London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 773 809 Rehabilitation and reorganisation after stroke Functional outcome during the first year after aneurysmal subarachnoid hemorrhage R. Braaksma1, Y. Nawijn2, S.M. Brink3, C.H. Emmelot4 Isala clinics, Zwolle, THE NETHERLANDS1, De Vogellanden, Zwolle, THE NETHERLANDS2, Isala clinics, Zwolle, THE NETHERLANDS3, Isala clinics, Zwolle, THE NETHERLANDS4 Purpose: to describe the subjective functional situation of patients during the first year after occur-rence of an aneurysmal subarachnoid hemorrhage (SAH). Materials and methods: a prospective cohort study within an aftercare project. Patients who had been hospitalized between February 2009 and December 2010 were included. Primary outcome measure was the Frenchay Activities Index (FAI). Secondary outcome measures were the Barthel Index (BI), Cognitive Failures Questionnaire (CFQ), Hospital Anxiety and Depression Scale (HADS), Caregiver Strain Index (CGSI) and a work questionnaire. Questionnaires were applied after 3, 6 and 12 months. At 3-months follow-up patients were asked to complete the FAI with the premorbid situation in mind. Results: 126 patients were hospitalized, from whom 57 patients participated in the aftercare project. Data of 36 patients was suitable for analysis. The premorbid FAI score, the score after 6 and 12 months were respectively 33.6 (95% CI 32-35.3), 28.9 (95% CI 26.5-31.4) and 31.2 (95% CI 29.1-33.2). Differences between the premorbid situation and the follow-up assessments at 6 and 12 months were statistically signif-icant, but not clinically relevant. BI, CFQ, HADS and CGSI did not show any significant change in time. At 12-months follow-up 9 of 26 previously working patients had fully resumed their occu-pation. Of the 22 patients who had been discharged home without rehabilitation treatment, 5 were referred for an out-patient rehabilitation treatment during follow-up. Most important reasons for referral were cognitive problems and problems in work resumption. Conclusion: although no clini-cally relevant changes were found, study results indicate a worsening of the functional situation as a result of a SAH, followed by improvement between 6 and 12 months. Questionnaire results did not suggest cognitive or psychological complaints, however cognitive problems turned out to be an important reason for referral for rehabilitation treatment in a later stadium. This study confirms the importance of assessment of SAH patients by a rehabilitation physician in order to signal problems and start appropriate rehabilitation treatment if necessary. 810 Rehabilitation and reorganisation after stroke Cardiorespiratory responses during the six-minute walk and ramp cycle ergometry tests and their relationship to physical activity in stroke N.M. Salbach1, D. Brooks2, J. Romano3, L. Woon4, T.E. Dolmage5 Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, CAN-ADA1, Department of Physical Therapy, Faculty of Medicine, University of Toronto; Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, CANADA2, Department of Re-spiratory Medicine, West Park Healthcare Centre, Toronto, CANADA3, Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, CANADA4, Department of Respiratory Medicine, Respiratory Diagnostic & Evaluation Services, West Park Healthcare Centre, Toronto, CANADA5 Background: The six-minute walk test (6MWT) is used to measure exercise capacity after stroke. We sought to compare cardiorespiratory responses during the 6MWT with responses to a ramp cycle ergometry test (CET) in community-dwelling individuals with stroke. A secondary objective was to determine the relationship between cardiorespiratory responses during each test and daily physical activity. Methods: Participants completed three evaluation sessions. The CET and 6MWT were conduct-ed in two separate sessions at least 72 hours apart. Participants wore a portable gas analysis unit (Cosmed™ K4b2) which also measured heart rate during the 6MWT. A uniaxial accelerometer (ac-tivPAL), attached to the thigh of the participant’s unaffected lower limb, was used to estimate daily physical activity over five days. Results: Complete CET and 6MWT data were obtained for 16 participants (14 men), a mean +/- standard deviation of 2.0 +/- 1.1 years after stroke and aged 71.1 +/- 9.7 years. Compared with the 6MWT, the CET elicited a higher VO2peak (p=0.032), VCO2peak (p=0.005), and self-reported perceived breathing (p<0.0001) and leg heaviness (p<0.0001) at test completion, and a lower peak heart rate (p=0.029). Except for the first minute, VO2 during the 6MWT was, on average, 80-85% of VO2peak from the CET. Among 15 participants, average steps per day was associated with 6MWT distance (r=0.538, p=0.039) but not with VO2peak from the CET (r=0.133, p=0.636). Conclusions: The intensity of exercise achieved during the 6MWT appears sufficiently high for aer-obic training assuming CET VO2peak accurately reflects aerobic capacity. Moreover, 6MWT dis-tance related to physical activity. Study findings have implications for using the 6MWT to prescribe aerobic exercise post-stroke and to indicate preparedness for physical activity post-stroke.
Karger_ESC London_2013
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