176
|
Knoop J, Steultjens MPM, van der Leeden M, van der Esch M, Thorstensson CA, Roorda LD, Lems WF, Dekker J. Proprioception in knee osteoarthritis: a narrative review. Osteoarthritis Cartilage 2011; 19:381-8. [PMID: 21251988 DOI: 10.1016/j.joca.2011.01.003] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 12/16/2010] [Accepted: 01/03/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To give an overview of the literature on knee proprioception in knee osteoarthritis (OA) patients. METHOD A literature search was performed and reviewed using the narrative approach. RESULTS (1) Three presumed functions of knee proprioception have been described in the literature: protection against excessive movements, stabilization during static postures, and coordination of movements. (2) Proprioceptive accuracy can be measured in different ways; correlations between these methods are low. (3) Proprioceptive accuracy in knee OA patients seems to be impaired when compared to age-matched healthy controls. Unilateral knee OA patients may have impaired proprioceptive accuracy in both knees. (4) Causes of impaired proprioceptive accuracy in knee OA remain unknown. (5) There is currently no evidence for a role of impaired proprioceptive accuracy in the onset or progression of radiographic osteoarthritis (ROA). (6) Impaired proprioceptive accuracy could be a risk factor for progression (but not for onset) of both knee pain and activity limitations in knee OA patients. (7) Exercise therapy seems to be effective in improving proprioceptive accuracy in knee OA patients. CONCLUSIONS Recent literature has shown that proprioceptive accuracy may play an important role in knee OA. However, this role needs to be further clarified. A new measurement protocol for knee proprioception needs to be developed. Systematic reviews focusing on the relationship between impaired proprioceptive accuracy, knee pain and activity limitations and on the effect of interventions (in particular exercise therapy) on proprioceptive accuracy in knee OA are required. Future studies focusing on causes of impaired proprioceptive accuracy in knee OA patients are also needed, taking into account that also the non-symptomatic knee may have proprioceptive impairments. Such future studies may also provide knowledge of mechanism underlying the impact of impaired proprioceptive accuracy on knee pain and activity limitations.
Collapse
|
177
|
Peen J, Theunissen J, Duurkoop P, Kikkert M, Dekker J. [The aftermath of the reduction in inpatient care and treatment; a retrospective study that considers the extent to which a group of chronic psychiatric patients made use of the Amsterdam mental health services]. TIJDSCHRIFT VOOR PSYCHIATRIE 2011; 53:509-517. [PMID: 21845553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND The move towards less hospital care and more community care for psychiatric patients began in the eighties. Chronic patients possibly have not really benefited from the new procedures. AIM To find out whether chronic psychiatric patients in Amsterdam were receiving adequate care and made good use of the available psychiatric services. METHOD We amalgamated the registration details of three mental health care institutions in Amsterdam over the period 1-1-2000 to 1-1-2005. RESULTS In 2005 4576 patients met the criteria for chronic mental illness. In five years, the number of patients in mental health care had risen by 50%. Most of these patients had received care via specialised programmes. 38% of chronic patients had no access to specialised programmes, many of which had waiting lists. Only 6.5% of chronic patients received long-term inpatient care. Not many long-term psychiatric patients used the acute psychiatric services. Each year only 10% of long-term psychiatric patients were admitted to a psychiatric hospital. If admitted, they spent a much longer time in hospital. The average number of days spent in hospital rose from 86 in 2000 to 131 in 2004. Crisis contacts increased in line with the increase in the numbers of chronic patients in care, but these crisis contacts were registered mainly with the patient treatment team and not with the municipal acute psychiatric service. CONCLUSION Only a small proportion of long-term psychiatric patients make use of the acute psychiatric services.
Collapse
|
178
|
Sloots M, Scheppers EF, Bartels EAC, Dekker JHM, Geertzen JHB, Dekker J. First rehabilitation consultation in patients of non-native origin: factors that lead to tension in the patient-physician interaction. Disabil Rehabil 2010; 31:1853-61. [PMID: 19479547 DOI: 10.1080/09638280902847085] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To explore which factors lead to tension in the patient-physician interaction in the first consultation by rehabilitation physicians of patients with chronic non-specific low back pain of Turkish and Moroccan origin. METHOD In-depth semi-structured, face to face interviews were conducted with 12 patients of Moroccan and Turkish origin and four native Dutch rehabilitation physicians. Interviews were transcribed and/or summarised. All interviews were subsequently coded and analysed according to themes. RESULTS Factors that lead to tension in the patient-physician interaction were as follows: differences in expectations regarding the aim of treatment, symptom presentation, views on responsibilities with regard to rehabilitation treatment, lack of trust, contradicting views of physicians from patients' country of origin with regard to the cause and treatment of pain and communication problems. CONCLUSION Sources of tension were identified during the interaction between Dutch physicians and patients of Turkish and Moroccan origin. These factors potentially are associated with future drop-out. Future research should clarify whether these factors indeed are associated with drop-out.
