Sint Maartenskliniek Research Development and Education

Nijmegen, Netherlands

Sint Maartenskliniek Research Development and Education

Nijmegen, Netherlands
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Van Kessel M.E.,Sint Maartenskliniek Research Development and Education | Van Nes I.J.W.,Sint Maartenskliniek Research Development and Education | Geurts A.C.H.,Sint Maartenskliniek Research Development and Education | Geurts A.C.H.,Radboud University Nijmegen | And 3 more authors.
Journal of Neuropsychology | Year: 2013

Various authors have referred to an association between neglect and non-spatial components of attention. It has been suggested that an increase in attentional load could exacerbate neglect symptoms and reveal subtle, well-compensated neglect. In the present study, 21 RH and 22 LH subacute stroke patients and 20 controls performed a computerized single-detection task (CVRT) and a dual task (CVRT-D) combining the detection task with a driving simulation task. Omissions, reaction times (RTs) and RT asymmetries were analysed to investigate the influence of increasing attentional load on neglect symptoms. RT asymmetries were most pronounced in RH patients. Although a clear increase in RT asymmetries between CVRT and CVRT-D was observed, the amount of increase did not differ between both patient groups. Within both patient groups, correlations between RT asymmetries and ipsilesional RTs as a measure of general attention were significant in the single task but not in the dual task, indicating that increased attentional load may result in different degrees of lateralized and general attentional problems. Half of the patients with neglect on the BIT (Behavioural Inattention Test) showed increased RT asymmetries from CVRT to CVRT-D. Moreover, two LH and RH patients without neglect symptoms on the BIT and CVRT showed distinctively increased asymmetries in the CVRT-D, fostering the idea of an emergence of subtle neglect under increased attentional load. Dual-task performance may draw attention towards patients who, without obvious signs of neglect, may show visuospatial attention deficits in complex situations. © 2012 The British Psychological Society.

Berkelmans R.,Helftheuvelweg 11 | Berkelmans R.,BerkelBike BV | Duysens J.,Catholic University of Leuven | Van Kuppevelt D.,Sint Maartenskliniek Research Development and Education
Assistive Technology Research Series | Year: 2010

Purpose: To develop a tricycle with Functional Electrical Stimulation (FES) for the leg muscles of spinal cord injured. It has to give the therapeutical benefits of FES, but also be practical in speed, range and reliability. Methods: We combined voluntary arm cranking with FES leg cycling. Three different models are made. One model is just a front part with one wheel, which can be attached and detached to a wheelchair. Two models can also be used outdoor tricycles and all models can be used as a stationary bike. Results: Compared with FES leg cycling only, the power output and the stamina improved. The combined exercise from arms and legs gives a higher oxygen uptake then separate exercises. Conclusion: A practical outdoor tricycle for people with SCI is developed. The different models are suitable for complete spinal cord injured ranging from C5 to T12. © 2010 The authors and IOS Press. All rights reserved.

Luites J.W.H.,Sint Maartenskliniek Research Development and Education | Wymenga A.B.,Sint Maartenskliniek | Blankevoort L.,University of Amsterdam | Kooloos J.M.G.,Radboud University Nijmegen | And 2 more authors.
Medical Engineering and Physics | Year: 2012

Anterior cruciate ligament reconstruction techniques are evolving with innovations like double-bundle (DB) grafts and computer assistance. The current DB techniques do not appear to make the clinical difference yet. Insight in various techniques may lead to better results. In this study, the anterior laxity of a DB reconstruction with an anteromedial (AM) graft fixated in 90° of flexion and a posterolateral (PL) graft fixated in 20° and computer-assisted anatomically placed femoral attachments was compared to normal values and single-bundle grafts. In 8 fresh-frozen human cadaveric knees, the anterior laxity was tested from 0° to 90° flexion, with a 100. Newton (N) anterior tibial load in joints with (1) intact ACL, (2) torn ACL, (3) single-bundle (SB) graft tensed with 15. N in 20°, (4) anatomic AM graft tensed with 15. N in 90°, (5) anatomic PL graft tensed with 15. N in 20°, and (6) anatomic DB graft (4. +. 5).All reconstructions caused a posterior position of the tibia. Relative to the normal anterior laxity, the single-bundle techniques showed significantly increased laxities: The SB technique in 0° (+1.1. mm) and 15° (+1.7. mm); The AM reconstructions in 45° (+1.6. mm) and 90° (+1.5. mm); The PL reconstructions in all angles (from +1.4 to +2.3. mm), except in 0°. The anatomic DB technique showed no significantly increased laxities and restored normal laxity in all angles. © 2011 IPEM.

