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Fermont A.J.,St Antonius Ziekenhuis | Wolterbeek N.,St Antonius Ziekenhuis | Wessel R.N.,St Antonius Ziekenhuis | Baeyens J.-P.,Vrije Universiteit Brussel | And 2 more authors.
Journal of Shoulder and Elbow Surgery | Year: 2015

Background: Studies concerning prognostic factors of recovery after arthroscopic rotator cuff repair mostly focus on tendon integrity or functional recovery as an outcome. Little is known about how they influence quality of life after surgery. We therefore tried to identify prognostic factors having an impact on quality of life after arthroscopic rotator cuff repair. Methods: This study included 30 patients who underwent arthroscopic rotator cuff repair. We assessed Western Ontario Rotator Cuff Index as primary outcome and RAND-36, Constant-Murley score, and a shoulder hindrance score as secondary outcomes. Patients were repeatedly measured: once preoperatively and 4 times postoperatively. Preoperative range of motion, obesity, fatty infiltration, and cuff retraction were preselected as prognostic factors. Results: Patients were significantly improved at 3months and 6months after arthroscopic rotator cuff repair. In multiple regression analysis, none of the preselected factors could be identified as a prognostic factor influencing quality of life after arthroscopic rotator cuff repair (measured with the Western Ontario Rotator Cuff Index). For the outcome variables RAND-36 (6months, 1year) and shoulder hindrance score (1year), fatty infiltration Goutallier stages 1 and 2 and retraction grades II, III, and IV were significant predictors. Conclusion: Although fatty infiltration and retraction grade predict the RAND-36 and shoulder hindrance score, this study could not support preoperative range of motion, obesity, fatty infiltration, or retraction of the cuff as a prognostic factor for quality of life after arthroscopic rotator cuff repair. This study shows that if selection of patients is done properly, these factors do not influence a successful outcome. © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Source


Swinnen E.,Vrije Universiteit Brussel | Beckwee D.,Vrije Universiteit Brussel | Meeusen R.,Vrije Universiteit Brussel | Baeyens J.-P.,Vrije Universiteit Brussel | And 2 more authors.
Topics in Stroke Rehabilitation | Year: 2014

The aim of this systematic review was to summarize the improvements in balance after robot-assisted gait training (RAGT) in stroke patients. Two databases were searched: PubMed and Web of Knowledge. The most important key words are "stroke," "RAGT," "balance," "Lokomat," and "gait trainer." Studies were included if stroke patients were involved in RAGT protocols, and balance was determined as an outcome measurement. The articles were checked for methodological quality by 2 reviewers (Cohen's κ = 0.72). Nine studies were included (7 true experimental and 2 pre-experimental studies; methodological quality score, 56%-81%). In total, 229 subacute or chronic stroke patients (70.5% male) were involved in RAGT (3 to 5 times per week, 3 to 10 weeks, 12 to 25 sessions). In 5 studies, the gait trainer was used; in 2, the Lokomat was used; in 1 study, a single-joint wearable knee orthosis was used; and in 1 study, the AutoAmbulator was used. Eight studies compared RAGT with other gait rehabilitation methods. Significant improvements (no to large effect sizes, Cohen's d = 0.01 to 3.01) in balance scores measured with the Berg Balance Scale, the Tinetti test, postural sway tests, and the Timed Up and Go test were found after RAGT. No significant differences in balance between the intervention and control groups were reported. RAGT can lead to improvements in balance in stroke patients; however, it is not clear whether the improvements are greater compared with those associated with other gait rehabilitation methods. Because a limited number of studies are available, more specific research (eg, randomized controlled trials with larger, specific populations) is necessary to draw stronger conclusions. © 2014 Thomas Land Publishers, Inc. Source


Swinnen E.,Vrije Universiteit Brussel | Baeyens J.-P.,Vrije Universiteit Brussel | Baeyens J.-P.,University College Thim Van der Laan | Pintens S.,University College Thim Van der Laan | And 4 more authors.
Clinical Biomechanics | Year: 2013