Collapse
|
179
|
Sloots M, Dekker JHM, Bartels EAC, Geertzen JHB, Dekker J. Reasons for drop-out in rehabilitation treatment of native patients and non-native patients with chronic low back pain in the Netherlands: a medical file study. Eur J Phys Rehabil Med 2010; 46:505-510. [PMID: 20414186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
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 non-native 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.
Collapse
|
180
|
van der Wees P, Hendriks E, van Beers H, van Rijn R, Dekker J, de Bie R. Validity and responsiveness of the ankle function score after acute ankle injury. Scand J Med Sci Sports 2010; 22:170-4. [PMID: 21083768 DOI: 10.1111/j.1600-0838.2010.01243.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The purpose of this study was to examine prognostic validity, concurrent validity and responsiveness of ankle function score (AFS) for patients with acute ankle injury. In a prospective cohort study, AFS was compared with Olerud and Molander ankle score (OMAS), patient-specific complaints (PSC), and global perceived effect. Sensitivity and specificity were calculated to estimate prognostic validity; correlation was calculated for concurrent validity. Effect Size, Standardized Response Mean, and Responsiveness Ratio were calculated to estimate responsiveness. The sensitivity of AFS was 76% and the specificity was 57%. Correlation between AFS and OMAS at baseline, end of treatment and difference was 0.82, 0.70 and 0.79, respectively. Outcomes for responsiveness of AFS were comparable to outcomes for OMAS and PSC. This study found limited evidence for the AFS as a prognostic and evaluative instrument. The AFS is a simple instrument based on basic functional outcomes (pain, stability, weight bearing, swelling and gait) and may be used in addition to subjective clinical judgment as a prognostic and evaluative tool for recovery after acute ankle injury.
Collapse
|
181
|
Jansen MJ, Hendriks EJ, Oostendorp RAB, Dekker J, De Bie RA. Quality indicators indicate good adherence to the clinical practice guideline on "Osteoarthritis of the hip and knee" and few prognostic factors influence outcome indicators: a prospective cohort study. Eur J Phys Rehabil Med 2010; 46:337-345. [PMID: 20926999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Evaluation with quality indicators of adherence to the clinical practice guideline on "Osteoarthritis of the hip and knee" and of treatment outcomes. AIM Furthermore to determine prognostic factors for outcome indicators. DESIGN Prospective cohort study. POPULATION Twenty-seven well informed physical therapists recorded patient and treatment characteristics of 103 community-dwelling patients referred by a general practitioner diagnosed with osteoarthritis of hip or knee. METHODS With selected process and outcome indicators adherences to the guideline and treatment outcomes were assessed. Prognostic factors were calculated for Algofunctional Index (AI) and Visual Analogue Scale (VAS) for pain (decreases of ≤25% indicating "poor outcome"), number of sessions (>12) and duration of treatment (>6 weeks), using multivariate logistic regression models. RESULTS Process indicators showed that information & advice was given to 95% of the patients and functions and activities were exercised in 97% respectively 87%. Aftercare was arranged for 46% of the patients, that was clearly lower than the benchmark of 90%. Outcome indicators VAS-pain and AI decreased by 45% and 36%, respectively. The combination ">12 months" duration of complaints and age ≥65" was associated with a "poor outcome" on AI (OR 2.53; 95% CI 1.01-6.38). Co-morbidity (OR 2.8; 95% CI 1.17-6.88), and "VAS-pain at baseline ≥51 mm" (OR 3.1; 95% CI 1.34-7.23) were associated with a higher number of treatment sessions. CONCLUSION AND CLINICAL REHABILITATION IMPACT and Quality indicators showed that a group of well-informed physical therapists could to a large extent adhere to key recommendations of the guideline and that clinically relevant improvements were obtained in terms of pain and physical functioning. Prognostic factors for poorer outcome on outcome indicators were comorbidity, a higher pain score at baseline and the combination ">12 months' duration of complaints and age ≥65".
