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Mol TI, van Bennekom CAM, Scholten EWM, Visser-Meily JMA, Reneman MF, Riedstra A, de Groot V, Meijer JWG, Bult MK, Post MWM. Self-regulation as rehabilitation outcome: what is important according to former patients? Disabil Rehabil 2022; 44:7484-7490. [PMID: 34747280 DOI: 10.1080/09638288.2021.1998663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Self-regulation refers to self-management and self-control, with or without disability. Outcomes of rehabilitation with respect to self-regulation are unclear. This study aims to identify elements of self-regulation that former patients consider important in the context of medical rehabilitation. MATERIALS AND METHODS Qualitative exploration based on focus group discussions (FGDs). Transcripts were analysed using thematic analysis as well as open coding. Forty individuals participated in seven diagnosis-related FGDs. RESULTS Six subthemes were raised in the FGDs which could be merged into three main themes. Two main themes are conditional for regaining self-regulation: 1) having insight into one's condition and abilities (i.e., insight into impairments. consequences of impairments. abilities); 2) to know how to cope with the consequences of the condition (be able to communicate limitations; have to trust in body and functioning). The subject of the last theme 3) is how to apply self-regulation in one's own life (to make use of abilities and optimize functioning). CONCLUSIONS Three main themes of self-regulation in the context of medical rehabilitation were identified by former patients, partly relating to the ability to self-regulate and partly to the execution of self-regulation. This knowledge can be used to define specific rehabilitation goals and further develop rehabilitation outcome measurement.IMPLICATIONS FOR REHABILITATIONAwareness of the fundamental subthemes of self-regulation in rehabilitation will positively contribute to theory building and improve clinical practice (e.g., goal setting).Paying explicit attention to the six subthemes as standard elements of rehabilitation will help to provide a comprehensive view concerning self-regulation.The conceptual model of self-regulation, based on patient perspectives, can contribute to the measurement of rehabilitation outcomes.
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Affiliation(s)
- T I Mol
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands.,Department of Rehabilitation Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - C A M van Bennekom
- Research and Development Division, Heliomare Rehabilitation Centre, Wijk aan Zee, the Netherlands.,Coronel Institute of Occupational Health, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - E W M Scholten
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands
| | - J M A Visser-Meily
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands
| | - M F Reneman
- Department of Rehabilitation Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - A Riedstra
- Research Committee Dutch Spinal Cord Association, Utrecht, the Netherlands
| | - V de Groot
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J W G Meijer
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands.,De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - M K Bult
- Cerebral Palsy Netherlands/Spina Bifida & Hydrocephalus Netherlands, Utrecht, The Netherlands
| | - M W M Post
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands.,Department of Rehabilitation Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
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2
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Mol TI, van Bennekom CAM, Scholten EWM, Visser-Meily JMA, Beckerman H, Passier PECA, Smeets RJEM, Schiphorst Preuper HR, Post MWM. The Self-Regulation Assessment (SeRA) questionnaire: development and exploratory analyses of a new patient-reported outcome measure for rehabilitation. Disabil Rehabil 2022:1-8. [DOI: 10.1080/09638288.2022.2080289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- T. I. Mol
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - C. A. M. van Bennekom
- Heliomare Rehabilitation Center, Research and Development, Wijk aan Zee, Netherlands
- Amsterdam University Medical Center, Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, Netherlands
| | - E. W. M. Scholten
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - J. M. A. Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - H. Beckerman
- Department of Rehabilitation Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, Netherlands
| | - P. E. C. A. Passier
- Department of Rehabilitation Medicine, Sint Antonius General Hospital, Nieuwegein, Netherlands
| | - R. J. E. M. Smeets
- CIR Revalidatie, Eindhoven, Netherlands
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, Netherlands
- Pain in Motion International Research Group (PiM), Antwerp, Belgium
| | - H. R. Schiphorst Preuper
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - M. W. M. Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Mol TI, van Bennekom CAM, Scholten EWM, Post MWM. Measures of self-regulation used in adult rehabilitation populations: A systematic review and content screening. Clin Rehabil 2022; 36:1120-1138. [PMID: 35473388 PMCID: PMC9284405 DOI: 10.1177/02692155221091510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objective We aimed to identify generic measures of self-regulation and to examine the
degree to which these measures fit a recently developed conceptual model of
self-regulation in a rehabilitation context. Data sources Pubmed, Embase, PsycInfo, and CINAHL were searched. Review methods Articles were included if they were published between January 2015 and August
2020 and reported on empirical studies (trials and observational studies)
using a measure of self-regulation or a related concept, in an adult
rehabilitation population. Main content was analysed by linking all items of
the selected measures to one or more of the six sub-themes of
self-regulation: (1) insight into physical and cognitive impairments, (2)
insight into the consequences of the impairments, (3) insight into
abilities, (4) to be able to communicate limitations, (5) trust in body and
functioning, and (6) make use of abilities. Results Two reviewers independently screened 7808 abstracts, resulting in the
inclusion of 236 articles. In these articles, 80 different measures were
used to assess self-regulation or related concept. Nineteen of these
measures met the inclusion criteria and were included for the content
analyses. Nine of these were self-efficacy measures. No measures covered
four or more of the six sub-themes of self-regulation. The three sub-themes
on gaining insights were covered less compared to the sub-domains ‘trust’
and ‘make use of abilities’. Conclusions Many measures on self-regulation exist None of these measures cover all six
sub-themes of self-regulation considered important to measure
self-regulation as a rehabilitation outcome.
