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Amsterdam-Zuidoost, Netherlands

Franke A.C.,Rehabilitation Center Het Roessingh | Snoek G.J.,Rehabilitation Center Het Roessingh | De Groot S.,Reade Center for Rehabilitation and Rheumatology | De Groot S.,University of Groningen | And 2 more authors.
Spinal Cord | Year: 2013

Study design: Retrospective cohort study.Objective: To assess development of arm hand skilled performance (AHSP) during and after in-patient rehabilitation in persons with cervical spinal cord injury (CSCI) and to determine factors that influence the outcome. Setting: Eight rehabilitation centres in the Netherlands with specialised spinal cord injury departments. Methods: AHSP was assessed using the Van Lieshout test (VLT) in persons admitted with recent CSCI. Assessment was carried out at the beginning (t1), after 3 months (t2), at the end (t3) of in-patient rehabilitation, and 1 and 5 years thereafter (t4, t5). Multilevel regression analysis was performed to determine development of AHSP and associations between AHSP and age, gender, motor completeness, lesion level (high or low CSCI), motor scores of upper extremity (MSUE), and pain in the tested arm. Results: Fifty-five participants were included with mean age 38 years (range 18-64). There were 73% male, 80% had high CSCI (C3-C6) and 69% had motor complete lesion. Scores of VLT improved significantly during in-patient rehabilitation (mean: t1=25; t3=33) (P=0.005), scores remained unchanged at 1 year (t4=32) and 5 years (t5=32) (P=0.903) after in-patient rehabilitation. Motor completeness, MSUE and pain were significantly related to the VLT score (P<0.001, P<0.001, P=0.015, respectively). Age, gender and lesion level had no significant relationship. Conclusion: AHSP improved during in-patient rehabilitation. It was then stable during the next 5 years after discharge. Persons with an incomplete lesion, high MSUE and no pain in the tested arm perform best on the VLT. © 2013 International Spinal Cord Society All rights reserved.

Sloots M.,Center for Rehabilitation and Rheumatology | Bartels E.A.C.,University | Angenot E.L.D.,Reade Center for Rehabilitation and Rheumatology | Geertzen J.H.B.,University of Groningen | Dekker J.,VU University Amsterdam
Journal of Clinical Nursing | Year: 2012

Aim. To explore the treatment experiences in patients of Moroccan and Turkish origin and their rehabilitation therapists regarding an adapted outpatient cardiac rehabilitation programme. Background. Non-native patients who participated in a cardiac rehabilitation programme at a Dutch rehabilitation centre had more difficulties to achieve the treatment aims than native Dutch patients. Therefore, an adapted programme for non-native patients, lacking proficiency in Dutch, has been instigated. The programme contains six adapted treatment modules and additional strategies: adapted education regarding (1) the heart and the vascular system and (2) the use of healthy food, with use the of (audio) visual educational materials, (3) adapted physical exercise module with explicit involvement of the patients' relatives, (4) standard use of professional interpreters, (5) increase in the number and length of consultations and (6) individual treatment instead of a group programme. Design. Qualitative study. Method. Semi-structured, face-to-face interviews were conducted with eight patients of Moroccan and Turkish origin and five native Dutch rehabilitation therapists. By comparison, three native Dutch patients were interviewed regarding the regular programme. Results. The results indicate that the patients' disease symptoms reduced and that patients adopted lifestyle changes. Therapists experienced that the number and length of the consultations, the structural use of interpreters and (audio) visual educational materials contributed to the achievement of the treatment aims. Conclusion. An adapted cardiac rehabilitation programme with separate modules and additional strategies for non-native patients appears to lead to satisfied patients who adopted lifestyle changes. Relevance to clinical practice. The findings of this study are important as the study highlights the practical actions that may be taken by physicians and healthworkers to adjust rehabilitation treatment to the needs of patients of non-native origin. © 2011 Blackwell Publishing Ltd.

van den Heuvel M.R.C.,VU University Amsterdam | Kwakkel G.,VU University Amsterdam | Kwakkel G.,Reade Center for Rehabilitation and Rheumatology | Beek P.J.,VU University Amsterdam | And 4 more authors.
Parkinsonism and Related Disorders | Year: 2014