Collapse
|
182
|
Peen J, Schoevers RA, Beekman AT, Dekker J. The current status of urban-rural differences in psychiatric disorders. Acta Psychiatr Scand 2010; 121:84-93. [PMID: 19624573 DOI: 10.1111/j.1600-0447.2009.01438.x] [Citation(s) in RCA: 481] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Reviews of urban-rural differences in psychiatric disorders conclude that urban rates may be marginally higher and, specifically, somewhat higher for depression. However, pooled results are not available. METHOD A meta-analysis of urban-rural differences in prevalence was conducted on data taken from 20 population survey studies published since 1985. Pooled urban-rural odds ratios (OR) were calculated for the total prevalence of psychiatric disorders, and specifically for mood, anxiety and substance use disorders. RESULTS Significant pooled urban-rural OR were found for the total prevalence of psychiatric disorders, and for mood disorders and anxiety disorders. No significant association with urbanization was found for substance use disorders. Adjustment for various confounders had a limited impact on the urban-rural OR. CONCLUSION Urbanization may be taken into account in the allocation of mental health services.
Collapse
|
183
|
Bobbioni-Harsch E, Pataky Z, Makoundou V, Kozakova M, Dekker J, Golay A. Fat distribution influences the cardio-metabolic profile in a clinically healthy European population. Eur J Clin Invest 2009; 39:1055-64. [PMID: 19807784 DOI: 10.1111/j.1365-2362.2009.02211.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Waist and hip circumferences are largely influenced by Fat Mass and several other determinants. To evaluate the specific effects of a preferential fat distribution, we corrected the waist and hip circumferences for all their determinants. We then examined the association between fat distribution and several cardio-metabolic parameters in a clinically healthy population. SUBJECTS AND METHODS In a subgroup of 625 females (F) and 490 males (M) from the RISC (Relationship between Insulin Sensitivity and Cardiovascular Disease) study, we evaluated insulin sensitivity by hyperinsulinaemic euglycaemic clamp and intima-media thickness (IMT) of the common (CCA) and internal (ICA) carotid artery by ultrasound imaging. Waist and hip circumferences were adjusted for age, height, fat and fat-free mass; in males, waist was also adjusted by hip and vice versa. RESULTS Both F and M with enlarged waist showed significantly increased plasma insulin, C-peptide, total cholesterol, non-high density lipoprotein-cholesterol, low density lipoprotein cholesterol and triglycerides, when compared with subjects with a smaller waist circumference. Males also showed lower glucose uptake and higher heart rate and ICA-IMT. A larger hip in both females and males was linked to a significantly greater inhibition of free fatty acids during the clamp test. CONCLUSION Adjustment of waist circumference for its determinants permits the detection of early impairment of cardiovascular function and of glucose and lipid metabolism in a clinically healthy population, in particular in normal body weight subjects. Enlarged hip adjusted values are associated with greater insulin sensitivity.
Collapse
|
184
|
van der Post L, Mulder CL, Bernardt CML, Schoevers RA, Beekman ATF, Dekker J. Involuntary admission of emergency psychiatric patients: report from the Amsterdam Study of Acute Psychiatry. Psychiatr Serv 2009; 60:1543-6. [PMID: 19880477 DOI: 10.1176/appi.ps.60.11.1543] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This brief report presents initial data from the Amsterdam Study of Acute Psychiatry (ASAP-I) about factors associated with the decision to admit patients compulsorily (involuntarily) to emergency psychiatric services in the Amsterdam region of the Netherlands. METHODS The study was a prospective cohort study of 1,970 consecutive patients who came into contact with the Psychiatric Emergency Service Amsterdam. RESULTS A history of more than 14 outpatient contacts the previous year was associated with a low risk of compulsory admission (OR=.3). An involuntary admission in the previous five years was associated with a higher risk (OR=3.7). Referral by a general practitioner was associated with a low risk compared with referral by police (OR=2.4) or by mental health services (OR=2.3). CONCLUSIONS The hypothesis that outpatient treatment may help to prevent compulsory admission found some support in this study. More research is needed to understand the mechanisms of the associations so that an intervention study can be developed to test this hypothesis.