Ruiter M.B.,Sint Maartenskliniek Research Development and Education | Kolk H.H.J.,Radboud University Nijmegen | Rietveld T.C.M.,Radboud University Nijmegen | Dijkstra N.,Radboud University Nijmegen | Lotgering E.,Radboud University Nijmegen
Aphasiology | Year: 2011

Background: A well-known test for measuring verbal adequacy (i.e., verbal effectiveness) in mildly impaired aphasic speakers is the Amsterdam-Nijmegen Everyday Language Test (ANELT; Blomert, Koster, & Kean, 1995). Aphasia therapy practitioners score verbal adequacy qualitatively when they administer the ANELT to their aphasic clients in clinical practice. Aims: The current study investigated whether the construct validity of the ANELT could be further improved by substituting the qualitative score by a quantitative one, which takes the number of essential information units into account. The new quantitative measure could have the following advantages: the ability to derive a quantitative score of verbal efficiency, as well as improved sensitivity to detect changes in functional communication over time. Methods & Procedures: The current study systematically compared a new quantitative measure of verbal effectiveness with the current ANELT Comprehensibility scale, which is based on qualitative judgements. A total of 30 speakers of Dutch participated: 20 non-aphasic speakers and 10 aphasic patients with predominantly expressive disturbances. Outcomes & Results: Although our findings need to be replicated in a larger group of aphasic speakers, the main results suggest that the new quantitative measure of verbal effectiveness is more sensitive to detect change in verbal effectiveness over time. What is more, it can be used to derive a measure of verbal efficiency. Conclusions: The fact that both verbal effectiveness and verbal efficiency can be reliably as well as validly measured in the ANELT is of relevance to clinicians. It allows them to obtain a more complete picture of aphasic speakers' functional communication skills. ©2011 Psychology Press.

Groen B.E.,Sint Maartenskliniek Research Development and Education | Geurts M.,Sint Maartenskliniek Research Development and Education | Geurts M.,Research Center for Movement Control and Neuroplasticity | Nienhuis B.,Sint Maartenskliniek Research Development and Education | And 2 more authors.
Gait and Posture | Year: 2012

Gait data need to be reliable to be valuable for clinical decision-making. To reduce the impact of marker placement errors, the Optimized Lower Limb Gait Analysis (OLGA) model was developed. The purpose of this study was to assess the sensitivity of the kinematic gait data to a standard marker displacement of the OLGA model compared with the standard Vicon Clinical Manager (VCM) model and to determine whether OLGA reduces the errors due to the most critical marker displacements. Healthy adults performed six gait sessions. The first session was a standard gait session. For the following sessions, 10. mm marker displacements were applied. Kinematic data were collected for both models. The root mean squares of the differences (RMS) were calculated for the kinematics of the displacement sessions with respect to the first session. The results showed that the RMS values were generally larger than the stride-to-stride variation except for the pelvic kinematics. For the ankle, knee and hip kinematics, OLGA significantly reduced the averaged RMS values for most planes. The shank, knee and thigh anterior-posterior marker displacements resulted in RMS values exceeding 10°. OLGA reduced the errors due to the knee and thigh marker displacements, but not the errors due to the ankle marker displacements. In conclusion, OLGA reduces the effect of erroneous marker placement, but does not fully compensate all effects, indicating that accurate marker placement remains of crucial importance for adequate 3D-gait analysis and subsequent clinical decision-making. © 2011 Elsevier B.V.

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