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Affiliation(s)
- T I Mol
- Center of Excellence for Rehabilitation Medicine, 526115UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,84792Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - C A M van Bennekom
- 100506Heliomare Rehabilitation Center, Research and Development, Wijk aan Zee, the Netherlands.,522567Amsterdam University Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam, the Netherlands
| | - E W M Scholten
- Center of Excellence for Rehabilitation Medicine, 526115UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - M W M Post
- Center of Excellence for Rehabilitation Medicine, 526115UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,84792Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Faber WXM, Nachtegaal J, Stolwijk-Swuste JM, Achterberg-Warmer WJ, Koning CJM, Besseling-van der Vaart I, van Bennekom CAM. Study protocol of a double-blind randomised placebo-controlled trial on the effect of a multispecies probiotic on the incidence of antibiotic-associated diarrhoea in persons with spinal cord injury. Spinal Cord 2020; 58:149-156. [PMID: 31712614 PMCID: PMC7223836 DOI: 10.1038/s41393-019-0369-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/20/2019] [Accepted: 10/02/2019] [Indexed: 12/31/2022]
Abstract
STUDY DESIGN Multi-centre, double-blind randomised placebo-controlled study. OBJECTIVE To investigate whether the use of a multispecies probiotic can prevent antibiotic-associated diarrhoea in people with spinal cord injury (SCI). SETTING Three Dutch SCI rehabilitation centres. METHODS Fifty-six people aged 18-75 years with SCI during inpatient rehabilitation, who require antibiotics, will be given probiotics or placebo randomly assigned (T0). After cessation of the antibiotics (T1), the participants will use probiotics/placebo for 3 more weeks (T2). Defaecation, assessed by the Bristol Stool Scale, and bowel management will be monitored daily until 2 weeks after cessation of probiotics/placebo intake (T3). Also, the degree of nausea and information on quality of life will be collected at T0, T1, T2 and T3. MAIN OUTCOME MEASURES The difference between the incidence of antibiotic-associated diarrhoea between people with SCI using probiotics compared to those using a placebo at the moment the antibiotics stops, the probiotics stops and two weeks thereafter. SECONDARY OUTCOME MEASURES The time to reach effective bowel management, degree of nausea and quality of life. REGISTRATION The Dutch Trial Register- NTR 5831.
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Affiliation(s)
- W X M Faber
- Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands.
| | - J Nachtegaal
- Department of Research & Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
| | - J M Stolwijk-Swuste
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht University, Utrecht, the Netherlands
| | | | - C J M Koning
- Winclove Probiotics B.V, Amsterdam, The Netherlands
| | | | - C A M van Bennekom
- Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
- Department of Research & Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
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Baltrusch SJ, van Dieën JH, Bruijn SM, Koopman AS, van Bennekom CAM, Houdijk H. The effect of a passive trunk exoskeleton on metabolic costs during lifting and walking. Ergonomics 2019; 62:903-916. [PMID: 30929608 DOI: 10.1080/00140139.2019.1602288] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
The objective of this study was to assess how wearing a passive trunk exoskeleton affects metabolic costs, movement strategy and muscle activation during repetitive lifting and walking. We measured energy expenditure, kinematics and muscle activity in 11 healthy men during 5 min of repetitive lifting and 5 min of walking with and without exoskeleton. Wearing the exoskeleton during lifting, metabolic costs decreased as much as 17%. In conjunction, participants tended to move through a smaller range of motion, reducing mechanical work generation. Walking with the exoskeleton, metabolic costs increased up to 17%. Participants walked somewhat slower with shortened steps while abdominal muscle activity slightly increased when wearing the exoskeleton. Wearing an exoskeleton during lifting decreased metabolic costs and hence may reduce the development of fatigue and low back pain risk. During walking metabolic costs increased, stressing the need for a device that allows disengagement of support depending on activities performed. Practitioner summary: Physiological strain is an important risk factor for low back pain. We observed that an exoskeleton reduced metabolic costs during lifting, but had an opposite effect while walking. Therefore, exoskeletons may be of benefit for lifting by decreasing physiological strain but should allow disengagement of support when switching between tasks. Abbreviations: COM: centre of mass; EMG: electromyography; LBP: low back pain; MVC: maximum voluntary isometric contraction; NIOSH: National Institute for Occupational Safety and Health; PLAD: personal lift augmentation device; PWS: preferred walking speed without exoskeleton; PWSX: preferred walking speed with exoskeleton; ROM: range of motion; RER: respiratory exchange ratio; V ̇O2max: maximum rate of oxygen consumption.
