of mass (CoM). Results: The orthotic intervention (with AFO) increased mean self-selected walking speed (18.66%25.59%), decreased mean overall temporal asymmetry (OTA) index (10.92% 16.08%) and increased mean spatial step symmetry (SSS) index (18.7%48.64%). A correlation between change in walking speed, and changes in (1) OTA and (2) SSS, predicted a linear correlation coefficient of r0.46 and r0.71 respectively, indicating a trend towards increased speed and improved symmetry. Whole body 3-D CoM velocity hodo- graphs were computed on 6 of 15 participants. With the AFO, participants had an increase in forward mean CoM velocity (9.89%3.07%); how- ever, no changes were seen in the mean vertical or medial-lateral CoM velocities. Conclusions: The orthotic intervention influenced functional ambulation by increasing walking speed, and decreasing temporal/spatial asymmetry. Potentially the increase in walking speed resulted from the greater postural shift in forward CoM velocity with the AFO by facilitat- ing better push-off. It is important to note the large population variability for asymmetry and functional ambulation outcomes; future analysis will concentrate on the mechanisms underlying the variability. Interlimb sym- metry and ambulation speed can serve as novel important clinical markers to demonstrate recovery in gait after rehabilitation using a clinical inter- vention such as AFO prescription. Key Words: Gait; Hemiplegia; Reha- bilitation. Poster 65 Assessment of Functional Ambulation in Adults with Hemiplegia Using Ankle Foot Orthotics After Stroke. Karen J. Nolan (Kessler Foundation Research Center, West Orange, NJ), Krupa K. Savalia, Anthony H. Lequerica, Elie P. Elovic. Disclosure: None declared. Objective: To evaluate the effect of AFOs on functional ambulation in individuals with hemiplegia secondary to stroke using quantifiable outcome measures. Design: A prospective study. Setting: Rehabilita- tion Research Center. Patients or Other Participants: Eighteen adults with stroke related hemiplegia 6 months using a prescribed AFO. Intervention(s): Not Applicable. Main Outcome Measure(s): The distance and velocity during the 6-Minute Walk Test (6MWT) and total time and velocity during the 25 Foot Walk (25ftW). Secondary analysis evaluated the 6MWT and 25ftW grouped by the time com- ponent of the Ambulation Index (AI). Results: Distance walked during the 6MWT was significantly greater with AFO (228.54m103.93m) than without AFO (197.49m104.13m), P.002. Time to complete the 25ftW was significantly greater without AFO (21.22sec20.57sec) than with AFO (15.49s14.65s), P.010. There was a significant difference in average velocity between the 25ftW and 6MWT during the with AFO condition, P.010. Secondary analysis grouped by the AI time component showed that brace effect on distance walked increases as level of function decreases, (Group 3: 6MWT with AFO, P.041, and 25ftW with AFO, P.040). Conclusion(s): AFO usage in hemiplegic stroke patients improves functional ambulation, partic- ularly in individuals with a slower gait velocity. The 25ftW, with and without AFO may be useful to the patient and clinician when deter- mining the importance of brace utilization. Speed modulation im- proved when the AFO was added to the paretic limb and AI grouping indicated that the AFO was more beneficial in individuals with a slower gait velocity (20 seconds for the 25ftW). As an exploratory study, the feasibility of different walking assessments was determined so that future studies can validate which objective measures can be used and easily implemented in clinical settings to quantify changes in functional ambulation with AFO utilization. Key words: Ambulation; Rehabilitation. Poster 66 Comparing Skill Acquisition Using a Cognitive-Based Treatment Approach to Contemporary Occupational Therapy in Stroke: A Pilot Randomized Controlled Trial. Sara McEwen (University of Toronto, Toronto, ON, Canada), Helene J. Polatajko, Jennifer D. Ryan, Carolyn Baum. Disclosure: None declared. Objective: The objective of this study was to conduct a pilot trial of the efficacy of the Cognitive Orientation to daily Occupational Per- formance (CO-OP) approach, relative to contemporary occupational therapy (COT) in improving performance in self-selected skills in community-dwelling adults with chronic stroke. Design: Pilot ran- domized controlled trial. Setting: Outpatient occupational therapy laboratories in a university setting. Participants: Eight community- dwelling people ranging from 10 to 18 months poststroke participated, with a mean age of 63.5 years (range, 49 – 88). Inclusion/exclusion criteria included NIH Stroke Scale scores of 13 or less, IQ scores of 80 or more, and no more than minimal aphasia. Interventions: Partici- pants were randomized to receive either a cognitive-based interven- tion, CO-OP, (n4), or contemporary occupational therapy (COT) (n4). CO-OP is a 10-session, cognitive-oriented approach to improv- ing occupational performance that makes use of a global cognitive problem-solving strategy. Therapists use guided discovery techniques to assist skill acquisition in 3 participant-selected skills. COT consisted of a combination of task-based and component-based training. Partic- ipants receiving COT also self-selected 3 skills and had up to 10 intervention sessions. Main Outcome Measures: The Performance Quality Rating Scale (PQRS) is a 10-point rating scale, and was used by treating therapists to rate participant performance pre- and post- intervention on self-selected skills. The Canadian Occupational Per- formance Measure (COPM) was used by participants to self-rate skill performance and performance satisfaction. Results: Nonparametric statistics were used. Participants in the CO-OP treatment group showed greater improvement in the PQRS (P.021) and in COPM Performance (P.021) compared with the COT group, but not in COPM Satisfaction (P.384). Conclusions: Preliminary analysis in- dicates larger improvements in skill performance in the CO-OP group compared to the COT group, as rated by both therapists and partici- pants. Study limitations include non-blinding and small sample size, but the results are promising, warranting a larger-scale investigation. Key Words: Occupational therapy; Rehabilitation; Stroke. Poster 67 Combined Bracing, Electrical Stimulation, and Functional Practice for Chronic, Upper Extremity Spasticity. Kathleen Hardy (Xavier University, Cincinnati, OH), Kacia Suerver, Amie Sprague, Valerie Hermann, Stephen Page. Disclosure: None declared. Objective: To evaluate feasibility and efficacy of an orthotic device incorporating electrical stimulation on upper extremity (UE) spasticity and function for patients with UE spastic hemiparesis secondary to chronic stroke. Design: Case series. Setting: Outpatient rehabilitation hospital. Participants: 2 patients with chronic stroke resulting in UE spastic hemiparesis. Intervention: Subjects were administered the Modified Ashworth Scale (MAS), the upper extremity section of the Fugl-Meyer Impairment Scale (FM), the Box and Block Test (B&B), and the Arm Motor Ability Test (AMAT). They were then individually fitted for a brace, and subsequently participated in treatment sessions occurring 2 days per week for 5 weeks and consisting of: (a) 30-minute clinical sessions, during which the UE was braced in a functional position while cyclic electrical stimulation was applied to the antag- onist extensors of the tricep and forearm; and (b) 15-minute, clinically based, training sessions, occurring directly after the above session. E31 2009 ACRM–ASNR JOINT EDUCATIONAL CONFERENCE ABSTRACTS Arch Phys Med Rehabil Vol 90, October 2009