University College Physiotherapy Thim Van der Laan

Switzerland

University College Physiotherapy Thim Van der Laan

Switzerland
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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.


Schuck A.,University of Zürich | Schuck A.,University College Physiotherapy Thim Van der Laan | Labruyere R.,University of Zürich | 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.


PubMed | University College Physiotherapy Thim van der Laan, University of Potsdam and Free University of Brussels
Type: Journal Article | Journal: BMC sports science, medicine and rehabilitation | Year: 2015

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.Twenty-seven (14 girls, 13 boys) healthy subjects (mean age: 141years, age range: 13-15 years) were randomly assigned to a CSTS (n=13) or a CSTU (n=14) group. Both training programs lasted 6weeks (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).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).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.ClinicalTrials.gov Identifier: NCT02290457 Registered 13 November 2014.


Villiger M.,University of Zürich | Villiger M.,University College Physiotherapy Thim van der Laan | Grabher P.,University of Zürich | 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.


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.


Swinnen E.,Vrije Universiteit Brussel | Baeyens J.-P.,Vrije Universiteit Brussel | Baeyens J.-P.,University College Physiotherapy Thim van der Laan | Knaepen K.,Vrije Universiteit Brussel | And 4 more authors.
Clinical Biomechanics | Year: 2015

Abstract Background Little attention has been devoted to the thorax and pelvis movements during gait. The aim of this study is to compare differences in the thorax and pelvis kinematics during unassisted walking on a treadmill and during walking with robot assistance (Lokomat-system (Hocoma, Volketswil, Switzerland)). Methods 18 healthy persons walked on a treadmill with and without the Lokomat system at 2 kmph. Three different conditions of guidance force (30%, 60% and 100%) were used during robot-assisted treadmill walking (30% body weight support). The maximal movement amplitudes of the thorax and pelvis were measured (Polhemus Liberty™ (Polhemus, Colchester, Vermont, USA) (240/16)). A repeated measurement ANOVA was conducted. Findings Robot-assisted treadmill walking with different levels of guidance force showed significantly smaller maximal movement amplitudes for thorax and pelvis, compared to treadmill walking. Only the antero-posterior tilting of the pelvis was significantly increased during robot-assisted treadmill walking compared to treadmill walking. No significant changes of kinematic parameters were found between the different levels of guidance force. Interpretation With regard to the thorax and pelvis movements, robot-assisted treadmill walking is significantly different compared to treadmill walking. It can be concluded that when using robot assistance, the thorax is stimulated in a different way than during walking without robot assistance, influencing the balance training during gait. © 2015 Elsevier Ltd. All rights reserved.


PubMed | Jessa Hospital, University College Physiotherapy Thim van der Laan and Vrije Universiteit Brussel
Type: Journal Article | Journal: Clinical biomechanics (Bristol, Avon) | Year: 2015

Little attention has been devoted to the thorax and pelvis movements during gait. The aim of this study is to compare differences in the thorax and pelvis kinematics during unassisted walking on a treadmill and during walking with robot assistance (Lokomat-system (Hocoma, Volketswil, Switzerland)).18 healthy persons walked on a treadmill with and without the Lokomat system at 2kmph. Three different conditions of guidance force (30%, 60% and 100%) were used during robot-assisted treadmill walking (30% body weight support). The maximal movement amplitudes of the thorax and pelvis were measured (Polhemus Liberty (Polhemus, Colchester, Vermont, USA) (240/16)). A repeated measurement ANOVA was conducted.Robot-assisted treadmill walking with different levels of guidance force showed significantly smaller maximal movement amplitudes for thorax and pelvis, compared to treadmill walking. Only the antero-posterior tilting of the pelvis was significantly increased during robot-assisted treadmill walking compared to treadmill walking. No significant changes of kinematic parameters were found between the different levels of guidance force.With regard to the thorax and pelvis movements, robot-assisted treadmill walking is significantly different compared to treadmill walking. It can be concluded that when using robot assistance, the thorax is stimulated in a different way than during walking without robot assistance, influencing the balance training during gait.


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.


PubMed | University College Physiotherapy Thim van der Laan
Type: Comparative Study | Journal: Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin | Year: 2010

Segmental Stabilizing Exercises (SSE) has a strong theoretical basis in treatment and prevention of Low Back Pain (LBP). The clinical effectiveness has not been clearly established.A systematic review of clinical- and randomized. controlled trials.To evaluate the effectiveness of SSE for acute, subacute, chronic and recurrent LBP.Electronic database PubMed was searched for reviews of SSE from November 2008 to March 2009. Keywords were low back pain, lumbar stabilization, segmental stabilizing exercises, spinal stabilization exercises. For chronic LBP, four comparisons were made: Effectiveness of SSE versus minimal intervention, effectiveness of SSE as a supplement, effectiveness of SSE versus other physiotherapy treatment and effectiveness of SSE versus surgery.17 trials were included. For acute LBP, SSE is equally effective as treatment by general practitioner in reducing short- term pain or disability. For long-term effects after an acute episode of LBP, SSE is more effective in reducing recurrence. For chronic LBP, SSE is more effective than a minimal intervention and may be as effective as other physiotherapeutic treatments in reducing pain and disability. Equal improvement in both groups was measured for surgery. There are no results concerning subacute LBP.For LBP, SSE is more effective than a minimal intervention, but it is not more effective than other physiotherapy interventions.


PubMed | University College Physiotherapy Thim Van Der Laan
Type: Journal Article | Journal: Medical & biological engineering & computing | Year: 2013

The aim of this study was to evaluate the use of miniaturized electromagnetic trackers (1 0.5 0.5 cm) fixed on teeth of the maxilla and mandible to analyse in vivo the 3D kinematics of the temporomandibular joint (TMJ). A third sensor was fixed to the forehead, and a fourth sensor was used as a stylus pointer to detect several anatomical landmarks in order to embed a local frame on the cranium. Temporomandibular opening/closing, chewing, laterotrusion and protrusion were examined.The prime objective within this study was to rigidly attach electromagnetic minisensors on teeth. The key for a successful affixation was the kevlar interface. The distances between the two mandibular affixed sensors and between the two maxillar affixed sensors were overall smaller than 0.033 cm for position and 0.2 for attitude throughout the temporomandibular motions. The relative motions between a forehead sensor and the maxilla affixed sensor are too big to suggest a forehead sensor as an alternative for a maxilla affixed sensor.The technique using miniaturized electromagnetic trackers furthers on the methods using electromagnetic trackers on external appliances. The method allows full range of motion of the TMJ and does not disturb normal TMJ function.

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