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Affiliation(s)
- S J Baltrusch
- a Department of Research and Development , Rehabilitation Center Heliomare , Wijk aan Zee , The Netherlands
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - J H van Dieën
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - S M Bruijn
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - A S Koopman
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - C A M van Bennekom
- a Department of Research and Development , Rehabilitation Center Heliomare , Wijk aan Zee , The Netherlands
| | - H Houdijk
- a Department of Research and Development , Rehabilitation Center Heliomare , Wijk aan Zee , The Netherlands
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
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6
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Baltrusch SJ, van Dieën JH, van Bennekom CAM, Houdijk H. The effect of a passive trunk exoskeleton on functional performance in healthy individuals. Appl Ergon 2018; 72:94-106. [PMID: 29885731 DOI: 10.1016/j.apergo.2018.04.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 04/17/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
The objective of this study was to assess the effect of a passive trunk exoskeleton on functional performance for various work related tasks in healthy individuals. 18 healthy men performed 12 tasks. Functional performance in each task was assessed based on objective outcome measures and subjectively in terms of perceived task difficulty, local and general discomfort. Wearing the exoskeleton tended to increase objective performance in static forward bending, but decreased performance in tasks, such as walking, carrying and ladder climbing. A significant decrease was found in perceived task difficulty and local discomfort in the back in static forward bending, but a significant increase of perceived difficulty in several other tasks, like walking, squatting and wide standing. Especially tasks that involved hip flexion were perceived more difficult with the exoskeleton. Design improvements should include provisions to allow full range of motion of hips and trunk to increase versatility and user acceptance.
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Affiliation(s)
- S J Baltrusch
- Department of Research and Development, Rehabilitation Center Heliomare, Wijk aan Zee, The Netherlands; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - J H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - C A M van Bennekom
- Department of Research and Development, Rehabilitation Center Heliomare, Wijk aan Zee, The Netherlands
| | - H Houdijk
- Department of Research and Development, Rehabilitation Center Heliomare, Wijk aan Zee, The Netherlands; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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7
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Eken MM, Harlaar J, Dallmeijer AJ, de Waard E, van Bennekom CAM, Houdijk H. Squat test performance and execution in children with and without cerebral palsy. Clin Biomech (Bristol, Avon) 2017; 41:98-105. [PMID: 28040656 DOI: 10.1016/j.clinbiomech.2016.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 10/31/2016] [Accepted: 12/13/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Knowledge on lower extremity strength is imperative to informed decision making for children with cerebral palsy (CP) with mobility problems. However, a functional and clinically feasible test is not available. We aimed to determine whether the squat test is suitable for this purpose by investigating test performance and execution in children with cerebral palsy and typically developing (TD) peers. METHODS Squat test performance, defined by the number of two-legged squats until fatigue (max 20), was assessed in twenty children with bilateral CP (6-19years; gross motor function classification system I-III) and sixteen TD children (7-16years). Muscle fatigue was assessed from changes in electromyography (EMG). Joint range-of-motion and net torque were calculated for each single squat, to investigate differences between groups and between the 2nd and last squat. FINDINGS Fifteen children with CP performed <20 squats (median=13, IQR=7-19), while all TD children performed the maximum of 20 squats. Median EMG frequency decreased and amplitude increased in mm. quadriceps of both groups. Ankle and knee range-of-motion were reduced in children with CP during a single squat by 10 to 15°. No differences between 2nd and last squat were observed, except for knee range-of-motion which increased in TD children and decreased in children with CP. INTERPRETATION Squat test performance was reduced in children with CP, especially in those with more severe CP. Muscle fatigue was present in both children with CP and TD peers, confirming that endurance of the lower extremity was tested. Minor execution differences between groups suggest that standardized execution is important to avoid compensation strategies. It is concluded that the squat test is feasible to test lower extremity strength in children with CP in a clinically meaningful way. Further clinimetric evaluation is needed before clinical implementation.
