Stroke Diagnosis Poster 43 Comparison of Two Novel Cognitive Interventions for Adults Experiencing Executive Dysfunction Post-stroke Vale ´rie Poulin (McGill University), Nicol Korner Bitensky, Deirdre Dawson, Maxime Lussier Objective: This pilot study compared two promising interventions to improve executive function (EF) and functional skills after stroke: 1) Cognitive Orientation to daily Occupational Performance (CO-OP), a problem-solving approach that entails guiding participants to set self- selected functional goals, develop plans, carry out their plans and verify goal attainment; and, 2) Computer-Based EF Training. Design: Pilot randomized controlled trial Setting: Home-based approach Participants: Nine persons with subacute stroke experiencing EF deficits Interventions: Participants received either CO-OP training (nZ5 partic- ipants) or individualized computer-based EF training (nZ4 participants) e both offered with the same intensity e 16 one-hour sessions, twice a week, for eight weeks. Main Outcome Measure(s): At baseline, on completion of the intervention and one month post-intervention: Performance and satisfaction with performance in self-selected functional goals were measured by the participant-rated Canadian Occupational Performance Measure. Signifi- cant others also rated the participants’ performance on each goal. EF was measured using neuropsychological tests and functional assessments. Results: Both groups reported similar clinically important improvements on their self-identified functional goals immediately post-intervention (CO-OP Z 25/30 goals improved; Computer training Z 18/19 goals) and at 1-month follow-up (CO-OP Z 24/30 goals; Computer training Z 16/19 goals). The significant others’ reports corroborated these findings. Results from neuropsychological tests and functional measures also suggest some improvements in executive functioning in both groups. Conclusions: Preliminary findings from this pilot trial support the use of both remedial (i.e. computer-based EF training) and compensatory inter- ventions (i.e. problem-solving training using the CO-OP intervention) with persons with subacute stroke experiencing EF deficits. Key Words: cognitive rehabilitation, computerized training, executive function, strategy training, stroke Disclosure: Vale ´rie Poulin has nothing to disclose. Poster 44 Construct Validity of the Fugl-Meyer Assessment of Lower Extremity to Evaluate Motor Impairment Post Stroke Chitra Balasubramanian (University of North Florida), Steven A. Kautz, Craig Velozo Objective: To investigate construct validity of the Fugl-Meyer Assessment of the Lower Extremity (FMA-LE) by using Rasch analysis. Design: Secondary analyses of data pooled from 5 existing datasets: a prospective cohort longitudinal study of stroke recovery, 3 cross- sectional studies investigating the link between impaired motor perfor- mance poststroke and gait characteristics and 1 study designed to screen individuals poststroke for clinical trials. Setting: University research centers. Participants: 200 participants with a stroke (67.8  12.2 years, 100 sub- acute, 100 chronic). Interventions: Not Applicable. Main Outcome Measure(s): Rasch item-fit statistics investigated dimen- sionality, Rasch-derived item-hierarchy examined hierarchical ordering and Differential Item Functioning (DIF) evaluated stability of item cali- brations across time since stroke. Results: Item-fit statistics suggest that the reflex items and the coordina- tion item ‘Tremor’ are empirically disconnected from others. After removal of the misfitting items, the remainder of the items fit the Rasch model. The Rasch-item-difficulty order was not consistent with the ex- pected item order (i.e., “Within synergy” and “Combine synergy” items deviated from their expected order). “Out of synergy” items, however, were consistent with their administration order of being the hardest. The DIF analyses revealed that response to LE-FMA differed between sub- acute and chronic populations. Overall, item difficulty levels were better matched to person ability levels for the chronic population. Conclusions: Misfit items should be removed to enhance fit to the Rasch model. The Rasch-generated item-difficulty order challenges the concep- tual hierarchy underlying the FMA-LE. DIF analyses suggest that the underlying conceptual hierarchical process for LE motor impairment is not stable across the sub-acute and chronic populations. Key Words: Fugl-meyer Assessment, Motor Recovery, Stroke, Rasch Analysis Disclosure: Chitra Balasubramanian has nothing to disclose. Poster 45 Telerehabilitation Versus Outpatient Delivery of Constraint-Induced Movement therapy: Update on a Randomized Controlled Trial Gitendra Uswatte (University of Alabama at Birmingham), Edward Taub, Peter Lum, David Brennan, Joydip Barman, Brendan Gilmone, Mary Bowman, Stacy Mckay, Samantha Flippo, Victor W. Mark Objective: Multiple studies show that Constraint-Induced Movement therapy (CIMT) efficaciously treats upper-extremity hemiparesis. This study tested whether outcomes vary if treatment is delivered on an outpatient basis (CIMT) or by an automated workstation in patients’ homes (Tele-AutoCITE). Design: Randomized controlled trial. Setting: Laboratory, home. Participants: Seventeen adults 1-year post-stroke with mild-to-moderate upper-extremity hemiparesis were randomized to CIMT (nZ9) or Tele- AutoCITE (nZ8). Interventions: CIMT participants received face-to-face, in-laboratory training of more-affected arm use following shaping principles for 30 hours over two weeks. Transfer of gains to daily life was addressed with a daily 30-minute package of behavioral techniques, including contracting and self-monitoring. A padded mitt was also placed on the less-affected hand to discourage its use. Tele-AutoCITE participants received the same treatment but at home on a workstation with 11 upper-extremity tasks. Software tracked the participants’ performance, provided feedback, and Archives of Physical Medicine and Rehabilitation journal homepage: www.archives-pmr.org Archives of Physical Medicine and Rehabilitation 2013;94:27e36 0003-9993/13/$36 - see front matter ª 2013 by the American Congress of Rehabiliation Medicine