259 The Participation and Quality of Life (PAR-QoL) Tool-Kit: Outcomes and Next Steps Sander Hitzig (University of Toronto), Franc¸ois Routhier, Luc Noreau, Dahlia Kairy, Atack Lynda, B. Catharine Craven Objective: The selection process for an appropriate quality of life (QoL) outcome tool for persons with spinal cord injury (SCI) can be a challenge. To help address this issue, the Participation and Quality of Life (PAR-QoL) tool-kit (www.parqol.com) was developed as a web-based resource designed to support SCI researchers and clinicians with the QoL outcome measure selection process. The current paper provides an overview on the development of the PAR-QoL Tool-Kit, outcomes to-date, and planned next steps. Design: Review. Setting: Toronto, ON; Quebec, QC. Participants: Not applicable. Interventions: The PAR-QoL Tool-Kit, a web-based educational resource. Main Outcome Measure(s): Web-analytics. Results: The PAR-QoL Tool-Kit provides information on over 60 QoL outcome measures, and summarizes which ones (a) have been used to assess specific secondary health conditions, (b) are sensitive to its impact, and (c) have appropriate psychometrics for the SCI.To help clarify QoL concepts, Dijkers (2005) model was used to classify each outcome measure to delineate if they assess an objective (i.e., societal) perspective of QoL or a subjective one (i.e., individual). To build a strong community of users, the site hosts a number of ’dynamic’
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e83 features, which includes a monthly blog, news and events, newsletter, ask-an-expert spotlight, and forum.Between Apr. 2012 and Mar. 31, 2014, the website received 77,453 visitors (15% return visitors), with the largest groups of visitors originating from the U.S. (28.7%), U.K. (11.5%), and Canada (9.4%). Conclusions: Although analytics demonstrate that the PAR-QoL tool-kit is being accessed by a significant number of users across the world, further work is needed to identify strategies for effective implementation. Key Words: Spinal cord injuries, Outcome assessment (health care), Quality of life, Internet Disclosure(s): None Disclosed. Poster 260 Evaluation of a Spinal Cord Injury Community Reintegration Outpatient Program (CROP) Service Sander Hitzig (University of Toronto), Patricia Bain, Sylvia Haycock, Deborah A. Hebert Objective: To evaluate the effectiveness of a community reintegration outpatient (CROP) service for promoting well-being and community participation following spinal cord injury (SCI). Design: Mixed methods study using a within-subject time-series design and qualitative content analysis. Setting: Rehabilitation institute. Participants: Community-dwelling adults (N Z 14) with traumatic and non-traumatic SCI who were less than 3 years post-injury/onset. Interventions: The CROP service is a 12-week (1 x week; 120 minutes) inter-professional closed therapeutic education service. Main Outcome Measure(s): Moorong Self-Efficacy Scale (MSES); Impact on Participation and Autonomy (IPA); Positive Affect and Negative Affect Scale (PANAS); Coping Inventory of Stressful Situations (CISS); World Health Organization Quality of Life (WHOQOL-BREF); Semi-structured qualitative interviews. Results: Twenty-one participants were recruited from two subsequent CROP services, with only 14 persons completing all data assessments. Data on the MSES, IPA, PANAS, CISS and WHOQOL-BREF were collected at baseline (week 0), exit (week 12), and at a three-month follow-up.Semistructured interviews were conducted at exit. Friedman tests’ revealed that self-efficacy (MSES) and positive affect (PANAS) improved from baseline to exit (p < .01), as did the use of social diversion as a coping strategy (CISS; p < .01), but the changes were not maintained at follow-up.Qualitative analyses identified four major themes: (1) Role of Self; (2) Knowledge Acquisition; (3) Skill Application; and (4) Group Processes. Conclusions: Participation in a therapeutic education service has the potential to improve well-being in persons with SCI, but there is a need to identify strategies to maintain gains long-term. Key Words: Spinal cord injuries, Adjustment, Psychological, Coping skills, Community Participation Disclosure(s): Sander Hitzig, None disclosed; Patricia Bain developed and manages the CROP Service; Sylvia Haycock developed and manages the CROP Service; Debbie Hebert, None disclosed. Poster 261 Role of Somatosensation in Upper Limb Function After Cervical Spinal Cord Injury: Implications for Evaluation Sarah Woodworth (Shepherd Center), Casey Kandilakis, Mark Sweatman, Lewis Wheaton, Deborah Backus Objective: Examine the relationship between sensorimotor impairment and UL function after cervical spinal cord injury. Design: Quasi-experimental, descriptive study. Setting: Non-profit, private rehabilitation hospital. Participants: Individuals with chronic, incomplete, tetraplegia. Interventions: None. Main Outcome Measure(s): The ASIA UL motor exam, the International Classification of Surgery of the Hand in Tetraplegia (ICSHT), and
