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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.


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.


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.


Kal E.,Heliomare Rehabilitation Center | Kal E.,VU University Amsterdam | Houdijk H.,Heliomare Rehabilitation Center | Houdijk H.,VU University Amsterdam | And 7 more authors.
Disability and Rehabilitation | Year: 2016

Purpose: Stroke survivors are inclined to consciously control their movements, a phenomenon termed "reinvestment". Preliminary evidence suggests reinvestment to impair patients motor recovery. To investigate this hypothesis, an instrument is needed that can reliably assess reinvestment post-stroke. Therefore, this study aimed to validate the Movement-Specific Reinvestment Scale (MSRS) within inpatient stroke patients.Method: One-hundred inpatient stroke patients (<1 year post-stroke) and 100 healthy peers completed the MSRS, which was translated to Dutch for the study purpose. To assess structural validity, confirmatory factor analysis determined whether the scale measures two latent constructs, as previously reported in healthy adults. Construct validity was determined by testing whether patients had higher reinvestment than controls. Reliability analyses entailed assessment of retest reliability (ICC), internal consistency (Cronbachs alpha), and minimal detectable change.Results: Both structural and construct validity of the MSRS were supported. Retest reliability and internal consistency indices were acceptable to good. The minimal detectable change was adequate on group level, but considerable on individual level.Conclusions: The MSRS is a valid and reliable tool and suitable to assess the relationship between reinvestment and motor recovery in the first months post-stroke. Eventually, this may help therapists to individualize motor learning interventions based on patients reinvestment preferences.Implications for rehabilitationThis study showed that the Movement-Specific Reinvestment Scale (MSRS) is a valid and reliable tool to objectify stroke patients inclination for conscious motor control.The MSRS may be used to identify stroke patients who are strongly inclined to consciously control their movements, as this disposition may hinder their motor recovery.Eventually, the MSRS may enable clinicians to tailor motor learning interventions to stroke patients motor control preferences. © 2016 Taylor & Francis.


Moraal M.,VU University Amsterdam | Slatman J.,Maastricht University | Pieters T.,VU University Amsterdam | Mert A.,Military Rehabilitation Center Aardenburg | Widdershoven G.,VU University Amsterdam
Disability and Rehabilitation: Assistive Technology | Year: 2013

Purpose: This study provides an analysis of bodily experiences of a man with a lower leg amputation who used a virtual rehabilitation program. Method: The study reports data from semi-structured interviews with a 32-year veteran who used a virtual environment during rehabilitation. The interviews were analyzed using interpretative phenomenological analysis (IPA). Results: During this rehabilitation program, he initially experienced his body as an object, which he had to handle carefully. As he went along with the training sessions, however, he was more stimulated to react directly without being aware of the body's position. In order to allow himself to react spontaneously, he needed to gain trust in the device. This was fostered by his narrative, in which he stressed how the device mechanically interacts with his movements. Conclusion: The use of a virtual environment facilitated the process of re-inserting one's body into the flow of one's experience in two opposite, but complementary ways: (1) it invited this person to move automatically without taking into account his body; (2) it invited him to take an instrumental or rational view on his body. Both processes fostered his trust in the device, and ultimately in his body.Implications for RehabilitationProviding (more) technological explanation of the technological device (i.e. the virtual environment), may facilitate a rehabilitation process.Providing (more) explicit technological feedback, during training sessions in a virtual environment, may facilitate a rehabilitation process. © 2013 Informa UK Ltd.

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