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Amsterdam-Zuidoost, Netherlands

Thijssen D.H.J.,Liverpool John Moores University | Thijssen D.H.J.,Radboud University Nijmegen | Van Duijnhoven N.T.L.,Radboud University Nijmegen | Janssen T.W.J.,VU University Amsterdam | And 5 more authors.
Assistive Technology Research Series | Year: 2010

Spinal cord injury (SCI) induces vascular adaptations below the level of the lesion, such as impaired cutaneous vasodilation. However, the mechanisms underlying these differences are unclear. The aim of this study is to examine arm and leg cutaneous vascular conductance (CVC)-responses to local heating in 17 able-bodied controls (39±13 years) and 18 SCI subjects (42±8 years). SCI subjects were counterbalanced for functional electro- stimulation(FES)-cycling exercise (SCI-EX, n=9) or control (SCI-C, n=9) and re-analyzed after 8 weeks. Arm and leg SkBF was measured by laser-Doppler flowmetry during local heating (42°C), resulting in an axon-reflex mediated first peak, nadir and a primarily NO-dependent plateau-phase. Data were expressed as a percentage of maximal CVC (%CVC max; 44°C). CVC-responses to local heating in the paralyzed leg, but also in the forearm of SCI subjects, were lower than in able-bodied controls (P<0.05 and 0.01, respectively). The 8-week intervention did not change forearm and leg CVC-responses to local heating in SCI-C and SCI-EX, but increased femoral artery diameter in SCI-EX (P<0.05). Interestingly, findings in skin microvessels contrast with conduit arteries, where physical (in)activity contributes to adaptations in SCI. The lower CVC-responses in the paralyzed legs might suggest a role for inactivity in SCI, but the presence of impaired CVC-responses in the normally active forearm suggests other mechanisms. This is supported by a lack of adaptation in skin microcirculation after FES-cycle training. This might relate to the less frequent and smaller magnitude of skin blood flow responses to heat stimuli compared with controls, than physical inactivity per se. © 2010 The authors and IOS Press. All rights reserved. Source


De Groot S.,Duyvensz Nagel Research Laboratory | De Groot S.,University of Groningen | Van Der Woude L.H.V.,University of Groningen | Niezen A.,Rehabilitation Center Amsterdam | And 2 more authors.
Spinal Cord | Year: 2010

Study design:Cross-sectional study.Objectives:To evaluate the physical activity scale for individuals with physical disabilities (PASIPD) in people with spinal cord injury (SCI).Setting:Eight Dutch rehabilitation centers with a specialized SCI unit.Methods:The PASIPD was examined by comparing group scores of people with different personal (age, gender and body mass index) and lesion characteristics (level (paraplegia/tetraplegia), completeness, time since injury (TSI)) in 139 persons with SCI 1 year after discharge from in-patient rehabilitation. Relationships between PASIPD scores and measures of activities (wheelchair skills, Utrecht Activity List, mobility range and social behavior subscales of the SIP68) and fitness (peak oxygen uptake, peak power output and muscular strength) were determined.Results:Persons with tetraplegia had significantly lower PASIPD scores than those with paraplegia (P<0.02). Persons with longer TSI had lower PASIPD scores than persons with shorter TSI (P<0.03). PASIPD scores showed moderate correlations with activities (0.36-0.51, P<0.01) and weak-to-moderate correlations with fitness parameters (0.25-0.36, P<0.05).Conclusion:In a fairly homogeneous group of persons with SCI, 1 year after in-patient rehabilitation, the PASIPD showed weak-to-moderate relationships with activity and fitness parameters. There seems to be a limited association between self-reported activity level and fitness in people with SCI. © 2010 International Spinal Cord Society All rights reserved. Source


De Groot S.,Duyvensz Nagel Research Laboratory | De Groot S.,University of Groningen | Post M.W.M.,University Utrecht | Bongers-Janssen H.M.H.,Adelante Rehabilitation Center | And 2 more authors.
Spinal Cord | Year: 2011

