Military Rehabilitation Center Aardenburg

Doorn, Netherlands

Military Rehabilitation Center Aardenburg

Doorn, Netherlands
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Hondebrink M.S.,Military Rehabilitation Center Aardenburg | Mert A.,Ciran Rehabilitation Centers | Van Der Lint R.,Military Rehabilitation Center Aardenburg | De Ru J.A.,Central Military Hospital | Van Der Wurff P.,Military Rehabilitation Center Aardenburg
Medicine (United States) | Year: 2017

Rehabilitation for vestibular disease is a safe method to partially alleviate symptoms of vertigo. It was hypothesized that principles of military aviation vestibular desensitization procedures that have a success rate of more than 80% can be extrapolated to chronic vestibular disease as well. The virtual reality motion base computer-assisted rehabilitation environment was used as treatment modality in 17 patients. They were exposed to sinusoidal vertical passive whole body motion in increasing intensity for a maximum of 12 sessions. The Dizziness Handicap Inventory (DHI) was used for assessment of the subjective complaints of vertigo. The median DHI scores of 50 points at baseline dropped to 22 points (P <.001) at follow-up. Post hoc analysis showed significant differences in outcome between measurements at baseline and at the end of the treatment, between baseline and follow-up, but not between end of treatment and follow-up. This pilot study concerning motion-based equilibrium reprocessing therapy (MERT) shows that it is a simple, quick, and well-tolerated treatment option to alleviate symptoms in patients with chronic peripheral vestibulopathies. © Copyright 2017 the Author(s). Published by Wolters Kluwer Health, Inc.


Hendrix C.G.,University Utrecht | Prins M.R.,University Utrecht | Prins M.R.,Military Rehabilitation Center Aardenburg | Prins M.R.,VU University Amsterdam | Dekkers H.,University Utrecht
Obesity Reviews | Year: 2014

Children with developmental coordination disorder (DCD) find themselves less competent than typically developing children with regard to their physical abilities and often experience failure. They are therefore likely to avoid physical activity. Physical inactivity is considered an important risk factor for developing overweight and obesity. The aim of this study is to assess the association between DCD and overweight and obesity in children and whether this association is influenced by age and/or gender. Six electronic databases were systematically searched. Titles and abstracts were screened for relevance. Remaining studies were subjected to full paper review. The quality of the included articles was assessed and relevant data were extracted for comparison. The search yielded 273 results. Twenty-one studies, based on 10 cohorts, were included. Participants' ages ranged from 4 to 14 years. In all cohorts, children with DCD had higher body mass index scores, larger waist circumference and greater percentage body fat compared with controls. Seven studies assessed the effect of gender and four studies provided information on the effect of age. Children with DCD seem to be at greater risk for overweight and obesity. This risk may be higher for boys and seems to increase with age and with the severity of motor impairment. © 2014 International Association for the Study of Obesity.


Prins M.R.,Military Rehabilitation Center Aardenburg | Prins M.R.,HU University of Applied Sciences Utrecht | Van Der Wurff P.,Military Rehabilitation Center Aardenburg | Van Der Wurff P.,HU University of Applied Sciences Utrecht | Groen G.J.,University of Groningen
Journal of Back and Musculoskeletal Rehabilitation | Year: 2013

Accompanying leg pain is commonly observed in patients with chronic low back pain (CLBP) and is assumed to be an indicator for the disorder severity. However, it is still unknown whether it is possible to estimate a patient's functional status by the extent of leg pain present. In a post rehabilitation cohort of 132 patients with CLBP (mean age 44.3 years) the relationship between pain extent and functional status was determined using pain drawings scored for pain extent by a simplified scoring system (Lower Extremity Region: LER) and several function related questionnaires. Primary outcomes were pain extent, pain intensity ratings (Visual Analog Scale: VAS), disability status (Oswestry Disability Index: ODI) and physical and mental health (Short Format 12: SF-12). Statistically significant differences between patients with low (1-2) and high (≥ 3) LER scores were found in VAS, ODI and SF-12 physical health scores, however, the LER score has a poor diagnostic accuracy in predicting desirable versus undesirable VAS, ODI and SF-12 scores. Pain intensity (VAS), back disability (ODI) and physical health are worse in CLBP patients with high LER scores. However LER scores cannot be used to predict elevated VAS, ODI and SF-12 scores in an individual patient. © 2013 - IOS Press and the authors. All rights reserved.