Collapse
|
185
|
Fassaert T, De Wit MAS, Tuinebreijer WC, Wouters H, Verhoeff AP, Beekman ATF, Dekker J. Psychometric properties of an interviewer-administered version of the Kessler Psychological Distress scale (K10) among Dutch, Moroccan and Turkish respondents. Int J Methods Psychiatr Res 2009; 18:159-68. [PMID: 19701920 PMCID: PMC6878421 DOI: 10.1002/mpr.288] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The Kessler Psychological Distress scale (K10) is an instrument that is widely used to screen for mental disorders, but information is lacking on its psychometric qualities in non-Western samples. This study used a population-based sample (N = 725) to assess the reliability and validity of the K10 across ethnic groups in an urban area. The results were generally supportive of the K10 as a reliable and valid instrument to screen for anxiety and depression in all three groups. Cronbach's alpha was high (0.93) and the results indicated the existence of a solid single factor structure. Item bias in relation to ethnic background was minor. In each group, there was good criterion validity with respect to one-month DSM-IV diagnosis for depressive and/or anxiety disorder. The results nevertheless highlight the importance of cross-cultural validation, as we found different cut-off values for ethnic subgroups to obtain optimal sensitivity and specificity for detecting depressive and/or anxiety disorders.
Collapse
|
186
|
Holla J, Fluit M, van Schaardenburg D, Dekker J, Verhagen E, Steultjens M. Recreational exercise in rheumatic diseases. Int J Sports Med 2009; 30:814-20. [PMID: 19685415 DOI: 10.1055/s-0029-1233467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to evaluate changes in health-related quality of life after eight to twelve months of recreational exercise in patients with rheumatic diseases (inflammatory joint disease, osteoarthritis, fibromyalgia and other generalized pain syndromes), and to determine whether patient (age, sex, diagnosis) and exercise characteristics (follow-up time, type of activity, frequency of participation) are related to health-related quality of life change. Health-related quality of life was assessed twice in 138 patients with rheumatic diseases. 1) At enrolment in a centre for outpatient recreational exercise and 2) following eight to twelve months of recreational exercise. Health-related quality of life was measured using the Short-Form Health Survey 36 and three numeric rating scales for pain, fatigue and general condition. Multiple linear regression was used to analyze the influence of patient and exercise characteristics on follow-up HRQoL-score. Patients showed significant improvements in pain and general condition, and reported a positive change in health. A diagnosis of inflammatory joint disease (e. g. rheumatoid arthritis, polyarthritis, spondylitis) or osteoarthritis, participating in sports activities two to three times per week, and following land-based fitness classes were associated with the most improvement in health-related quality of life. Regular participation in recreational exercise contributes to improved health-related quality of life in patients with rheumatic diseases.
Collapse
|
187
|
van Weely SFE, van Denderen CJ, van der Horst-Bruinsma IE, Nurmohamed MT, Dijkmans BAC, Dekker J, Steultjens MPM. Reproducibility of performance measures of physical function based on the BASFI, in ankylosing spondylitis. Rheumatology (Oxford) 2009; 48:1254-60. [DOI: 10.1093/rheumatology/kep190] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
188
|
van der Esch M, Steultjens M, Wieringa H, Dinant H, Dekker J. Structural joint changes, malalignment, and laxity in osteoarthritis of the knee. Scand J Rheumatol 2009; 34:298-301. [PMID: 16195163 DOI: 10.1080/03009740510018651] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the relationship between (i) structural joint changes (i.e. joint space narrowing and osteophyte formation) and laxity and (ii) joint malalignment and laxity in osteoarthritis (OA) of the knee. METHODS A cross-sectional study was carried out on 35 outpatients with osteoarthritis of the knee. Weight-bearing radiographs of the knees were used to assess joint space narrowing (JSN) and osteophyte formation. Knee joint laxity was assessed using a device that measures the angular deviation of the knee in the frontal plane (varus-valgus laxity). Malalignment was assessed using a goniometer. All analyses were performed using knees as units of analysis (i.e. 70 knees). RESULTS The mean laxity of 70 knees was 8.0+/-4.1 degrees. Knees with minute JSN were significantly more lax than knees with no JSN. There was no significant relationship between osteophyte formation and laxity. Malaligned knees were significantly more lax than aligned knees. CONCLUSION Both joint space narrowing and malalignment are related to laxity. These results support the premise that biomechanical factors play a role in the degeneration of the osteoarthritic knee joint.