Study design: Cross-sectional study. Objectives: To describe the satisfaction of the manual wheelchair user with hand rim wheelchair-related aspects (for example, dimensions, weight and comfort) and wheelchair service-related aspects and to determine the relationship between wheelchair users' satisfaction, personal and lesion characteristics, and active lifestyle and participation in persons with a spinal cord injury (SCI). Setting: Eight Dutch rehabilitation centers with a specialized SCI unit. Methods: The Dutch version of the Quebec user evaluation of satisfaction with assistive technology (D-QUEST) was filled out by 109 participants 1 year after discharge from inpatient SCI rehabilitation. Relationships between the D-QUEST scores and personal and lesion characteristics, and active lifestyle and participation (physical activity scale for individuals with physical disabilities (PASIPD), Utrecht activity list (UAL), mobility range and social behavior subscales of the SIP68 (SIPSOC)) were determined. Results: A high level of satisfaction was found with wheelchair-related aspects. The participants were less satisfied with the service-related aspects. Participants with an incomplete lesion were slightly more satisfied regarding both aspects than those with a complete lesion. A higher satisfaction regarding wheelchair dimensions and a higher overall satisfaction were related to a more active lifestyle. Persons who were more satisfied with the simplicity of use of the wheelchair had a better participation score. Conclusion: Dutch persons with SCI are in general quite satisfied with their hand rim wheelchair. Some aspects of the wheelchair (dimensions and simplicity of use) are important to optimize as these are related to an active lifestyle and participation. © 2011 International Spinal Cord Society All rights reserved. Source


De Groot S.,Duyvensz Nagel Research Laboratory | De Groot S.,University of Groningen | Bevers G.,VU University Amsterdam | Post M.W.M.,University Utrecht | And 3 more authors.
Disability and Rehabilitation | Year: 2010

Purpose. To evaluate the implementation of standardized physical and functional tests to monitor patients with a spinal cord injury (SCI) in eight rehabilitation centers and to analyze the enablers and the barriers of the implementation process. Method. The method involved prospective effect and process evaluation. Team members responded to mailed questionnaires at the start (n115) and end (n82) of the 1-year implementation period. Furthermore, a questionnaire was administered to managers (n8), coordinators (n8), and 32 persons with SCI in four centers. Outcome of the effect evaluation was the phase of implementation of standardized testing in each center. The process evaluation analyzed enablers and barriers of the implementation process. Results. After a year of implementation, half of the centers shifted to higher implementation phases. None of the centers was classified in the highest phase. Enablers were the positive attitude of the team members regarding standardized testing and an encouraging local coordinator. Most important barrier was lack of time to implement the standardized testing. Conclusion. There is a large support for implementing standardized tests to monitor patients with SCI. During the 1-year, a positive shift was visible in the extent of implementation. Successful implementation of patient monitoring requires substantial amounts of time and effort of the rehabilitation centers involved. © 2010 Informa UK Ltd. Source


Alta T.D.,Onze Lieve Vrouwe Gasthuis | Bergmann J.H.,Kings College London | Veeger D.J.,Technical University of Delft | Veeger D.J.,VU University Amsterdam | And 5 more authors.
Journal of Shoulder and Elbow Surgery | Year: 2011

Hypothesis: Results of the reverse shoulder prosthesis on pain are generally satisfying; however, active range of motion (ROM) is often not optimal, especially after revision. A kinematic and clinical analysis of the reverse prosthesis was performed to provide more precise information on its glenohumeral motion pattern. We hypothesized that the difference in the primary and revision cases is due to differences in the motion in the glenohumeral joint. Materials and methods: The motion pattern of 31 patients with a reverse prosthesis (35 shoulders, 19 primary and 16 revisions) was measured during 3 active ROM tasks-forward flexion, abduction, and axial rotation. Average age was 71 ± 8 years (range, 58-85 years). Average follow-up was 23 ± 14 months (range, 4-63 months). Kinematic measurements were performed with a 3-dimensional electromagnetic tracking device. Clinical evaluation was performed by obtaining Constant score, Disabilities of Arm, Shoulder and Hand (DASH) score, and the Simple Shoulder Test (SST). Acromial-prosthetic distance was measured on anteroposterior radiographs. Results: Primary placed prostheses showed significantly better active glenohumeral motion than revisions for forward flexion (71° ± 18° vs 53° ± 26°, P < .05), abduction (64° ± 15° vs 46° ± 24°, P < .05), and active external rotation (31° ± 25° vs 13° ± 16°, P < .05). Constant score improved for the whole group from 24 (range, 5-47) to 50 (range, 8-87; P < .001), for the primary group from 28 (range, 13-47) to 60 (range, 8-87; P < .001) and for revisions from 20 (range, 5-47) to 38 (range, 11-73; P < .001). Acromial-prosthetic distance showed no significant correlation for active glenohumeral motion. Five shoulders with a deficient teres minor muscle showed no significant decrease of external rotation. Conclusion: Active ROM is better in primary placed prosthesis, and this difference takes place mainly in the glenohumeral joint. In all our patients, Constant scores improved significantly postoperatively. However, we could not find any clinical correlating parameters to explain this difference. © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Source

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