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Clarys P.,Vrije Universiteit Brussel | Clijsen R.,University College Physiotherapy Thim Van der Laan | Taeymans J.,Bern University of Applied Sciences | Barel A.O.,Vrije Universiteit Brussel
Skin Research and Technology | Year: 2012

Background: Measurement of stratum corneum (SC) hydration often involves the use of commercial instruments. The aim of this study was to compare and validate two recent instruments: the Corneometer 825® (digital probe) and the Skicon-200 EX®. Methods: In vitro calibration was carried out on filter pads using different solvents, measurements over different layers of plastic foils, and evaluation of desorption kinetics. In vivo measurements were carried out on skin sites covering a range of very dry to well-hydrated skin areas. Results: Conductance measurements are influenced by electrolytes while capacitance measurements are not. Dielectric constant of the solvents influences the values of both instruments (r respectively 0.92 and 0.99). The capacitance method carries information from deeper layers (up to 45 μm) compared with the conductance instrument (up to 15 μm). Desorption experiments show a strong relation between the amount of water and respectively the capacitance and the conductance values. The in vivo experiments revealed a strong relation between the two methods (r = 0.97). Sensitivity of the capacitance method is limited for the highest hydration values. Conclusions: Both instruments allow a certain calibration and both give good estimates of the SC hydration. © 2011 John Wiley & Sons A/S.

Villiger M.,University of Zurich | Villiger M.,University College Physiotherapy Thim Van der Laan | Grabher P.,University of Zurich | Hepp-Reymond M.-C.,ETH Zurich | And 8 more authors.
Frontiers in Human Neuroscience | Year: 2015

Rehabilitative training has shown to improve significantly motor outcomes and functional walking capacity in patients with incomplete spinal cord injury (iSCI). However, whether performance improvements during rehabilitation relate to brain plasticity or whether it is based on functional adaptation of movement strategies remain uncertain. This study assessed training improvement-induced structural brain plasticity in chronic iSCI patients using longitudinal MRI. We used tensor-based morphometry (TBM) to analyze longitudinal brain volume changes associated with intensive virtual reality (VR)-augmented lower limb training in nine traumatic iSCI patients. The MRI data was acquired before and after a 4-week training period (16–20 training sessions). Before training, voxel-based morphometry (VBM) and voxel-based cortical thickness (VBCT) assessed baseline morphometric differences in nine iSCI patients compared to 14 healthy controls. The intense VR-augmented training of limb control improved significantly balance, walking speed, ambulation, and muscle strength in patients. Retention of clinical improvements was confirmed by the 3–4 months follow-up. In patients relative to controls, VBM revealed reductions of white matter volume within the brainstem and cerebellum and VBCT showed cortical thinning in the primary motor cortex. Over time, TBM revealed significant improvement-induced volume increases in the left middle temporal and occipital gyrus, left temporal pole and fusiform gyrus, both hippocampi, cerebellum, corpus callosum, and brainstem in iSCI patients. This study demonstrates structural plasticity at the cortical and brainstem level as a consequence of VR-augmented training in iSCI patients. These structural changes may serve as neuroimaging biomarkers of VR-augmented lower limb neurorehabilitation in addition to performance measures to detect improvements in rehabilitative training. © 2015 Villiger,Grabher,Hepp Reymond, Kiper ,Curt,Bolliger,Hotz Boendermaker, Kollias,Engand Freund.

Schuck A.,University of Zurich | Schuck A.,University College Physiotherapy Thim Van der Laan | Labruyere R.,University of Zurich | Labruyere R.,ETH Zurich | And 8 more authors.
Journal of NeuroEngineering and Rehabilitation | Year: 2012

Background: Functional training is becoming the state-of-the-art therapy approach for rehabilitation of individuals after stroke and spinal cord injury. Robot-aided treadmill training reduces personnel effort, especially when treating severely affected patients. Improving rehabilitation robots towards more patient-cooperative behavior may further increase the effects of robot-aided training. This pilot study aims at investigating the feasibility of applying patient-cooperative robot-aided gait rehabilitation to stroke and incomplete spinal cord injury during a therapy period of four weeks. Short-term effects within one training session as well as the effects of the training on walking function are evaluated. Methods. Two individuals with chronic incomplete spinal cord injury and two with chronic stroke trained with the Lokomat gait rehabilitation robot which was operated in a new, patient-cooperative mode for a period of four weeks with four training sessions of 45 min per week. At baseline, after two and after four weeks, walking function was assessed with the ten meter walking test. Additionally, muscle activity of the major leg muscles, heart rate and the Borg scale were measured under different walking conditions including a non-cooperative position control mode to investigate the short-term effects of patient-cooperative versus non-cooperative robot-aided gait training. Results: Patient-cooperative robot-aided gait training was tolerated well by all subjects and performed without difficulties. The subjects trained more actively and with more physiological muscle activity than in a non-cooperative position-control mode. One subject showed a significant and relevant increase of gait speed after the therapy, the three remaining subjects did not show significant changes. Conclusions: Patient-cooperative robot-aided gait training is feasible in clinical practice and overcomes the main points of criticism against robot-aided gait training: It enables patients to train in an active, variable and more natural way. The limited number of subjects in this pilot trial does not permit valid conclusions on the effect of patient-cooperative robot-aided gait training on walking function. A large, possibly multi-center randomized controlled clinical trial is required to shed more light on this question. © 2012 Schück et al.; licensee BioMed Central Ltd.

