e390 Y.G. Yi et al. / Annals of Physical and Rehabilitation Medicine 61S (2018) e309–e433 and to perform a genetic study based on Next-Generation Sequenc- ing (NGS). Material and method This was a single-centre, prospective, obser- vational study. Patients included were a Haemophilia Centre (HC) for bleeding symptoms of unknown cause (normal or abnormal haemostatic tests not explaining the bleeding phenotype) and hav- ing joint laxity and Musculoskeletical Rehabilitation Unit (RHB) for joint laxity and reporting bleeding symptoms. Bleeding severity was assessed by the haematologist using the ISTH Bleeding assess- ment tool (ISTHBAT) and joint hyperlaxity by the physiatrist by the Beighton score. Molecular analysis was performed using TruSight One Sequencing Panel Kit (Illumina). Quality and population fre- quency filters were applied and the search was limited to 78 genes related with Heritable Disorders of Connective Tissue (HDCT). Results Forty-three patients were included between June 2016 and January 207. All were females; median age was 38.6 years (range 17–62 years). Median ISTH-BAT score was 8 (range 3–17) and Beighton score 7 to 9 (range 3–9). ISTH-BAT score was abnor- mal in 77% and Beighton score in 80%. In 25 patients, both scores were abnormal. A total of 175 potential mutations were identified in HDCT related genes for all except one patient. In 46.5% a direct correlation between the identified mutation and the clinical phe- notype could be established. In 10 patients, mutations in COL5A1, COL5A2, COL1A1 and COL1A2 genes were identified and validated by Sanger sequencing. Conclusion Clinical assessment for symptomatic joint hypermo- bility should be considered in patients with significant bleeding history of unknown cause. NGS could be a useful tool for the study of the responsible genes and the classification of patients. Keywords Hipermobility; Bleeding Disclosure of interest The authors declare that they have no com- peting interest. https://doi.org/10.1016/j.rehab.2018.05.907 ISPR8-1060 Role of O-C2 angle in the development of dysphagia in patients with halo-vest fixation M. Miyagi 1,∗ , H. Takahashi 2 , K. Tsuchiya 2 , H. Sekiya 3 , S. Ebihara 1 1 Toho University Graduate School of Medicine, Department of Rehabilitation Medicine, Tokyo, Japan 2 Toho University Omori Medical Center, Department of Orthopaedic Surgery, Tokyo, Japan 3 Toho University Omori Medical Center, Department of Oral Surgery, Tokyo, Japan ∗ Corresponding author. E-mail address: midori.miyagi@med.toho-u.ac.jp (M. Miyagi) Introduction/Background The halo-vest brace has been a com- mon mode for immobilization of the cervical spine. The incidence of complications such as pin loosing and infection are known in patients with halo-vest fixation. Dysphagia is one of the most seri- ous complications seen with the use of a halo-vest brace. The aim of this study was to elucidate factors associated with the incidence of dysphagia in patients treated using a halo-vest brace in terms of not only demographic data, but also radiological findings of the cervical spine. Material and method We retrospectively reviewed medical records and radiological measurements using lateral plain X-rays of the cervical spine in patients who had undergone halo-vest fixation in our institute between January 2006 and August 2016. Severity of dysphagia was assessed using the Food Intake Level Scale (FILS) from medical records. Patients were classified into non-dysphagia (FILS level: 10) and dysphagia (FILS level: 1–9) groups. Results Forty-three patients were attributed for analysis. Twenty-eight patients were classified into non-dysphagia group, 15 patients were classified into dysphagia group. Mean age was grater (P = 0.041), length of ICU stay was longer (P = 0.002), and frequency of tracheostomy was larger (P = 0.043) in the dysphagia group. Mean O-C2 angle was smaller in the dysphagia group (P = 0.027). Body mass index [odds ratio (OR) = 0.522, 95% confi- dence interval (CI) = 0.377–0.934, P = 0.024], ICU stay (OR = 1.302, 95% CI = 1.272–10.624, P = 0.016), and O-C2 angle (OR = 0.911, 95% CI = 0.833–0.996, P = 0.041) remained independent risk factors related to incidence of dysphagia. Spearman rank correlation showed a negative linear correlation between ICU stay and FILS level (r = 0.476, P = 0.001) and a positive linear correlation between O-C2 angle and FILS level (r = 0.385, P = 0.011). Conclusion This study suggested the significance of O-C2 angle as well as ICU stay for incidence and severity of dysphagia in patients with halo-vest fixation. Keywords Dysphagia; Halo-vest; O-C2 angle Disclosure of interest The authors declare that they have no com- peting interest. https://doi.org/10.1016/j.rehab.2018.05.908 ISPR8-0236 Cycling with/without functional electrical stimulation improves lower limbs disability in patients post-stroke: A systematic review with meta-analysis A. Shariat 1,∗ , N. Nakhostin Ansari 1,2 , J.A. Cleland 3 , M. Ghayour Najafabadi 4,5 , A.H. Memari 1 , R. Kordi 1 , M. Kargarfard 6,7 , P. Noormohammadpour 1 , S. Naghdi 1,2 1 Tehran University of Medical Sciences, Sports Medicine Research Center, Neuroscience Institute, Tehran, Iran 2 Tehran University of Medical Sciences, Department of Physiotherapy, School of Rehabilitation, Tehran, Iran 3 Franklin Pierce University, Manchester, New Hampshire, USA 4 Faculty of Physical Education, University of Tehran, Tehran, Iran 5 Department of Motor behaviour, Tehran, Iran 6 Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran 7 Department of Exercise Physiology, Isfahan, Iran ∗ Corresponding author. E-mail address: ardalansh2002@gmail.com (A. Shariat) Introduction/Background Cycling with or without functional elec- trical stimulation (FES) is an effective way to rehabilitate patients with lower limb disability. The purpose of this systematic review and meta-analysis was to quantify the effectiveness of different protocols of cycling with/without FES on lower limbs after stroke. Material and method The following databases were searched: PubMed, Cochrane Central Register of Controlled Trials, Ovid Medline, EBSCO Cumulative Index of Nursing and Allied Health Lit- erature, Ovid EMBASE, Physiotherapy Evidence Database (PEDro), and Occupational Therapy Systematic Evaluation of Effectiveness, by means of words relevant to randomized and stroke, cycling and lower limbs disability. Randomized-controlled trials from 1990 to July 2017 were included following predetermined search and selec- tion criteria. Data extraction was performed using a predetermined data collection form. Results A total of 15 trials satisfied eligibility criteria for this review. Cycling had a positive effect on 6 meter walking test per- formance [30.4 s; -1.9 to 62.6 (standardized mean difference; 95% confidence interval)] compared with no or placebo intervention (control). Cycling had a positive effect on walking speed (0.10 m/s; 0.1–0.2), based on the results of 10 meter walking test, compared with control. Cycling had a positive effect on balance based on Berg score (0.25; -0.44 to 0.94) compared with control. Cycling with FES had a positive effect on balance (1.95; 1.33–2.52) compared with cycling alone. Conclusion Although cycling alone has a positive effect on walk- ing ability, walking speed, and balance the effects are small and variable. In terms of balance, positive effects substantially smaller