Collapse
|
189
|
Hendriks HJM, Brandsma JW, Wagner C, Oostendorp RAB, Dekker J. Experiences with physiotherapists’ consultation: Results of a feasibility study. Physiother Theory Pract 2009. [DOI: 10.3109/09593989609036438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
190
|
Hendriks HJM, Kerssens JJ, Heerkens YF, Elvers JWH, Dekker J, van der Zee J, Oostendrop RAB. Referral patterns and utilization of physiotherapy services following a one-time physiotherapist consultation in general practice. Physiother Theory Pract 2009. [DOI: 10.1080/09593980307968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
191
|
De Boer ME, Leemrijse CJ, Van Den Ende CHM, Ribbe MW, Dekker J. The availability of allied health care in nursing homes. Disabil Rehabil 2009; 29:665-70. [PMID: 17453988 DOI: 10.1080/09638280600926561] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To determine the availability of allied health care in nursing homes in the Netherlands, and its dependency on characteristics of the nursing home. METHODS Structured surveys by telephone were carried out in a sample of 100 from a country total of 286 somatic (for somatic patients only) and combined (with units for both somatic and psychogeriatric patients) nursing homes. Multiple linear regression analyses were performed to determine relationships between the availability of care and the type of nursing home, its country location (urban/non-urban) and the presence of specific wards/units within the nursing home. RESULTS Physiotherapy and occupational therapy were present in almost all nursing homes (99% and 93% respectively); 92% of the nursing homes offered speech- and language therapy and 88% had dietetics available. Average availability rates were: 2.16 full time equivalents per 100 beds/places for physiotherapy, 0.96 for occupational therapy, 0.38 for speech- and language therapy and 0.18 for dietetics. Somatic nursing homes and nursing homes with stroke-units, day-care, or outpatient care present, had higher availability rates on allied health care. CONCLUSIONS Allied health care disciplines varied in terms of full-time equivalents per 100 beds/places. Per discipline also a wide variation exists in full-time equivalents per 100 beds/places among all participating nursing homes, regardless of their type. Characteristics of nursing homes had small effects on availability rates. International research is recommended in order to compare data and eventually reach consensus on optimal availability rates of allied health care in nursing homes, tuned to the demand.
Collapse
|
192
|
Schepers VPM, Ketelaar M, Visser-Meily JMA, Dekker J, Lindeman E. Responsiveness of functional health status measures frequently used in stroke research. Disabil Rehabil 2009; 28:1035-40. [PMID: 16950733 DOI: 10.1080/09638280500494694] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare the responsiveness of several functional health status measures frequently used in stroke research, namely the Barthel Index (BI), Functional Independence Measure (FIM), Frenchay Activities Index (FAI) and Stroke-Adapted Sickness Impact Profile 30 (SA-SIP 30). METHOD Patients with a first-ever supratentorial stroke admitted for inpatient rehabilitation were included. Complete datasets for 163 patients were available for analysis. Floor/ceiling effects and responsiveness, quantified by effect sizes, were studied for the periods between rehabilitation admission and six months post stroke (subacute phase) and between six and 12 months post stroke (chronic phase). RESULTS Effect sizes in the subacute phase were similar and were classified as large for the BI, FIM total and FIM motor score. The FIM cognitive score showed a considerable ceiling effect and had the smallest effect size in the subacute phase. In the chronic phase, the FAI and SA-SIP 30 detected the most changes and had moderate effect sizes. CONCLUSIONS BI, FIM total and FIM motor score, FAI and SA-SIP 30 were responsive measures. We recommend the use of the BI in the subacute phase and the use of the FAI and SA-SIP 30 in the chronic phase, especially for the stroke rehabilitation population.