Granacher U.,University of Potsdam | Schellbach J.,University College Physiotherapy Thim Van der Laan | Klein K.,University College Physiotherapy Thim Van der Laan | Prieske O.,University of Potsdam | And 3 more authors.
BMC Sports Science, Medicine and Rehabilitation | Year: 2014

Background: It has been demonstrated that core strength training is an effective means to enhance trunk muscle strength (TMS) and proxies of physical fitness in youth. Of note, cross-sectional studies revealed that the inclusion of unstable elements in core strengthening exercises produced increases in trunk muscle activity and thus provide potential extra training stimuli for performance enhancement. Thus, utilizing unstable surfaces during core strength training may even produce larger performance gains. However, the effects of core strength training using unstable surfaces are unresolved in youth. This randomized controlled study specifically investigated the effects of core strength training performed on stable surfaces (CSTS) compared to unstable surfaces (CSTU) on physical fitness in school-aged children. Methods: Twenty-seven (14 girls, 13 boys) healthy subjects (mean age: 14 ± 1 years, age range: 13-15 years) were randomly assigned to a CSTS (n = 13) or a CSTU (n = 14) group. Both training programs lasted 6 weeks (2 sessions/week) and included frontal, dorsal, and lateral core exercises. During CSTU, these exercises were conducted on unstable surfaces (e.g., TOGU © DYNAIR CUSSIONS, THERA-BAND. © STABILITY TRAINER). Results: Significant main effects of Time (pre vs. post) were observed for the TMS tests (8-22%, f = 0.47-0.76), the jumping sideways test (4-5%, f = 1.07), and the Y balance test (2-3%, f = 0.46-0.49). Trends towards significance were found for the standing long jump test (1-3%, f = 0.39) and the stand-and-reach test (0-2%, f = 0.39). We could not detect any significant main effects of Group. Significant Time x Group interactions were detected for the stand-and-reach test in favour of the CSTU group (2%, f= 0.54). Conclusions: Core strength training resulted in significant increases in proxies of physical fitness in adolescents. However, CSTU as compared to CSTS had only limited additional effects (i.e., stand-and-reach test). Consequently, if the goal of training is to enhance physical fitness, then CSTU has limited advantages over CSTS. Trial registration: ClinicalTrials.gov Identifier: NCT02290457 Registered 13 November 2014. © 2014 Granacher et al.; licensee BioMed Central.

Swinnen E.,Vrije Universiteit Brussel | Baeyens J.-P.,Vrije Universiteit Brussel | Baeyens J.-P.,University College Physiotherapy Thim Van der Laan | Pintens S.,University College Physiotherapy Thim Van der Laan | And 7 more authors.
NeuroRehabilitation | Year: 2014

BACKGROUND: Although the trunk is important for maintaining balance during walking only very limited information about the trunk muscle activity during walking with body weight support (BWS) is reported in literature. OBJECTIVE: The aim of this study was to measure the effect of BWS on the trunk muscle activity during treadmill walking. METHODS: 14 persons with multiple sclerosis and 14 healthy persons walked on a treadmill with 0%, 10%, 20%, 30%, 50% and 70% BWS. Bilateral EMG measurements (surface electrodes) on the m. rectus abdominis, m. obliquus externus, m. erector spinae and m. multifidus were performed. The maximal muscle activation was presented as a percentage of a performance related reference contraction. A repeated measures ANOVA with simple contrasts was applied (SPSS20). RESULTS: In general when comparing walking with BWS with walking with 0% BWS there is an increase in m. obliquus externus activity and a decrease in back muscle activity. With increasing percentages of BWS an increase in activity of the abdominal muscles and a decrease in back muscle activity was found, with most changes in high percentages BWS. CONCLUSION: Based on the results, it is recommended to decrease the percentage BWS as fast as possible beneath 30% BWS. © 2014 ? IOS Press and the authors.

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