Background Few studies have addressed trunk and pelvis movements during gait, although they play an important role in gait control. The aim of this study was to compare trunk and pelvis kinematics between slower walking (1, 2, 3, 4 kmph) and normal walking (5 kmph), and between healthy adults who were young (n = 15, 20-30 years) and older (n = 17, 50-60 years). Methods After 4 min of treadmill walking, the 3-dimensional trunk and pelvis kinematics was measured (Polhemus Liberty™, 250 Hz). A repeated measures ANOVA with simple contrasts was used to look for differences between the velocity conditions of walking and independent t-testing for comparison between the age groups (significance level: 5%, SPSS20). Findings Walking more slowly than with normal velocity induces (1) a decrease in vertical center of mass of the trunk displacement, trunk lateral flexion and axial rotation and pelvis lateral and antero-posterior tilting, and (2) an increase in lateral and antero-posterior center of mass of the trunk displacement. Compared to young persons, older persons show: (1) larger pelvis axial rotations and trunk lateral and antero-posterior movements, and (2) smaller pelvis lateral tilting and trunk vertical movements and rotations. Interpretation The literature reports that patients often walk slowly and that older persons show different gait patterns compared to young persons. This study shows that there are changes in trunk and pelvis kinematics (1) when walking more slowly than with normal velocity and (2) in older persons compared to young persons. These data could be taken into account in gait rehabilitation. © 2013 Elsevier Ltd. Source


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

Background: Although body weight supported (BWS) treadmill training (TT) leads to some improvements in walking ability, it has not been proven that it is more effective than other walking therapies in persons with multiple sclerosis (PwMS). One possible explanation could be that BWSTT focuses on the cyclic movement of the lower extremities while the trunk is passively suspended in the harness. Objective: This study aimed to assess the 3 dimensional trunk and pelvis movements during BWS treadmill walking. Methods: 14 PwMS and 14 healthy persons (8 male/20 female; age 23 to 59 years) walked with 0%, 10%, 20%, 30%, 50% and 70% BWS. After a familiarization period, kinematic electromagnetic tracking (Polhemus Liberty™ 240/16) of the trunk and pelvis movements was applied. Statistical analysis consisted of a repeated measures ANOVA with simple contrasts (SPSS 20). Results: This study shows that BWS walking leads in general to smaller maximum trunk and pelvis movement amplitudes compared with walking without BWS, this with exception of the pelvis anterior-posterior movement in healthy subjects. Conclusion: These data help to identify and isolate the effect of different BWS levels in PwMS and in healthy persons and suggest to use BWS lower than 30% for treadmill training. © 2014 - IOS Press and the authors. Source


Swinnen E.,Vrije Universiteit Brussel | Baeyens J.-P.,Vrije Universiteit Brussel | Baeyens J.-P.,University College Thim Van der Laan | Knaepen K.,Vrije Universiteit Brussel | And 7 more authors.
Disability and Rehabilitation: Assistive Technology | Year: 2015

Purpose: The goal was to assess in healthy participants the three-dimensional kinematics of the pelvis and the trunk during robot-assisted treadmill walking (RATW) at 0%, 30% and 50% body weight support (BWS), compared with treadmill walking (TW). Methods: 18 healthy participants walked (2kmph) on a treadmill with and without robot assistance (Lokomat; 60% guidance force; 0%, 30% and 50% BWS). After an acclimatisation period (four minutes), trunk and pelvis kinematics were registered in each condition (Polhemus Liberty™ [240Hz]). The results were analysed using a repeated measures analysis of variance with Bonferroni correction, with the level of suspension as within-subject factor. Results: During RATW with BWS, there were significantly (1) smaller antero-posterior and lateral translations of the trunk and the pelvis; (2) smaller antero-posterior flexion and axial rotation of the trunk; (3) larger lateral flexion of the trunk; and (4) larger antero-posterior tilting of the pelvis compared with TW. Conclusions: There are significant differences in trunk and pelvis kinematics in healthy persons during TW with and without robot assistance. These data are relevant in gait rehabilitation, relating to normal balance regulation. Additional research is recommended to further assess the influence of robot assistance on human gait.Implications for RehabilitationThe trunk and pelvis moves in a different way during walking with robot assistance.The data suggest that the change in movement is due to the robot device and the harness of the suspension system more than due to the level of suspension itself. © 2014 Informa UK Ltd. Source

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