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Katwijk aan Zee, Netherlands

Sloots M.,Jan Van Breemen Institute | Sloots M.,Institute for Rheumatology and Rehabilitation | Dekker J.H.M.,Rehabilitation Center Heliomare | Pont M.,Rehabilitation Center Amsterdam | And 3 more authors.
Journal of Rehabilitation Medicine

Objective: To explore which factors led to drop-out in patients of Turkish and Moroccan origin with chronic nonspecific low back pain who participated in a rehabilitation programme. Subjects: Patients of Turkish or Moroccan origin with chronic non-specific low back pain (n=23) from 2 rehabilitation centres and 4 rehabilitation departments of general hospitals in the Netherlands. Methods: In-depth semi-structured interviews were conducted with patients of Turkish and Moroccan origin (n=23), rehabilitation physicians (n=8) and rehabilitation therapists (w=2). Interviews were transcribed or summarized and subsequently coded and analysed according to themes. Results: Most patients dropped out due to expectations of a specific medical diagnosis and pain relief as the main aims of rehabilitation treatment. Other reasons for drop-out detected in the interviews were: lack of acknowledgement of the patient's complaints, lack of trust in the rehabilitation physician, contradicting views to those of the physician from the patients' country of origin with regard to the cause and treatment of pain, and communication problems. Conclusion: The major reason for drop-out was patients having different expectations, from those of their health providers, of the aim of treatment, as a result of a different view of the origin and treatment of low back pain. © 2010 Foundation of Rehabilitation Information. Source

Hoogerdijk B.,Rehabilitation Center Heliomare | Runge U.,Runge Consult | Haugboelle J.,University College Sjaelland
Scandinavian Journal of Occupational Therapy

The aim of this study is to understand better how individuals with traumatic brain injury make sense of their adaptation process and their performance of occupations within this process. For this study, four participants were interviewed twice. Thereafter analyses following a narrative approach led to the construction of four individual narratives. The results indicate that the adaptation process following traumatic brain injury is (1) a necessary struggle to gain a new identity; (2) facilitated by engagement in familiar occupations in familiar environments; (3) a protracted learning process that continues long after rehabilitation ends; (4) individual and situated. The results suggest that healthcare professionals including occupational therapists should: allow individuals with traumatic brain injury to test and practise their abilities within their own home environments; provide them with the necessary space to practise on their own; guide them in using their own and new strategies in a way that is both efficient and personally satisfying. Finally, this study discusses whether rehabilitation services should be offered over a protracted period of time. Professional support following the rehabilitation period-precisely the period in which they are trying to establish a meaningful existence with their disabilities-could be a more useful path to follow. © 2011 Informa Healthcare. Source

Scholtes V.A.,VU University Amsterdam | Becher J.G.,VU University Amsterdam | Comuth A.,Adelante | Dekkers H.,Rehabilitation Center Heliomare | And 2 more authors.
Developmental Medicine and Child Neurology

Aim: To evaluate the effectiveness of functional progressive resistance exercise (PRE) strength training on muscle strength and mobility in children with cerebral palsy (CP). Method: Fifty-one children with spastic uni- and bilateral CP; (29 males, 22 females; mean age 10y 5mo, SD 1y 10mo, range 6y 0mo-13y 10mo; Gross Motor Function Classification System levels I-III) were randomized to the intervention group (n=26) or the control group (n=25, receiving usual care). The intervention group trained for 12 weeks, three times a week, on a five-exercise circuit, which included a leg-press and functional exercises. The training load progressively increased based on the child's maximum level of strength, determined by the eight-repetition maximum. Muscle strength (measured with hand-held dynamometry and a six-repetition maximum leg-press test), mobility (measured with the Gross Motor Function Measure, two functional tests, and a mobility questionnaire), and spasticity (measured by the appearance of a catch) were evaluated before, during, directly after, and 6 weeks after the end of training by two blinded research assistants. Results: Directly after training, there was a statistically significant effect ( p<0.05) on muscle strength (knee extensors +12% [0.56N/kg; 95% confidence interval{CI} 0.13-0.99]; hip abductors +11% [0.27N/kg; 95% CI 0.00-0.54]; total +8% [1.30N/kg; 95% CI 0.56-2.54]; six-repetition maximum +14% [14%; 95% CI 1.99-26.35]), but not on mobility or spasticity. A detraining effect was seen after 6 weeks. Interpretation: Twelve weeks of functional PRE strength training increases muscle strength up to 14%. This strength gain did not lead to improved mobility. © The Authors. Journal compilation © Mac Keith Press 2010. Source

