Duyvensz Nagel Research Laboratory

Amsterdam, Netherlands

Duyvensz Nagel Research Laboratory

Amsterdam, Netherlands
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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.


Nooijen C.F.J.,Erasmus Medical Center | De Groot S.,Duyvensz Nagel Research Laboratory | De Groot S.,University of Groningen | Postma K.,Erasmus Medical Center | And 5 more authors.
Spinal Cord | Year: 2012

Study design: A prospective cohort study. Objectives: To study the longitudinal relationship between objectively measured everyday physical activity level, and physical fitness and lipid profile in persons with a recent spinal cord injury (SCI). Setting: A rehabilitation centre in the Netherlands and the participant's home environment. Methods: Data of 30 persons with a recent SCI were collected at the start of active rehabilitation, 3 months later, at discharge from inpatient rehabilitation, and 1 year after discharge. Physical activity level (duration of dynamic activities as % of 24 h) was measured with an accelerometry-based activity monitor. Regarding physical fitness, peak oxygen uptake (VO2peak) and peak power output (POpeak) were determined with a maximal wheelchair exercise test, and upper extremity muscle strength was measured with a handheld dynamometer. Fasting blood samples were taken to determine the lipid profile. Results: An increase in physical activity level was significantly related to an increase in VO2peak and POpeak, and an increase in physical activity level favourably affected the lipid profile. A nonsignificant relation was found with muscle strength. Conclusion: Everyday physical activity seems to have an important role in the fitness and health of persons with a recent SCI. An increase in physical activity level was associated with an increase in physical fitness and with a lower risk of cardiovascular disease. © 2012 International Spinal Cord Society All rights reserved.


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.


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.


Alta T.D.,Onze Lieve Vrouwe Gasthuis | Bergmann J.H.,King's 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.


Alta T.D.W.,Onze Lieve Vrouwe Gasthuis | Veeger H.E.J.,VU University Amsterdam | Veeger H.E.J.,Technical University of Delft | Janssen T.W.J.,VU University Amsterdam | And 2 more authors.
Clinical Orthopaedics and Related Research | Year: 2012

Background: It has been suggested that limited active ROM of reverse shoulder prostheses relates to lack of strength. However, the postoperative strength has not been quantified. Questions/purposes: We therefore measured joint torques in patients with reverse shoulder prostheses and correlated torques with functional scores. Methods: We recruited 33 patients (age, 72 ± 8 years) with a reverse prosthesis (37 shoulders, 21 primary and 16 revisions). We obtained Constant-Murley, DASH, and Simple Shoulder Test ([D]SST) scores, and performed two isokinetic protocols (abduction/adduction and external/internal rotation) at 60° per second. Minimum followup was 4 months (average, 23 months; range, 4-63 months). Results: Twenty-three patients (24 shoulders; 13 primaries, 11 revisions) were able to perform at least one of the defined tasks. Mean abduction and adduction torques were 15 Nm ± 7 Nm and 16 Nm ± 10 Nm (19%-78% of normal shoulders). External and internal rotation tasks could be performed by only 13 patients (14 shoulders; nine primary, five revisions) generating 9 Nm ± 4 Nm and 8 Nm ± 3 Nm, respectively (13%-71% of normal shoulders). We found moderate correlations between Constant-Murley, DASH and (D)SST (D = Dutch translation) scores and abduction and external rotation. Conclusions: Patients with a reverse prosthesis had reduced strength when compared with normal values reported in the literature (only 65% of patients could perform the protocol). This effect was greatest for external rotation and might explain clinical outcomes with which a moderately strong relationship was observed. Our observations suggest limited strength is a major factor in reduced ROM. © 2012 The Author(s).


Horstman A.M.,VU University Amsterdam | Gerrits K.H.,VU University Amsterdam | Gerrits K.H.,Duyvensz Nagel Research Laboratory | Beltman M.J.,VU University Amsterdam | And 5 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2010

Horstman AM, Gerrits KH, Beltman MJ, Koppe PA, Janssen, TW, de Haan A. Intrinsic properties of the knee extensor muscles after subacute stroke. Objective: To characterize muscle properties of paretic lower-limb (PL) and nonparetic lower-limb (NL) knee extensors in patients with subacute stroke. Design: Case-control study. Setting: Rehabilitation center research laboratory. Participants: Patients with subacute stroke (n=14) and able-bodied age-matched control subjects (n=12). Interventions: Not applicable. Main Outcome Measures: Half relaxation times (HRTs) and maximal rates of torque development (MRTDs) were assessed as indicators of contractile speed using both voluntary and electrically evoked contractions. Moreover, changes in torque were measured during a fatigue protocol (35 electrically evoked intermittent contractions; 1.5s on, 2s off) and recovery. Results: No differences among groups were found for normalized MRTDs during electrically evoked contractions (P=.117). However, during voluntary contractions both PLs (53% of control, P=.022) and NL (71% of control, P<.001) had significantly lower MRTD compared with control. Both PL (134% of control, P=.001) and NL (123% of control, P=.032) had significantly higher HRTs than control, indicating muscle slowing in patients with subacute stroke. PLs fatigued more and faster than control (P=.011) and both PL and NL recovered slower (P<.001). Conclusions: The changes in HRTs and fatigue suggest adaptations in muscle properties toward slower, more fatigable muscle shortly after stroke. The inability to make use of contractile speed because of impaired neural activation seems the most limiting factor during the initial phase of torque development in PL. Thus, besides strengthening, muscle endurance and speed should also be addressed during rehabilitation. © 2010 American Congress of Rehabilitation Medicine.


PubMed | Duyvensz Nagel Research Laboratory
Type: Journal Article | Journal: Spinal cord | Year: 2011

Cross-sectional study.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).Eight Dutch rehabilitation centers with a specialized SCI unit.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.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.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.


PubMed | Duyvensz Nagel Research Laboratory
Type: Journal Article | Journal: Spinal cord | Year: 2010

Cross-sectional study.To evaluate the physical activity scale for individuals with physical disabilities (PASIPD) in people with spinal cord injury (SCI).Eight Dutch rehabilitation centers with a specialized SCI unit.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.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).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.


PubMed | Duyvensz Nagel Research Laboratory
Type: Journal Article | Journal: Disability and rehabilitation | Year: 2010

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.The method involved prospective effect and process evaluation. Team members responded to mailed questionnaires at the start (n = 115) and end (n = 82) of the 1-year implementation period. Furthermore, a questionnaire was administered to managers (n = 8), coordinators (n = 8), 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.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.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.

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