Collapse
|
193
|
van der Zwan L, Scheffer P, Dekker J, Stehouwer C, Heine R, Teerlink T. Abstract: P817 MYELOPEROXIDASE AND C-REACTIVE PROTEIN ARE BOTH NEGATIVELY ASSOCIATED WITH THE ARGININE/ADMA RATIO, LINKING INFLAMMATION TO REDUCED NITRIC OXIDE PRODUCTION. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71171-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
194
|
Dekker J, Rijkelijkhuizen J, Alssema M, Holst J, Mari A, Rhodes T, Eekhoff E, Teerlink T, Scheffer P, Nijpels G, Nijpels G, Girman C. Abstract: P409 INCRETINS ARE ASSOCIATED WITH POSTPRANDIAL TRIGYCERIDES. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70704-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
195
|
Aro AR, Smith J, Dekker J. Contextual evidence in clinical medicine and health promotion. Eur J Public Health 2008; 18:548-9. [PMID: 18786949 DOI: 10.1093/eurpub/ckn082] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
196
|
Wesseling J, Dekker J, van den Berg WB, Bierma-Zeinstra SMA, Boers M, Cats HA, Deckers P, Gorter KJ, Heuts PHTG, Hilberdink WKHA, Kloppenburg M, Nelissen RGHH, Oosterveld FGJ, Oostveen JCM, Roorda LD, Viergever MA, ten Wolde S, Lafeber FPJG, Bijlsma JWJ. CHECK (Cohort Hip and Cohort Knee): similarities and differences with the Osteoarthritis Initiative. Ann Rheum Dis 2008; 68:1413-9. [PMID: 18772189 DOI: 10.1136/ard.2008.096164] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To describe the osteoarthritis study population of CHECK (Cohort Hip and Cohort Knee) in comparison with relevant selections of the study population of the Osteoarthritis Initiative (OAI) based on clinical status and radiographic parameters. METHODS In The Netherlands a prospective 10-year follow-up study was initiated by the Dutch Arthritis Association on participants with early osteoarthritis-related complaints of hip and/or knee: CHECK. In parallel in the USA an observational 4-year follow-up study, the OAI, was started by the National Institutes of Health, on patients with or at risk of symptomatic knee osteoarthritis. For comparison with CHECK, the entire cohort and a subgroup of individuals excluding those with exclusively hip pain were compared with relevant subpopulations of the OAI. RESULTS At baseline, CHECK included 1002 participants with in general similar characteristics as described for the OAI. However, significantly fewer individuals in CHECK had radiographic knee osteoarthritis at baseline when compared with the OAI (p<0.001). In contrast, at baseline, the CHECK cohort reported higher scores on pain, stiffness and functional disability (Western Ontario and McMaster osteoarthritis index) when compared with the OAI (all p<0.001). These differences were supported by physical health status in contrast to mental health (Short Form 36/12) was at baseline significantly worse for the CHECK participants (p<0.001). CONCLUSION Although both cohorts focus on the early phase of osteoarthritis, they differ significantly with respect to structural (radiographic) and clinical (health status) characteristics, CHECK expectedly representing participants in an even earlier phase of disease.
Collapse
|
197
|
Beckerman H, van Zee IE, de Groot V, van den Bos GAM, Lankhorst GJ, Dekker J. Utilization of health care by patients with multiple sclerosis is based on professional and patient-defined health needs. Mult Scler 2008; 14:1269-79. [PMID: 18653735 DOI: 10.1177/1352458508094884] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This cross-sectional study investigates healthcare utilization, and determines which predisposing, enabling, and health factors are associated with healthcare utilization among 121 patients with multiple sclerosis (MS). METHODS Data on patient-related predisposing, enabling, and health factors were collected by means of written questionnaires and a home visit from a well-trained physiotherapist. RESULTS Of the 121 patients with MS (mean age 43 years, mean score on the Expanded Disability Status Scale 3.5, disease duration 6 years), 16% were hospitalized in the previous year; 62% consulted their general practitioner, and 69% consulted their neurologist in the previous 6 months. Other medical specialists were consulted in the 6-month period by 50% of the study population. In a 4-week period preceding the home visit, 41% of the patients were treated by an allied healthcare professional. Multivariate logistic regression analyses showed that consulting the general practitioner, the neurologist, other medical specialists, and allied healthcare professionals, and the use of equipment/aids by MS patients is primarily related to their health, either as perceived by the patients themselves or defined by the professional. CONCLUSIONS MS patients in the Netherlands make appropriate use of healthcare facilities, because their utilization can predominantly be explained by health-related factors, and not by predisposing or enabling factors.