Schalk S.A.F.,Military Rehabilitation Center Aardenburg | Jonkergouw N.,Military Rehabilitation Center Aardenburg | Van Der Meer F.,Military Rehabilitation Center Aardenburg | Swaan W.M.,Military Rehabilitation Center Aardenburg | And 3 more authors.
Medicine (United States) | Year: 2015

Individuals with a transfemoral amputation (TFA) may experience limitations in daily life due to reduced mobility and prosthesis- related problems. An osseointegrated prosthesis fixation (OPF) procedure in amputees might contribute to a solution for patients with short stumps or socket-related problems. To date, no study has specifically described the application of an OPF procedure in individuals with a TFA. This study evaluated the level of daily life activities of a 21-year old service member with a bilateral TFA and cerebral trauma. Due to a short stump length and coordination problems, an OPF procedure was deemed the most suitable option. The result of this procedure and the rehabilitation program showed an increased mobility and satisfaction as obtained by the assessment of life habits questionnaire (LIFE-H) and lower extremity functional scale. The participant was able to walk short distances and the Genium knee provided a stance position. Stair ambulation is impossible because of inadequate muscle capacity. In this specific case we conclude that the quality of life improved through the use of an OPF. However, OPF might not be the appropriate device for every individual with TFA, due to varying bone compositions, co-morbidities, and limited clinical experience and unknown long-term effects. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Prins M.R.,Military Rehabilitation Center Aardenburg | Van Wurff P.D.,VU University Amsterdam | Meijer O.G.,HU University of Applied Sciences Utrecht | Bruijn S.M.,Fujian Medical University | Van Dieen J.H.,VU University Amsterdam
PLoS ONE | Year: 2016

Introduction Patients with chronic low back pain (CLBP) often demonstrate altered timing of thorax rotations in the transverse plane during gait. Increased axial trunk stiffness has been claimed to cause this movement pattern. Objectives The objective of this study was to assess whether axial trunk stiffness is increased in gait in CLBP patients. Methods 15 CLBP patients and 15 healthy controls walked on a treadmill that imposed rotational perturbations in the transverse plane. The effect of these perturbations on transverse pelvis, thorax and trunk (thorax relative to pelvis) rotations was evaluated in terms of residual rotations, i.e., the deviation of these movements from the unperturbed patterns. In view of the heterogeneity of the CLBP group, we additionally performed a subgroup comparison between seven patients and seven controls with maximal between-group contrast for timing of thorax rotations. Results Rotations of the walking surface had a clear effect on transverse pelvis, thorax and trunk rotations in all groups. No significant between-group differences on residual transverse pelvis, thorax and trunk rotations were observed. Conclusion Axial trunk stiffness in gait does not appear to be increased in CLBP. Altered timing of thorax rotations in CLBP does not seem to be a result of increased axial trunk stiffness. © 2016 Prins et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Van Kerckhoven G.,University Utrecht | Mert A.,Military Rehabilitation Center Aardenburg | De Ru J.A.,Central Military Hospital Utrecht
Journal of Laryngology and Otology | Year: 2014

Background: Ototoxicity caused by medication can lead to debilitating symptoms such as dizziness, vertigo and postural instability. There is no current 'gold standard' treatment available. Case report: A 79-year-old male, with bilateral loss of vestibular function caused by gentamicin toxicity after surgery for prosthetic valve endocarditis, complained of dizziness, difficulty in walking and an increased risk of falling. Physical examination showed a positive head thrust test suggesting bilateral loss of vestibular function. Results: The patient underwent a specific motion-based virtual reality enhanced protocol for peripheral vestibular disease. He showed a great improvement, with a 50 per cent reduction in his Dizziness Handicap Inventory score. Conclusion: Computer-aided rehabilitation programmes might represent an important advance in gait and posture training. © JLO (1984) Limited 2014.


