e20 Stroke

Results: Outcomes from healthy populations demonstrated the advantage

of external focus (think about the task effect) over internal focus (thinking

about the movement itself) during motor skill training leading to better

motor performance and long-term learning (Wulf, 2007).The research for

individuals with stroke is very limited with only two studies meeting our

criteria (Fasoli et al., 2002; Durham et al., in press). Both studies recruited

participants with mild arm impairments, and found that external focus

improved arm reaching more than internal focus cues. No retention data

was measured.

Conclusions: There appears to be a temporary motor training benefit

of utilizing external focus cues compared to internal focus cues for

individuals with mild arm impairment after stroke. Additional studies

are needed to address wide gaps in the literature including retention

data to determine if there are long-term learning effects and the

recruitment of individuals with moderate to severe arm impair-

ments.A study is currently underway at our institution to address

some of the key issues.

Key Words: Motor Learning, Attentional Focus, Stoke Rehabilitation

Disclosure(s): None Disclosed.

Poster 32

WITHDRAWN

Poster 33

Outcome Measure Use in Community-Based Stroke Rehabilitation:Survey of Therapists’ Current Practice in Scotland

Jacqui H. Morris (University of Dundee), Thilo Kroll

Objective: To examine rationale for outcome measure selection by UK

rehabilitation physiotherapists (PTs), occupational therapists (OTs), speech

and language therapists (SLTs).

Design: Web-based survey examining current outcome measure use,

selection and satisfaction with measures. Telephone interviews with

purposefully selected therapists to explore survey findings more

fully.

Setting: Community stroke rehabilitation settings in which rehabilitation

therapists work across14 health boards in Scotland, UK.

Participants: 113 therapists (51 physiotherapists, 39 occupational thera-

pists, 23 speech and language therapists).

Interventions: Not applicable.Main Outcome Measure(s): Web-based survey examining current

outcome measure use, selection and satisfaction with measures. Telephone

interviews with purposefully selected therapists to explore survey findings

more fully.

Results: Most commonly used instruments: PTs: Berg Balance Scale

(80.4%), Tinetti Balance (74.5%), Tinetti Gait (68.6%); OTs: Rivermead

Behavioural Memory Test (48.7%), Barthel Index (46.1%); SLTs:

Therapy Outcome Measure (52.2%), Frenchay Aphasia Screening Test

(30.4%); non-validated (21.7%); locally developed measures 9.9%.

Measure selection: Relevance to patients’ goals (nZ68; 60.2%); easy to

use (nZ59; 52.2%); Good evidence (nZ53; 46.9%); Sensitivity to

change (nZ51; 45.1%); specificity to outcome (nZ49; 43.4%). Only

8.5% and 2.5% of respondents prioritised measure accessibility and

aphasia friendliness respectively; only 13.6% considered eliciting pa-

tients’ views as a selection priority. 37.5% of respondents expressed

dissatisfaction with available measures. Interviews highlighted tension

between best measurement practice and financial constraints, lack of time

and environmental barriers.

Conclusions: Although therapists prioritised patient-centredness and

outcome measures relevance as important for measurement selection many

measures focused on impairment and few therapists prioritised

eliciting patient views or measurement accessibility as a key selection

criteria.Findings highlight gaps between UK policies emphasising patient-

centredness and community rehabilitation practice.

Key Words: Rehabilitation, Stroke, Outcome assessment

Disclosure(s): None Disclosed.

Poster 34

Decreased Tidal Volume May Limit Cardiopulmonary PerformanceDuring Peak Exercise in Subacute Stroke

Jason-Flor Villarosa Sisante (University of Kansas Medical Center),Anna Mattlage, Michael Rippee, Sandra Billinger

Objective: Reduced pulmonary function may be an underlying cause of

post-stroke fatigue during physical activities. The aim of this study is to

determine whether pulmonary function is reduced at peak exercise in

subacute stroke compared to sedentary adults.

Design: A retrospective cohort design.

Setting: Exercise Laboratories, Kansas City, Kansas.

Participants: 10 individuals with subacute stroke and 10 sedentary,

gender-matched and age-similar controls performed a cardiopulmonary

exercise testing on a recumbent stepper.

Interventions: Not applicable.Main Outcome Measure(s): We hypothesized the following cardiopul-

monary measures during peak exercise would be lower in subacute stroke:

peak oxygen consumption (peak VO2, in ml�kg-1�min-1), minute ventila-

tion (VE, in L�min-1), tidal volume (Vt, in L), respiratory rate (RR, in

breaths per minute), and heart rate (HR, in bpm).

Results: Independent t-test revealed subacute stroke had significantly

lower values (p < 0.05) in peak VO2, VE and Vt compared to controls

during peak exercise. However, RR and HR were not different between

groups. No between-group differences were found for age, height,

weight and body mass index. Both groups gave good effort as RER

was > 1.1.

Conclusions: These groups were similar with respect to age, body height

and weight. We report that peak VO2 declines early after stroke. The

largest deficit was found in Vt. Pulmonary function may have a greater

influence on tolerance for physical activity and exercise. These results

suggest that diminished cardiopulmonary fitness in subacute stroke is a

result of impaired pulmonary function. Rehabilitation professionals

should consider respiratory muscle training to improve pulmo-

nary function.

Key Words: Stroke, Exercise Test, Pulmonary Function Test

Disclosure(s): None Disclosed.

Poster 35

Differences in Upper Extremity Versus Lower Extremity MotorFunction in Person’s With Chronic Stroke

Jill Seale (University of Texas Medical Branch), Katy Mitchell,Sharon Olson, Merry Lynne Hamilton, Alexis Ortiz

Objective: To explore differences and relationships upper and lower ex-

tremity (UE/LE) motor function, mobility, gait and quality of life (QOL) in

persons in the chronic phase of stroke.

Design: Prospective, descriptive, methodological research.

Setting: Participants were recruited from the community, and completed

study at a university laboratory.

Participants: Thirty participants, 29-80 years of age. Inclusion criteria:

history of first stroke with unilateral motor deficits at least 1 year ago;

ability to ambulate greater � 10 meters, unassisted; medically stable;

sufficient cognition. Exclusion criteria: other pathologies that affect gait.

Interventions: Not applicable.Main Outcome Measure(s): QOL was assessed using the transformed

Stroke Impact Scale-16 (SIS16), transformed participation (TP) and

percent recovery (PR). Gait was measured using the GAITRite�

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