Medicine and Health Sciences Commons^™

Steroid Treatment Causes Weakness In Spinal Dural Arteriovenous Fistula, Mina Na, Do, Brandon Kase, Md, Roger Liu, Do, Kristin Gustafson, Do

Department of Rehabilitation Medicine Posters

Introduction: Spinal dural arteriovenous fistula (SDAVF) is an abnormal connection between the arterial and venous system creating an increase in blood flow and pressure into the spinal veins¹ at an estimated frequency of 5-10 cases per million per year.² Activities that increase intrathoracic and venous pressure such as Valsalva, abdominal compression and steroids_² can lead to a venous infarction, subarachnoid hemorrhage, paraplegia or tetraplegia.³ SDAVF is difficult to diagnose as it presents similarly to other neurologic disorders, but if diagnosed early, deficits can be prevented and reversed with intervention.¹

Case Description: A 54-year-old male presented …

60 Year Old Male With Autonomic Dysreflexia In C7 Ais A Secondary To A Suprapubic Catheter Inflation In The Membranous Urethra, Brandon Kase, Md, Joshua Levin, Do, Kristin Gustafson, Do

Department of Rehabilitation Medicine Posters

Introduction: Autonomic dysreflexia is a potentially lifethreatening complication in patients with a spinal cord injury above the level of T6. A dangerous symptom is an increase in blood pressure induced by reflex sympathetic hyperactivity secondary to a noxious stimuli which can lead to cerebral hemorrhages, seizures, heart failure or pulmonary edema.¹ The most common causes of autonomic dysreflexia are noxious stimuli to the 1) bladder such as urinary tract infection, distension, or catheterization; 2) bowel, such as constipation or 3) skin such as wounds, or tight clothing. Though Foley catheters and intermittent catheterizations are well known causes of dysreflexia …

Upper Limb Capabilities, Self-Care And Fine Motor Activities With And Without Equipment In Persons With Cervical Spinal Cord Injury At Discharge From Rehabilitation And 1 Year Post-Injury, Ralph J. Marino, David Chen, Sara Mulroy, Edelle Field-Fote, Benjamin Leiby

Department of Rehabilitation Medicine Posters

Introduction: There is little information on the impact of assistive technology or devices (AT) on function. The purpose of this project was to explore the impact of AT on self-care (SC) and fine motor (FM) function in persons with cervical SCI, and to examine the functional capabilities of those who benefit from AT.

Methods: Persons with acute cervical SCI, all levels and AIS grades, with an upper extremity motor score (UEMS) > 0 were enrolled. At discharge from rehabilitation and 1 year post-injury we collected the Capabilities of Upper Extremity questionnaire (CUE-Q), and the combined SC and FM questions of the …

Carbidopa-Levadopa Improves Speech Apraxia After Open Traumatic Brain Injury, James J. Bresnahan, Md, Philip J. Koehler Iii, Do, Mithra B. Maneyapanda, Md

Department of Rehabilitation Medicine Posters

Case Description

• A 24-year-old male with open traumatic brain injury (TBI) due to gunshot wound (GSW).
• Initial evaluation revealed a GCS of 3 with GSW to left arm, left abdomen, left flank, and left skull.
• Initial work up with CT-Head showed extensive subarachnoid hemorrhage and cerebral edema with residual bullet fragments in the posterior fossa.
• Thirty days later he was transferred to our rehabilitation hospital.

Locked-In Syndrome Due To Neuromyelitis Optica Spectrum Disorder In Acute Rehabilitation: A Case Report, James J. Bresnahan, Md, Summer Schultz, Md, Mithra B. Maneyapanda, Md

Department of Rehabilitation Medicine Posters

Case Description

• 56-year-old female patient with prior questionable diagnoses of brainstem infarct, multiple sclerosis, and systemic lupus erythematosus who presented to the hospital with progressive dysarthria, lethargy, and weakness.
• MRI noted bilateral demyelinating lesions of the midbrain, pons, and middle cerebellar peduncles as well as nonspecific signal abnormality in the spinal cord at T6-T7.
• Her condition further deteriorated to flaccid complete tetraplegia. Communication was limited to extraocular movements and eye blinking.
• Serum aquaporin-4 antibody assay was positive.
• She was diagnosed with NMOSD resulting in transverse myelitis and locked-in syndrome.
• She was treated with IVIG and high-dose steroids and eventually plasma …

A Novel Case Based Approach To Icf Education For Pm&R Residents, Nick Freedman, Do, Michael Mallow, Md, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Posters

Little exists in the literature on reliable methods of ICF education. Our goal was to increase knowledge of the ICF and encourage residents to use the ICF framework to inform their clinical thinking through a case-based exercise.

An Unusual Cause Of Proximal Thigh Pain: Focal Dystonia Of The Psoas, James J. Bresnahan, Md, Mitchell H. Paulin, Md

Department of Rehabilitation Medicine Posters

Case Description

• 68-year old female presented for evaluation of right groin pain.
• The pain in her groin radiated superiorly to the lower abdomen and inferiorly to the anteromedial aspect of the proximal thigh and was ongoing for >8 years
• Physicians seen: Neurosurgery, Orthopaedics, Pain Management
• Testing: MRI L-Spine showing degenerative changes and no significant neuroforaminal or spinal stenosis.
• Treatments: PT, multiple epidural steroid injections, facet joint injections, medial branch blocks, and a spinal cord stimulator trial

50th Anniversary: Leading The Way In Rehabilitation Medicine (1969-2019), Carol Abbott

Department of Rehabilitation Medicine Posters

No abstract provided.

