Cara Prideaux

Pharmacologic Treatment for Depression at Injury Is Associated With Fewer Clinician Visits for Persistent Symptoms After Mild Traumatic Brain Injury: A Medical Record Review Study

Depression and traumatic brain injury (TBI) substantially contribute to the U.S. health care burden. Depression is a known risk factor for prolonged recovery after TBI. However, the effect of depression treatment on health care utilization has yet to be studied.

Poster 189 Multilevel Spondylolysis in An Adolescent Athlete: A Case Report

gained popularity among clinicians and increased cross sectional area (CSA) of median nerve at carpal tunnel level has been found as the most sensitive parameter for sonographic finding of CTS. Quantitative US (QUS) can be used for demonstrating muscle changes according to denervation. In this study we aimed to find diagnostic utility of quantitative US in patients with CTS. Design: A single blinded pilot study. Setting: Tertiary care hospital, physical medicine and rehabilitation clinic. Participants: The study was completed with 31 hands of 19 patients and 20 hands of 10 healthy controls. Interventions: The study consisted three groups; mild CTS, moderatesevere CTS, and healthy controls. All subjects were assessed clinically by first researcher. Patients with clinical CTS were referred to NCS. Median and ulnar motor, median and ulnar sensory NCS were performed by a blinded electromyographer. Main Outcome Measures: Ultrasonographic assessments were performed by a blinded, well trained specialist with using a 6-18 MHz linear array probe (Esaote Mylab 60, Italy). Nerve CSAs were measured in psiform bone level by tracing the nerve just inside its hyperechoic rim. Abductor pollicis brevis (APB) and adductor digiti minimi muscles were visualized axial and longitudinal with a standardized protocol. BMP images of these muscles were captured and histograms were obtained with free software. Results: Median nerve CSA of patients with CTS was larger than healthy age matched controls (P1⁄4.001). Despite the QUS scores of APB muscle were increased in patients with CTS, there was no statistical significance (P1⁄4.08). Conclusions: Median nerve CSAs were larger than healthy control in patients with CTS. QUS of APB muscle in axial view particularly increased in patients with moderate-severe CTS. QUS may be beneficial to differentiated the severe cases. Level of Evidence: Level II

Wrestlers with Limb Deficiencies: A Descriptive Study.

ObjectiveThe objective of this study was to determine if wrestling is a safe, positive athletic option for limb-deficient individuals. DesignThis descriptive study consisted of an opportunity sample of limb-deficient wrestlers, aged 5 yrs and older with at least 1 yr of experience. Participants completed a questionnaire regarding health, satisfaction, and achievements. Descriptive statistics were used for analysis. ResultsSixteen male wrestlers reported nine below-the-knee, five above-the-knee, and three below-the-elbow limb deficiencies. There were nine congenital deficiencies and seven amputations acquired during childhood. Two individuals won National Collegiate Athletic Association championships, and seven competed collegiately. All reported a positive impact on quality-of-life, 87% reported no difficulty finding acceptance with the team, and 50% experienced wrestling-related residual limb complications. Associations between (1) residual limb complications before and during wrestling and (2) skin breakdown before and during wrestling did not demonstrate statistical significance (P = 0.30 and 0.1189, respectively). ConclusionsThis study suggests that wrestling is a safe, positive sport for limb-deficient individuals, that it fosters competitive equality between impaired and nonimpaired participants, and that it has a positive impact on health and quality-of-life. The incidence of residual limb complications warrants monitoring.

Poster 35 Evaluation of Correlation Between the Modified Balance Error Scoring System and the Sensory Organization Test as Measures of Postural Stability

300 U (29.2) versus placebo (11.2) (P .001 for both comparisons versus placebo); results at week 12 were similar. OAB-PSTQ total scores at weeks 6 and 12 also were improved for both the 200 U and 300 U onabotulinumtoxinA groups versus placebo; 20.6%, 58.4%, and 56.6% of patients in the placebo, onabotulinumtoxinA 200 U and onabotulinumtoxinA 300 U groups, respectively, reported they were very satisfied with treatment at week 6 (P .001 versus placebo). Conclusions: Patients with NDO treated with onabotulinumtoxinA 200 U or 300 U had significantly improved QOL and greater treatment satisfaction compared with patients treated with placebo, with no clinically relevant differences in efficacy between onabotulinumtoxinA doses.

Poster 27: Stroke-Like Migraine Attacks After Radiation Therapy: A Case Report

Disclosures: L. M. Ruppert, Proctor and Gamble, unrestricted educational grant, Research grants Objective: To establish whether a short multidisciplinary program emphasizing education and home exercise can produce a significant improvement in exercise adherence and knowledge of osteoporosis in cancer patients with diagnosis of osteopenia/osteoporosis. Design: Retrospective review. Setting: Tertiary care cancer center. Participants: 31 individuals with the diagnosis of cancer and osteopenia/osteoporosis based on T scores, deemed able to safely and effectively participate in a group exercise program. Interventions: Four 30-minute lectures over 4 consecutive weeks given by a physiatrist, physical therapist, endocrinologist, and dietician, followed by a 60-minute exercise class lead by a physical therapist. The course is followed by a review and reevaluation 2 weeks after the last class. A binder containing lecture notes and illustrated instructions on exercises was given at first class. Main Outcome Measures: Subjective questionnaires, pre/post test to assess knowledge, pre/post Berg balance scale, pre/post assessment of body mechanics (sit-to-stand/ supine-to-sit/supported sit/picking up an object). Results: 20 participants completed the course. Mean pretest score 55.6 with SD 20.3, mean posttest score 81.8 with SD 16.1. Mean Berg on intake 52 with SD 36, mean Berg on discharge 54 with SD 3. 6 participants showed no change in their Berg scores. Mean score on body mechanics at intake 3.9 with SD 2, and mean on discharge 8.7 with SD 1.7. 14/30 participants reported a regular exercise program (at least 3-4 /wk) at intake, and 17/20 participants who completed the course reported a regular exercise program. 6/7 participants who have received 3-month follow-ups reported performing regular exercise, consisting of the exercises provided in the course. Three-month follow-ups are currently ongoing. Conclusions: A short multidisciplinary program emphasizing education and home exercise can produce improvement in exercise adherence and knowledge in cancer patients with osteopenia/osteoporosis.