Research Report Abstracts - Gesundheit

WPT2011, Research Report Abstracts eS881
Active Sensation Test (HASTe). All subjects underwent MRI
testing that included structural and functional MRI scans in
a Phillips 3 Tesla (T) scanner. A manual brush protocol was
used for fMRI acquisition of perception and discrimination
of stimulation to the right index finger. The superior thalamic
radiations (STR) were reconstructed within the stroke
subjects, using a semi-automated double ROI diffusion tractography
approach.
Analysis: Analysis of MRI data was done using Oxford
Centre for Functional MRI of the Brain (FMRIB) Software
Library (FSL). Fiber tracking was carried out in DTIstudio
and was based on the fiber assignment continuous tracking
(FACT) algorithm. Correlations were computed for fiber density,
fMRI activation in SI and SII, and HASTe accuracy
scores.
Results: Brush perception in controls activated left SI and
SII and right cerebellum; the stroke group activated left
supramarginal gyrus, SII and precentral gyrus. Brush discrimination
in controls activated a previously described
network linking left SI and bilateral SII with the right paracingulate
gyrus, middle frontal gyrus and precentral gyrus.
Activation for the stroke group was primarily contralesional
(right), located in supramarginal, paracingulate, precentral
and left SII. Fiber density within the lesioned STR was diminished
for all but one subject. SI activation strongly correlated
to STR fiber density (r = .79, p = .02). SI and SII activation
trended toward significance with HASTe scores (r −.52 and
.56, respectively, p = .12).
Conclusions: This study confirms the relationship between
structural connectivity (STR fiber density) and functional
activation in the primary sensory cortex and suggests a similar
relationship between haptic sensory function and fMRI
activation within SI and SII.
Implications: Since sensory deficits impact motor recovery,
the development of rehabilitation protocols that maximize
neural plasticity within the STR and sensory cortex are
needed to promote greater functional recovery.
Keywords: Stroke; fMRI; Diffusion tractography
Funding acknowledgements: OSUMC Neuroscience Signature
Program Seed Grant, National Center for Research
Resources TL1 RR025753, The Wright Center of Innovation
(WCI) in Biomedical Imaging at The Ohio State University,
Ohio Department of Development (AGMT TECH 03-051).
Ethics approval: Protocol was approved by The Ohio State
University Biomedical Sciences IRB.
Research Report Platform Presentation
Number: RR-PL-2072 Thursday 23 June 11:30
RAI: Elicium D201-202
MOVING CLINICAL PRACTICE FORWARD IN
CHILDREN WITH PRIMARY LANGUAGE
DISORDER USING THE INTERNATIONAL
CLASSIFICATION OF FUNCTION, DISABILITY
AND HEALTH FRAMEWORK
Nicola K., Watter P.
The University of Queensland, Division of Physiotherapy,
Brisbane, Australia
Purpose: This audit examined the assessments used by
members of the interprofessional team which provided management
for children with primary language disorder (PLD).
This service was provided within a school setting – The
Glenleighden School (TGS) – in Brisbane, Australia which
operates specifically to manage these clients. The framework
provided by the International Classification of Function, Disability
and Health (ICF) was used to identify the scope of
assessment and where duplication of assessments and possible
over-assessment may occur.
Relevance: PLD is a developmental language disorder with
unknown aetiology often called Specific Language Impairment
in the literature, and prevalence of 7.4%. Children
with PLD have a complex presentation including additional
deficits in fine and gross motor performance, education
and behaviour, requiring interprofessional management. This
paper explores the placement, scope and overlap of the assessments
used by the interprofessional team within the ICF
framework, illustrating the usefulness of the ICF in guiding
future assessment in this population.
Participants: Files of all children (n = 119, males = 90)
attending TGS between 2000 and 2008, and diagnosed with
primary language disorder, were audited.
Methods: The assessments used within each discipline were
identified and placed within the ICF framework after discussion
with relevant professionals and reference to manuals.
Tests, including subtests, were organized according to ICF
domains rather than discipline. To allow us to identify
where tests measured similar performances, results of each
assessment were audited and relationships between assessments
were explored, both between and within various ICF
domains.
Analysis: Statistical Package for the Social Sciences program
was used to compute frequencies and correlations between
the assessment results. Alpha was set at p = 0.05.
Results: Across disciplines, multiple and most assessments
occur in the body structure and function (BSF) and activity
domains (AD) with no formal assessment of participation.
Some recognition of contextual factors was reported. Strong
and significant correlations were found between many subtests
across and within the ICF domains, for example (i)
across domains: Posture and balance scores (BSF) correlated
with Bruininks balance scores (AD), (r = 0.775, p = 0.00),