Meeting Abstracts Oral Session O1: Spontaneous Motor Recovery After Cerebrolysin Treatment in a Mouse Model of Stroke

s From the 2018 Annual Meeting 1110 Neurorehabilitation and Neural Repair 32(12) were recruitment rate, successful protocol completion, and documentation of safety incidences. Additionally, preliminary data on BLT training efficacy (step length, cadence, symmetry) and change in over-ground walking performance (10-meter walk test), and exercise capacity (6-minute walk test) were collected at baseline, posttraining, and at 1 month. Enrollment goal is 36 participants. Results: Between September 5, 2017, through July 10, 2018, 25 people were screened, and 21 met the criteria for enrollment. Ninety-five percent (20 of 21) enrolled participants successfully completed the study. One dropout occurred on day 1 of 6 of training and was due to excess fatigue. There were no serious adverse events with BLT or tsDCS, and both were well tolerated. All patients reported feeling stronger and more confident in forwarding walking. Posttraining, the mean change in walking speed was +0.27 ± 0.20 m/s and sustained +0.30 ± 0.21 m/s at 1 month. Similarly, there was a 56.2 ± 38.8 M improvement in walking capacity posttraining and 65.5 ± 41.0 M at 1 month. Conclusion: This pilot study shows the feasibility and safety of BLT+ tsDCS in stroke. Our preliminary findings suggest that our BLT protocol is efficacious in improving over-ground walking speed and exercise capacity in chronic stroke patients. To maintain blinding, between-group comparison (to determine the effect of tsDCS) is deferred until study completion. F50: A Novel EMG-Based Robotic Control for Restoring Normal Synergies After Stroke Thomas Augenstein, Edward Washabaugh, Christian Remy, Chandramouli Krishnan University of Michigan, Ann Arbor, MI, USA Muscle weakness and loss of independent joint control are the 2 most common neuromotor impairments after stroke. While there are a number of approaches to improve poststroke muscle weakness, there are currently no rehabilitation strategies that directly target a patient’s inability to match and independently activate the normal patterned muscle coordination strategies, or “muscle synergies.” Our goal is to develop an EMG-based controller for retraining healthy muscle synergies in patients with stroke-related disabilities. The controller can be integrated into rehabilitation robots for their ability to structure the robot’s force output based on input EMG activity. However, developing such a controller would require a clear understanding of the relationship between the applied force from a rehabilitation robot and the resulting changes to a patient’s muscle synergies. Therefore, this study was performed to quantify how the muscle synergies of horizontal planar-reaching are affected by direction of an applied force at the end-effector (ie, hand). A 2 DOF, 10 muscle model was developed in MATLAB using parameters obtained from the OpenSim (version 3.3) open source software system. Simulation experiments were then performed in MATLAB to investigate the relationship between the applied force and the resulting muscle synergies. The simulated event was composed of several trials of the same righthanded, planar, multidirectional reaching task from 0° (to the right) to 360°. Each trial applied a different steering force direction at the subject’s hand, varying from −45° to 45° relative to the reaching direction. The simulation trials were also validated by evaluating the EMG patterns of a healthy subject when performing the same reaching task with varying steering force directions. For the 0° steering force trials, the muscle synergies and their activation timings were extracted using nonnegative matrix factorization (NMF). For all other trials, the synergy matrix was fixed and the activation timings were extracted from the product of the EMG of that trial and the pseudo-inverse of the synergy matrix from the 0° steering force trial. By fixing the synergy matrix in the trials with steering forces, we can directly track activation changes of a certain synergy as steering force is varied. For both simulation and experimental trials, circular statistics revealed a linear relationship between changes in steering force direction and principal direction of synergy activation. These results suggest that the activation of a synergy can be controlled directly by the direction of an applied steering force. This has relevant implications in synergy-based controller design because a computer can easily manipulate a patient’s muscle synergies and track the changes while avoiding the computational expense of NMF. In addition, similar analysis could be used to extract the relationship between applied forces and changes in synergies for other types of motion. F51: Validity of Subjective Sleep Inventories for Assessment of Sleepiness in Inpatient Rehabilitation for Stroke Heather Johns, Elaina Cummer, Ellie Flack, Sarah Neveux, Elena Skornyakov, Douglas Weeks University of Washington, Seattle, WA, USA Wake Forest University, Winston-Salem, NC, USA Eastern Washington University, Spokane, WA, USA St. Luke’s Rehabilitation Institute, Spokane, WA, USA Objective: To study the association between self-report measures of sleepiness and sensor-based objective sleep measures among patients with stroke during inpatient medical rehabilitation. Design: Patients receiving inpatient rehabilitation for stroke were consecutively approached to participate. Participants were fitted with an actigraph for 4 days and administered 3 subjective measures of sleepiness: Karolinska Sleepiness Scale (KSS), Wits Pictorial Sleepiness Scale (WPSS), and a Fatigue Visual Analog Scale (VAS) on days 2 and 4. Objective sleep metrics derived from the actigraph were minutes of nighttime sleep and minutes of daytime sleep. Setting: Inpatient rehabilitation facility. Participants: Adult male and female patients receiving inpatient rehabilitation services for stroke. Interventions: None. Main Outcome Measures: KSS, WPSS, VAS, minutes of nighttime sleep, and minutes of daytime sleep. Results: Correlations as measures of criterion-related validity were derived among subjective and objective sleep measures on 16 patients with stroke. The only correlations that were significant were among the KSS and minutes of daytime sleep (r range = .522 to .556). No subjective measures correlated with nighttime sleep (r range = −.472 to .324). Conclusions: There was poor agreement between subjective measures of nighttime sleep and objective metrics of sleep, suggesting that selfreport sleep measures may not accurately represent true sleep status in stroke. The KSS seems to be effective for identifying patients with excessive daytime sleep. Further work is needed to identify subjective sleepiness scales for use in patients with stroke. F52: Interventions to Augment Upper Extremity Motor Improvement in Individuals With a Traumatic Brain Injury: A Systematic Review Sandeep Subramanian, Melinda Fountain, Ashley Hood UT Health San Antonio, San Antonio, UT, USA