European Geriatric Medicine - Supplement 1 - Volume 6

Poster presentations / European Geriatric Medicine 6S1 (2015) S32

–

S156

S111

Methods:

Retrospective data collection about all discharges during

June to September 2013 from a community hospital geriatric

rehabilitation ward.

Results and Discussion:

Average LOS for patients with male NOK

was 37.9 days compared to 31.2 days for those with female relatives;

a significant difference existed between patients with sons and

daughters (P = 0.023) and a trend noted between all comparable

groups. Civil status influenced LOS: divorced patients had shortest

LOS whereas single, never married, patients had the longest LOS;

possibly due to smaller support networks secondary to lack of

offspring. No correlation existed between LOS and distance of NOK,

however discharge location affected LOS: the quickest discharges

were to home, rather than a placement. LOS for those going home

with female NOK (n = 35) was shorter than those with male NOK

(n = 31) however this was not replicated with placements.

Conclusions:

We have made several observations regarding the

demographics of NOK. Generally, if a patient has a female NOK they

have a shorter LOS, in concurrence with our sexist observations.

P-299

Geriatric assessment in nonagenarian patients: prognostic

factors, interdisciplinary interventions and effectiveness on

functional ability

C. Roqueta Guill ´en

, S. Ubero

, M.I. Mart´ınez-Fern ´andez

M. Mart´ın

, N. Leiva

, R. Miralles

Parc de Salut Mar. Centre F`orum, Barcelona, Spain;

Centre F`orum,

Barcelona;

Centre F`orum, Barcelona, Spain;

Parc de Salut Mar

–

Centre Forum, Barcelona, Spain

Objectives:

1. To prove whether nonagenarian patients improve

their functional ability while admitted to a geriatric convalescence

unit. 2. To identify the prognostic factors of functional gain.

Patients and Method:

Prospective study of 212 nonagenarian

patients (75.94% women; average age 92.02 years), who were

admitted to the unit over a period of six years. An overall

geriatric assessment of all the patients was performed, as well as

a program of interdisciplinary interventions and, when indicated,

a rehabilitation program (physiotherapy and occupational therapy).

Variables: age, gender, previous functional ability (Lawton and

Barthel indices), at admission and at discharge (Barthel index), main

diagnosis at admission, cognitive function (Folstein MMSE), depres-

sion (screening question and Yesavage GDS if necessary), nutritional

status (seric albumin, total plasmatic cholesterol, food intake),

comorbidity (Charlson index), presence of geriatric syndromes,

complications during the stay in the unit. Functional improvement

was assessed using the relative functional gain calculation or

corrected Heinemann index (RFG-CHI) (adequate RFG-CHI ≥35%).

Results:

One hundred and twenty-nine patients obtained a RFG-CHI

≥35% (62.62%). Variables associated with a RFG-CHI ≥35% in a mul-

tivariate analysis: Folstein MMSE ≥13 points (OR = 2.63; p = 0.011);

plasmatic albumin ≥2.90 g/dl (OR = 2.61; p = 0.017); admitted for

any non-neurological/vascular disease (OR = 4.92; p

0.001) and

absence of immobility syndrome (OR = 5.62; p

0.001).

Conclusions:

1. A high number of nonagenarians improved their

functional ability with a RFG-CHI ≥35%. 2. The geriatric assessment

and the usual clinical history make it possible to identify most of

the predictive factors of functional gain.

P-300

Gait pattern visualization in geriatric patients using a

displacement measurement of distributed centres of pressure

M. Rudek

, J.-P. Steinmetz

, A. Jahnen

Pontifical Catholic University of Paran´a, Brazil;

Department of

Research and Development, Zitha Senior and Centre for Memory and

Mobility, Luxembourg, Luxembourg;

Luxembourg Institute of Sceince

and Technology (LIST), Luxembourg, Luxembourg

Objectives:

With the present research we investigate the feasibility

of gait stability measurements during walking in a geriatric

rehabilitation setting and visualize the corresponding gait pattern

by a graphical representation to support the interpretation of the

gait analysis.

Methods:

Traditional methods use a platform with embedded

sensors to measure standing stability, with patients instructed to

stand up straight and still during the tests. The method presented

in this work provides additional information on the distribution

of balance and stability during walking by using the GAITRite

system. Our method computationally solves the export of centre

of pressure data (CoP) from the GAITRite

database and plots CoP

distributions of each foot separately along the walkway resulting

in a graphic representation to ease the interpretation of instability

of the patient’s gait by the clinician.

Results:

The graphic representation allows us to perform: (i) intra-

individual comparisons by observing the walking patterns of the

same individual to evaluate the progression of the treatment (e.g.,

rehabilitation), and (ii): inter-individual comparisons by comparing

gait characteristics among different groups (e.g., patients, healthy

individuals).

Conclusions:

The present pilot research discusses a new method to

investigate the distribution of centre of pressures of an individual

during walking. We are able to demonstrate inter- and intra-

individual differences in the walking patterns depending on

the characteristics of the patient. Further research is needed

to improve the developed algorithm to discern better between

different treatment evolutions and between different pathological

and healthy samples.

P-301

Galvanic vestibular stimulation as a possible treatment for

camptocormia?

D. S ´anchez Rodr´ıguez

, A. Romeo Brualla

, M. Tejero Sanchez

N. Bas Costas

, F. Escalada Recto

, A. Tortosa Rodriguez

Centre Forum Hospital del Mar, Spain;

Physical Medicine and

Rehabilitation Department. Parc de Salut Mar, Barcelona, Spain;

Physical Medicine and Rehabilitation Department. Parc de Salut Mar,

Spain

Introduction:

Camptocormia is a disorder characterized by

involuntary flexion of the thoracolumbar spine in sagittal plane

while standing and walking, which resolves completely in supine

position. Camptocormia is associated with Parkinson’s disease

(69%). Therapeutic approaches have not achieved positive results.

Vestibular galvanic stimulation (VGS) could induce a swinging

pelvis, trunk and head back, reducing the angle of anterior trunk

flexion (ATF) in these patients.

Methods:

Longitudinal study; 7 patients with camptocormia that

held a 20-minute VSG session (1.5mA) were included.

Primary outcome: ATF at stand-up position, measured as the

distance (cm) between the C7 spinous process and the vertical

reference line that crosses the sacrum perpendicularly.

AFT was registered in: 1/Stand-up at minute 0 (stand-up); 2/After

remaining 60 seconds (s) with opened eyes (60sOE); 3/After 60s

with closed eyes (60sCE). Evaluations: Before, immediately after

and one month after treatment with VSG. Statistical analysis was

performed using t-student.

Results:

Two males, 5 females, aged 77.5(SD6.1), 5 of whom were

diagnosed of Parkinson’s disease, were included.

AFT after VSG decreased in the stand-up (p

0.05); reduction

obtained in 60sOE (p = 0.075) and 60sCE (p = 0.083) was

nonsignificant. A reduction of 11.25%(SD12.5) in the stand-up,

14.35%(SD11.9) in 60sOE and 16.4%(SD15.9) in 60sCE was observed.

One month after treatment, the effect of ATF reduction remained

in 50% of the patients. Comparing AFT results after a month with

pre-VSG results, differences in the conditions of 60sOE (p = 0.048)

and 60sCE (p = 0.032) were observed.