Balance training has been demonstrated to improve postural control in patients with Parkinson's disease (PD). The objective of this pilot randomized clinical trial was to investigate whether a balance training program using augmented visual feedback is feasible, safe, and more effective than conventional balance training in improving postural control in patients with PD. Methods: Thirty-three patients with idiopathic PD participated in a five-week training program consisting of ten group treatment sessions of 60min. Participants were randomly allocated to (1) an experimental group who trained on workstations consisting of interactive balance games with explicit augmented visual feedback (VFT), or (2) a control group receiving conventional training. Standing balance, gait, and health status were assessed at entry, at six weeks, and at twelve weeks follow-up. Results: Sixteen patients were allocated to the control group and seventeen to the experimental group. The program was feasible to apply and took place without adverse events. Change scores for all balance measures favored VFT, but the change in the primary outcome measure, i.e. the Functional Reach test, did not differ between groups (t(28)=-0.116, p =908). No other differences between groups were statistically significant. Conclusions: VFT proved to be a feasible and safe approach to balance therapy for patients with PD. In this proof-of-concept study VFT was not superior over conventional balance training although observed trends mostly favored VFT. These trends approached clinical relevance only in few cases: increasing the training load and further optimization of VFT may strengthen this effect. Trial registration: Controlled Trials, ISRCTN47046299. © 2014 Elsevier Ltd.

Van Leeuwen C.M.,University Utrecht | Van Leeuwen C.M.,Swiss Paraplegic Research | Post M.W.,University Utrecht | Post M.W.,Swiss Paraplegic Research | And 7 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2012

Objective: To clarify relationships between activities, participation, mental health, and life satisfaction in persons with spinal cord injury (SCI) and specify how personal factors (self-efficacy, neuroticism, appraisals) interact with these components. We hypothesized that (1) activities are related directly to participation, participation is related directly to mental health and life satisfaction, and mental health and life satisfaction are 2 interrelated outcome variables; and (2) appraisals are mediators between participation and mental health and life satisfaction, and self-efficacy and neuroticism are related directly to mental health and life satisfaction and indirectly through appraisals. Design: Follow-up measurement of a multicenter prospective cohort study 5 years after discharge from inpatient rehabilitation. Setting: Eight Dutch rehabilitation centers with specialized SCI units. Participants: Persons (N=143) aged 18 to 65 years at the onset of SCI. Interventions: Not applicable. Main Outcome Measures: Mental health was measured by using the Mental Health subscale of the 36-Item Short Form Health Survey and life satisfaction with the sum score of "current life satisfaction" and "current life satisfaction compared with life satisfaction before SCI." Results: Structural equation modeling showed that activities and neuroticism were related to participation and explained 49% of the variance in participation. Self-efficacy, neuroticism, and 2 appraisals were related to mental health and explained 35% of the variance in mental health. Participation, 3 appraisals, and mental health were related to life satisfaction and together explained 50% of the total variance in life satisfaction. Conclusions: Mental health and life satisfaction can be seen as 2 separate but interrelated outcome variables. Self-efficacy and neuroticism are related directly to mental health and indirectly to life satisfaction through the mediating role of appraisals. © 2012 by the American Congress of Rehabilitation Medicine.

Van Delden A.E.Q.,VU University Amsterdam | Beek P.J.,VU University Amsterdam | Beek P.J.,Brunel University | Roerdink M.,VU University Amsterdam | And 3 more authors.
Neurorehabilitation and Neural Repair | Year: 2015

Background. Bilateral training in poststroke upper-limb rehabilitation is based on the premise that simultaneous movements of the nonparetic upper limb facilitate performance and recovery of paretic upper-limb function through neural coupling effects. Objective. To determine whether the degree of coupling between both hands is higher after bilateral than after unilateral training and control treatment. Methods. In a single-blinded randomized controlled trial, we investigated rhythmic interlimb coordination after unilateral (mCIMT) and bilateral (mBATRAC) upper-limb training and a dose-matched control treatment (DMCT) in 60 patients suffering from stroke. To this end, we used a series of tasks to discern intended and unintended coupling effects between the hands. In addition, we investigated the control over the paretic hand as reflected by movement harmonicity and amplitude. All tasks were performed before and after a 6-week intervention period and at follow-up 6 weeks later. Results. There were no significant between-group differences in change scores from baseline to postintervention and from postintervention to follow-up with regard to interlimb coupling. However, the mBATRAC group showed greater movement harmonicity and larger amplitudes with the paretic hand after training than the mCIMT and DMCT groups. Conclusions. The degree of coupling between both hands was not significantly higher after bilateral than after unilateral training and control treatment. Although improvements in movement harmonicity and amplitude following mBATRAC may indicate a beneficial influence of the interlimb coupling, those effects were more likely due to the particular type of limb movements employed during this training protocol. © The Author(s) 2014.

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