Ravensbergen H.J.C.,Simon Fraser University | De Groot S.,Amsterdam Rehabilitation Research Center Reade | De Groot S.,University of Groningen | Post M.W.M.,University Utrecht | And 3 more authors.
Neurorehabilitation and Neural Repair

Background. Autonomic dysfunction after spinal cord injury (SCI) is an under-researched area when compared with motor and sensory dysfunction. Cardiovascular autonomic dysfunction is a particular concern, leading to impaired control of blood pressure and heart rate. Objectives. (1) To determine the prevalence of hypotension in individuals with SCI during and after rehabilitation; (2) To investigate changes in cardiovascular variables during and after rehabilitation; (3) To evaluate the influence of personal and lesion characteristics on cardiovascular variables. Methods. Cardiovascular variables (resting systolic [SAP] and diastolic [DAP] arterial pressures and resting [HRrest] and peak heart rates [HRpeak]) were measured on 5 test occasions: start of inpatient rehabilitation, 3 months later, at discharge, and at 1 and 5 years after discharge. The time course and effects of personal and lesion characteristics on cardiovascular variables were studied using multilevel regression analyses. Results. The prevalence of hypotension was unchanged during rehabilitation and for 5 years after discharge. Odds for hypotension were highest in those with cervical and high thoracic lesions, younger individuals, and men. DAP increased during the 5 years after discharge. HRrest decreased during and after rehabilitation. SAP, DAP, HRrest, and HRpeak were lowest in those with cervical and high thoracic lesions. SAP and DAP increased with age; HRpeak decreased with age. Conclusions. These longitudinal data provide normative values for blood pressure and heart rate changes with time after injury according to lesion and personal characteristics. These results can be used to guide clinical practice and place changes in cardiovascular function caused by interventions in perspective. © The Author(s) 2013. Source

Sloots M.,Jan Van Breemen Institute | Dekker J.H.M.,Rehabilitation Center Heliomare | Bartels E.A.C.,VU University Amsterdam | Geertzen J.H.B.,University of Groningen | And 2 more authors.
European Journal of Physical and Rehabilitation Medicine

Aim. Drop-out of rehabilitation treatment in non-native patients with chronic low back pain has been reported to be higher than in native Dutch patients. It was expected that drop-out in non-native patients would be due to different expectations on the content of rehabilitation treatment and due to language or communication problems. Aim of this study was to determine differences in reasons for drop-out between native patients and nonnative patients with chronic non-specific low back pain participating in a rehabilitation program. Methods. A retrospective study in medical files (N.=99) of patients who dropped out of treatment was performed in two rehabilitation centers and two rehabilitation departments of general hospitals. Patient files were checked for diagnosis, status of origin, gender, age and reason for drop-out. The differences in frequency in reasons for drop-out between native and non-native patients were tested by Chi-square tests. Results. Withdrawal due to different expectations on the content of rehabilitation treatment occurred significantly more frequently in non-native patients (P=0.035). Withdrawal due to refusal to participate (no further reason given) occurred more often (P=0.008) in native Dutch patients than in non-native patients. No significant differences between non-native patients and native Dutch patients were reported regarding withdrawal due to language or communication problems, and no show (patient did not show up at consultation sessions without informing about the reason and without making an appointment for a new consultation). Conclusion. The present study provided evidence that drop-out in non-native patients is often related to different expectations regarding the content of rehabilitation treatment. Source

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