PubMed | University of Strathclyde and Military Rehabilitation Center Aardenburg
Type: Journal Article | Journal: PloS one | Year: 2016

Prosthetic alignment, positioning of a prosthetic foot relative to a socket, is an iterative process in which an amputees gait is optimized through repetitive optical gait observation and induction of alignment adjustments when deviations are detected in spatiotemporal and kinematic gait parameters. An important limitation of the current prosthetic alignment approach is the subjectivity and the lack of standardized quantifiable baseline values. The purpose of this systematic review is to investigate if an optimal alignment criterion can be derived from published articles. Moreover, we investigated the effect of alignment changes on spatiotemporal, kinematic and kinetic gait parameters.A total of 11 studies were included, two controlled before-and-after studies and nine-interrupted time series studies.The results demonstrate that alignment changes have a predictable influence on the included kinetic parameters. However, the effect of alignment changes on spatio-temporal and kinematic gait parameters are generally unpredictable. These findings suggest that it is imperative to include kinetics in the process of dynamic prosthetic alignment. Partially this can be established by communication with the prosthetic user in terms of perceived socket comfort, but the use of measurement tools should also be considered. While current literature is not conclusive about an optimal alignment, future alignment research should focus on alignment optimisation based on kinetic outcomes.


PubMed | VU University Amsterdam and Military Rehabilitation Center Aardenburg
Type: Journal Article | Journal: PloS one | Year: 2016

Patients with chronic low back pain (CLBP) often demonstrate altered timing of thorax rotations in the transverse plane during gait. Increased axial trunk stiffness has been claimed to cause this movement pattern.The objective of this study was to assess whether axial trunk stiffness is increased in gait in CLBP patients.15 CLBP patients and 15 healthy controls walked on a treadmill that imposed rotational perturbations in the transverse plane. The effect of these perturbations on transverse pelvis, thorax and trunk (thorax relative to pelvis) rotations was evaluated in terms of residual rotations, i.e., the deviation of these movements from the unperturbed patterns. In view of the heterogeneity of the CLBP group, we additionally performed a subgroup comparison between seven patients and seven controls with maximal between-group contrast for timing of thorax rotations.Rotations of the walking surface had a clear effect on transverse pelvis, thorax and trunk rotations in all groups. No significant between-group differences on residual transverse pelvis, thorax and trunk rotations were observed.Axial trunk stiffness in gait does not appear to be increased in CLBP. Altered timing of thorax rotations in CLBP does not seem to be a result of increased axial trunk stiffness.


PubMed | Military Rehabilitation Center Aardenburg and Hospital Lillebaelt
Type: | Journal: Scandinavian journal of rheumatology | Year: 2016

The aim of the current study was to investigate the diagnostic value of three sacroiliac (SI) joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging (MRI) and stratified by gender.Patients without clinical signs of nerve root compression were selected from a cohort of patients with persistent low back pain referred to an outpatient spine clinic. Data from Gaenslens test, the thigh thrust test, and the long dorsal sacroilia ligament test and sacroiliitis identified by MRI were analysed.The median age of the 454 included patients was 33 (range 18-40) years and 241 (53%) were women. The prevalence of SI joints with sacroiliitis was 5%. In the whole study group, only the thigh trust test was associated with sacroiliitis, the area under the receiver operating characteristic (ROC) curve (AUC) was 0.58 [95% confidence interval (CI) 0.51-0.65], sensitivity 31% (95% CI 18-47), and specificity 85% (95% CI 82-87). In men, sacroiliitis was associated with all the SI joint tests assessed and multi-test regimens, with the greatest AUC found for at least one positive out of three tests [AUC 0.68 (95% CI 0.56-0.80), sensitivity 56% (95% CI 31-79), and specificity 81% (95% CI 77-85)]. In women, no significant associations were observed between the SI joint tests and sacroiliitis.Only in men were the SI joint tests found to be associated with sacroiliitis identified by MRI. Although, the diagnostic value was relatively low, the results indicate that the use of SI joint tests for sacroiliitis may be optimized by gender-separate analyses.


PubMed | University Utrecht, Central Military Hospital Utrecht and Military Rehabilitation Center Aardenburg
Type: Case Reports | Journal: The Journal of laryngology and otology | Year: 2014

Ototoxicity caused by medication can lead to debilitating symptoms such as dizziness, vertigo and postural instability. There is no current gold standard treatment available.A 79-year-old male, with bilateral loss of vestibular function caused by gentamicin toxicity after surgery for prosthetic valve endocarditis, complained of dizziness, difficulty in walking and an increased risk of falling. Physical examination showed a positive head thrust test suggesting bilateral loss of vestibular function.The patient underwent a specific motion-based virtual reality enhanced protocol for peripheral vestibular disease. He showed a great improvement, with a 50 per cent reduction in his Dizziness Handicap Inventory score.Computer-aided rehabilitation programmes might represent an important advance in gait and posture training.

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