Research Posters e103

neuropsychological testing by telephone especially for those individuals Participants: Twenty-seven students and eight Zambian participants were
who find it difficult to travel. surveyed. Students were accompanied by 4 Harding DPT faculty. The
Key Words: Neuropsychology, Traumatic Brain Injury, mild-TBI Zambian participants were healthcare workers and citizens of the Southern
Disclosures: None. province of Zambia. Six hundred fifty patients were seen over a three
day period.
Research Poster 296188 Interventions: Not Applicable.
Reorganization of Primary Somatosensory Cortex Main Outcome Measure(s): Formal student surveys student and informal
After Upper Limb Amputation May Lack Functional impressions gathered via student journal. Patient data for patients seen.
Significance Results: The surveys revealed that the student consistently perceived im-
provements in clinical skills in the areas of screening/differential diag-
Benjamin Philip (Washington University School of Medicine), nosis, clinical reasoning, and provision of care in austere environments.
Ken Valyear, Carmen Cirstea, Scott Frey Additionally the students perceived improvements in cultural awareness
and the ability to interact with other healthcare disciplines.
Research Objectives: To measure reorganization of primary somatosen- Conclusion/Discussion: Mandatory service learning and medical missions
sory cortex following unilateral traumatic upper limb amputation in training, including an international Medical Missions Practicum experi-
humans, and its relevance to pain and sensation in the residual and ence improves student DPT skills in clinical reasoning, provision of care,
phantom limbs. We hypothesized that the former hand territory - cortical and cultural awareness.
area normally responsive to now-absent hand - would respond to tactile Key Words: Cultural Competency, Global Health, Service-Learning,
stimulation on the face due to maladaptive plasticity, a phenomenon pur- Clinical Skills
ported to drive phantom limb pain. Disclosures: None.
Design: Survey design. Observational study.
Setting: University laboratory setting.
Participants: Nineteen upper limb amputees (7 female, 15 below-elbow; Research Poster 327038
age 4916) were recruited. Inclusion criteria: age 18-79, unilateral trau- Responsiveness to Self-Reporting Physical Activity
matic/surgical amputation of upper limb (minimum: all five fingers), MRI Among Older Patients Receiving Ambulatory
compatible. Exclusion criteria: psychiatric disorders, neurological illness, Rehabilitation
other motor disorder. Twenty-nine age-, sex-, and handedness-matched
healthy adults were recruited for a control pool. Steven McPhail (Queensland University of Technology and Metro South
Interventions: Not applicable. Health)
Main Outcome Measure(s): Functional magnetic resonance imaging (fMRI)
activity in former hand area of the cerebral cortex during passive pneumatic Research Objectives: To examine how older ambulatory patients recov-
cutaneous stimulation of the left face, right face, or intact left hand (controls: or ering from injuries perceive and self-report physical activity, including
right hand). Sensory function, as measured by fingertip grating orientation assessment-induced changes in self-perceptions, and desire to receive
acuity and palmar locognosia acuity. Standard clinical pain assessments, support to increase their physical activity.
including phantom and residual limb pain; and phantom limb sensation. Design: Cohort study.
Results: During stimulation of the intact hand, amputees showed greater Setting: Referral hospital ambulatory rehabilitation clinics.
activity in bilateral somatosensory cortices, compared to controls. Face Participants: Ambulatory hospital patients (mean (SD) age 63 (9) years)
stimulation led to no activity in former hand territory. Activity in the receiving multidisciplinary rehabilitation therapies for musculoskeletal
former hand territory during face or intact-hand stimulation showed no conditions participated.
correlation with any measure of pain, sensory function, or demographics. Interventions: Participants were receiving routine multidisciplinary
Conclusion/Discussion: Upper limb amputation is associated with bilat- therapies in hospital ambulatory care clinics.
eral changes in brain responses to somatosensory stimulation, but the Main Outcome Measure(s): Participants nZ140 were initially asked if
functional significance of these changes remains elusive. We found no they considered themselves to be sufficiently physically active to experi-
evidence to support the traditional “maladaptive plasticity” explanation of ence health benefits. They then self-reported the type and duration of
the cortical origins of phantom limb pain. physical activity they had completed in the past 7-days (using a stan-
Key Words: Amputation, Phantom Limb Pain, Phantom Limb Sensation, dardized physical activity questionnaire). Participants were again asked if
Sense Of Touch, Somatosensory Cortex they were sufficiently physically active and were permitted to retain or
Disclosures: None. alter their initial response. The proportion of patients who altered their
response and clinical factors associated with patients’ responses
Research Poster 301998 were examined.
Results: Initially, 56/140 (40%) of participants reported being sufficiently
Required International Service Learning: Improving physically active. After self-reporting physical activity for the past 7-days,
Cultural Awareness and Clinical Skills in DPT 22/56 (39%) of these patients changed their response to indicate they were
Students not sufficiently physically active. Among participants (aged 50 to 84
years), 90% desired to be more physically active. No patient or clinical
Gerry Ezell (Harding University), Michael McGalliard
factors had strong associations with patients’ decisions to change or retain
Research Objectives: To describe a heath-care service learning educa- their self-report of whether they consider themselves to be sufficiently
tional experience and investigate the perceptions of the students and physically active. Older age was associated with less self-reported physical
foreign participants of the experience. activity (p < 0.001).
Design: Descriptive survey study examining the perceptions of participants Conclusion/Discussion: Patients were often inaccurate in their perception
regarding differential diagnosis/screening and changes in cultural aware- of whether they were meeting minimum physically active guidelines (in
ness after taking part in a 2-week mandatory international service-learning comparison to self-reported physical activity) and many readily changed
experience. their responses after completing a physical activity questionnaire. How-
Setting: Rural Zambian Zonal Health Clinic providing general community ever, there was still tendency to over-report meeting physical activity
ambulatory care and continuing medical education. Prior to the to the recommendations.
international experience, the students completed two foundational didactic Key Words: Physical Activity, Geriatric, Ambulatory, Assessment
training courses in service learning and Medical missions. Disclosures: None.

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