Trends In Rates Of Asia Impairment Scale Conversion In Traumatic Complete Spinal Cord Injury, R. Marino, M. Leff, D. Cardenas, D. Chen, S. Kirshblum, B. Leiby

Department of Rehabilitation Medicine Posters

Objective: Recent studies on conversion of ASIA Impairment Scale (AIS) grades report higher rates of conversion than older studies. The purpose of this study is to examine the rate of conversion over time in persons with ASIA Impairment Scale (AIS) grade A spinal cord injury (SCI), accounting for level of injury.

Methods: Subjects were injured between 1995 and 2015, enrolled in the National SCI Database as Day-1 admissions, at least 16 years old at the time of injury, classified as AIS A, and had an initial examination within 2 weeks of injury. Change in AIS grade was determined for …

Functional Swallow-Related Outcomes Following Transoral Robotic Surgery For Base Of Tongue Carcinoma: A Pilot Study, Kelly Salmon, Slpd, Ccc-Slp, Bcs-S, Clt-Lana, Cesar Ruiz, Slpd, Ccc-Slp, Bcs-S

Department of Rehabilitation Medicine Posters

In an era where the incidence of oropharyngeal cancer has been growing steadily, there is a limited amount of research exploring functional outcomes for individuals whose definitive cancer management approach includes transoral robotic surgical (TORS) resection with or without adjuvant treatment.

This study was designed to examine functional outcome measures related to tongue strength, swallow function, oral intake, and quality of life in individuals newly diagnosed with base of tongue (BOT) cancer whose treatment plan included surgical resection via TORS, with or without a plan for subsequent adjuvant treatment in the form of radiation or chemoradiation. Data was collected preoperatively …

A Week Devoted To Wellness In The Preclinical Phase: Lessons Learned, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Posters

Background

During the 2017-2018 academic year, a large private medical college underwent a complete transformation of its curriculum from a primarily lecture based, traditional format to an integrated, longitudinal format that included both time limited blocks and longitudinal threads of content. Wellness, conceptualized at both wellness of the provider and the patient, is one of the eight threads.

Goals

• Provide a structured pause in medical school for you to reflect on your own wellness
• Allow time to explore the ideas of resilience
• Provide time for rejuvenation
• Allow you to start building productive habits to last you throughout your entire medical …

All Limbs Lead To The Trunk, Daniel E. Graves, Phd, Darryn Atkinson, Phd, Pt

Department of Rehabilitation Medicine Posters

This poster describes the development of and the psychometric properties of the trunk scale that measures the voluntary motor ability in the thoracic and upper lumbar regions. The function of the trunk musculature has far reaching implications, particularly in persons with SCI, where postural control and voluntary movement are compromised to varying degrees. Precisely coordinated muscle actions must occur in the appropriate sequence, duration, and combination for the optimal movement function and maintenance of balance and posture during dynamic activities. Trunk mobility is required for nearly all mobility tasks, particularly transitional movements such as rolling, supine to sit, and sit …

Culture Of Mobility, Beth Colborn, Dpt, Helene Daly, Msn, Rn, Kathleen Hilbert, Rn, Msn, Cm, Gordon R. Reeves, Md, Jessica Shank, Pt, Mpt, Elizabeth Singh, Dpt, Lisa Wus, Dnp, Rn, Crnp, Pccn-Cmc

Department of Rehabilitation Medicine Posters

Objectives

•Create an interdisciplinary approach to patient mobility and functional independence

•Provide education and support to lead a culture of mobility

•Develop a system that reduces immobility related adverse outcomes and promotes overall patient well-being

•Utilize evidence based practice to create a program that will decrease variation in patient care in order to optimize hospital based outcomes

Acute Rehabilitation Of Spinal Epidural Abscess Following Triple Laminectomy: A Case Report, B. A. Dahlben, Ms, D. Fleischmann, Md

Department of Rehabilitation Medicine Posters

Case Description:

• A 36-year-old man presented with a large epidural collection, shown on MRI to extend from C1-S5 and resulting in spinal canal narrowing (Figures 1-3). The patient was admitted for acute inpatient rehabilitation after neurosurgical treatment and stabilization s/p C7-T1, T7-8, L4-5 laminectomies.
• He presented with impaired mobility and activities of daily living, and reported moderate pain in the back and lower extremities, but without specific distribution, during PT/OT therapies.
• Throughout his 7-day length of stay, the patient was closely monitored for methicillin-susceptible S. aureus bacteremia, and he received IV oxacillin and oral rifampin. Active medical problems …

Road To Recovery: Dysphagia Treatment With An Adult With Sma Type Ii, Kara Maharay, M.S., Ccc-Slp, Bcs-S, Kelly Salmon, M.A., Ccc-Slp, Bcs-S, Clt-Lana, Ronald S. Kaiser, Ph.D

Department of Rehabilitation Medicine Posters

Objective: Spinal Muscular Atrophy (SMA) is a genetic and degenerative motor neuron disease that affects muscle control including the muscles responsible for head and neck control and swallowing (Kesting, n. d.). There is limited research on the benefits of exercise as a therapeutic modality for people with Spinal Muscular Atrophy (SMA) (Swoboda et al., 2007) and no existing research specifically targeting pharyngeal or laryngeal strengthening to improve swallow function. As demonstrated by the positive outcome in this case study, speech-language pathologists should be aware that various modalities for dysphagia treatment such as biofeedback, neuromuscular electrical stimulation (NMES), and an exercise …