Collapse
|
198
|
van der Esch M, Steultjens M, Harlaar J, Wolterbeek N, Knol DL, Dekker J. Knee varus-valgus motion during gait--a measure of joint stability in patients with osteoarthritis? Osteoarthritis Cartilage 2008; 16:522-5. [PMID: 17892952 DOI: 10.1016/j.joca.2007.08.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2007] [Accepted: 08/13/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the validity of varus-valgus motion as a measure of knee joint stability by establishing the relationship of varus-valgus motion with muscle strength, joint proprioception, joint laxity and skeletal alignment in patients with knee osteoarthritis (OA). METHODS Sixty-three patients with OA of the knee were tested. Varus-valgus motion was determined with a video-based optoelectronic gait analysis system. Muscle strength was measured using a computer-driven isokinetic dynamometer. Proprioceptive acuity was assessed by establishing the joint motion detection threshold in the anterior-posterior direction. Laxity was assessed using a device which measures the passive angular deviation of the knee in the frontal plane. Alignment was assessed using a goniometer. Regression analyses were performed to assess the relationship between varus-valgus motion, muscle strength, joint proprioception, joint laxity and skeletal alignment. RESULT Varus-valgus motion was not related to muscle strength, joint proprioception, joint laxity and skeletal alignment. CONCLUSIONS Knee joint stability cannot be measured as varus-valgus motion. Rather, a number of independent factors seem to contribute to the process of stabilization of the knee joint.
Collapse
|
199
|
Stikker TE, Schoevers RA, Swinkels JA, Mulder CL, Dekker J, van Tilburg W. [The judge follows the advice of the psychiatrist; an investigation into the jurisprudence concerning compulsory admission requests and decisions under the Dutch Act on Special Admissions to Psychiatric Hospitals (Bopz)]. TIJDSCHRIFT VOOR PSYCHIATRIE 2008; 50:567-577. [PMID: 18785104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND People are under the impression that there are differences between regions and between psychiatrists and judges in the criteria that are applied with regard to compulsory admission under the Dutch Act on Special Admissions to Psychiatric Hospitals (Bopz). AIM To find out how the legal criteria are currently put into operation, what topics come up for discussion and what evidence the judge generally requires in order to have recourse to compulsory admission. METHOD All judgments pronounced between 2002 and June 11 2005 and published in the journal Bopz Jurisprudence (bj) were analysed juridically. results In two-thirds of the cases the judge followed the advice of the psychiatrist and decided on compulsory admission. The required admission was refused for formal judicial reasons or because circumstances during the court hearing differed from those prevailing at the time when the medical report was drawn up. There was very little discussion about psychiatric disturbances or about the seriousness of the danger involved, but no objective criteria on this subject exist. CONCLUSIONS The jurisprudence suggests that within the boundaries of the legally defined criteria there is still room for manoeuvre and negotiation with regard to compulsory admission applications under the Bopz Act. It is very important that the psychiatrist fully underpins his findings and draws up his application in accordance with the requirements of the Bopz Act and satisfies the judge's need for detailed information. The development and utilisation of instruments for assessing the degree of danger and the severity of the psychiatric disturbance within the framework of the Bopz could be a useful supplement to the law in its current form.
Collapse
|
200
|
Swinkels ICS, van den Ende CHM, de Bakker D, Van der Wees PJ, Hart DL, Deutscher D, van den Bosch WJH, Dekker J. Clinical databases in physical therapy. Physiother Theory Pract 2007; 23:153-67. [PMID: 17558879 DOI: 10.1080/09593980701209097] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Clinical databases in physical therapy provide increasing opportunities for research into physical therapy theory and practice. At present, information on the characteristics of existing databases is lacking. The purpose of this study was to identify clinical databases in which physical therapists record data on their patients and treatments and to investigate the basic aspects, data sets, output, management, and data quality of the databases. Identification of the databases was performed by contacting members of the World Confederation for Physical Therapy, searching Pubmed, searching the Internet, and snowball sampling. A structured questionnaire was used to study the characteristics of the databases. The search was restricted to North America, Australia, Israel, and Western Europe. Seven clinical databases on physical therapy were identified. Four databases collected data on specific patient categories, whereas the others collected data on all patients. All databases collected data on patient characteristics, referrals, diagnoses, treatments, and closure, whereas some databases also collected functional status information. The purposes of the databases were diverse, but they can be summarized as quality improvement, research, and performance management. Although clinical databases are new to the field, they offer great potential for physical therapy research. Potential can be increased by further cooperation among databases allowing international comparative studies.
Collapse
|