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Affiliation(s)
- M M Eken
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Heliomare Rehabilitation, Research and Development, Wijk aan Zee, The Netherlands.
| | - J Harlaar
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - A J Dallmeijer
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - E de Waard
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
| | - C A M van Bennekom
- Heliomare Rehabilitation, Research and Development, Wijk aan Zee, The Netherlands; Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - H Houdijk
- Heliomare Rehabilitation, Research and Development, Wijk aan Zee, The Netherlands; Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
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van der Naalt J, Draijer WL, van Bennekom CAM. [Identifying mild traumatic brain injury: clinical signs and consequences]. Ned Tijdschr Geneeskd 2017; 161:D1540. [PMID: 28488558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Identification of patients with mild traumatic brain injury (TBI) is important since 85,000 patients visit the emergency department with a head trauma annually. Although most patients recover well, 15-20% of the patients with head trauma develop persistent symptoms that interfere with resumption of daily activities. It is particularly important to identify the clinical signs that define mild TBI. Presence of anterograde amnesia after the injury, for example, is an important clinical diagnostic sign to establish the diagnosis of TBI. Posttraumatic emotional distress may increase posttraumatic symptoms. General practitioners should be aware of the problems in this patient group and identify patients with mild TBI who are at risk of developing persistent symptoms that limit participation in society.
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Affiliation(s)
- J van der Naalt
- Universitair Medisch Centrum Groningen, afd. Neurologie, Groningen
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van Velzen JM, van Bennekom CAM, Polomski W, Slootman JR, van der Woude LHV, Houdijk H. Physical capacity and walking ability after lower limb amputation: a systematic review. Clin Rehabil 2016; 20:999-1016. [PMID: 17065543 DOI: 10.1177/0269215506070700] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To review the influence of physical capacity on regaining walking ability and the development of walking ability after lower limb amputation. Design: A systematic search of literature was performed. The quality of all relevant studies was evaluated according to a checklist for statistical review of general papers. Subjects: Lower limb amputees. Main measures: Physical capacity (expressed by aerobic capacity, anaerobic capacity, muscle force, flexibility and balance) and walking ability (expressed by the walking velocity and symmetry). Results: A total of 48 studies that complied with the inclusion criteria were selected. From these studies there is strong evidence for deterioration of two aspects of physical capacity (muscle strength and balance) and of two aspects of walking ability (walking velocity and symmetry) after lower limb amputation. Strong evidence was found for a relation between balance and walking ability. Conclusion: Strong evidence was only found for a relation between balance and walking ability. Evidence about a relation between other elements of physical capacity and walking ability was insufficient. Training of physical capacity as well as walking ability during rehabilitation following lower limb amputation should not be discouraged since several parameters have been shown to be reduced after amputation, although their relation to regaining walking ability and to the development of walking ability remains unclear.
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Affiliation(s)
- J M van Velzen
- Heliomare Research and Development, Wijk aan Zee, Amsterdam, The Netherlands.
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10
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van Bennekom CAM, Wind H, Hulshof CTJ, Frings-Dresen MHW. [Return to work after acquired brain injury. Invisible consequences may interfere with vocational participation]. Ned Tijdschr Geneeskd 2016; 160:A9608. [PMID: 27299485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Acquired brain injury may lead to cognitive, emotional and behavioural problems which often go unrecognised. Combined with the patient's lack of self-awareness this may impede social participation, in particular in returning to work. To stress the importance of diagnosing and treating such consequences, we present two patients. A 40-year-old man suffering from the invisible consequences of brain injury caused by several cerebral infarctions. He tried but failed several times to hold down a job before he was sent to a specialized vocational rehabilitation centre. A 28-year-old man with severe traumatic brain injury started vocational rehabilitation at an early stage. This resulted in a full return to work within six months of the trauma. The Dutch guideline on acquired brain injury and vocational participation aims to help professionals and patients in the vocational rehabilitation process. The guideline strongly recommends setting up an interdisciplinary team consisting of a rehabilitation physician, an occupational physician, and employer and employee.
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Affiliation(s)
- C A M van Bennekom
- Academisch Medisch Centrum-Universiteit van Amsterdam, Coronel Instituut voor Arbeid en Gezondheid, Amsterdam
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Kal EC, van der Kamp J, Houdijk H, Groet E, van Bennekom CAM, Scherder EJA. Stay Focused! The Effects of Internal and External Focus of Attention on Movement Automaticity in Patients with Stroke. PLoS One 2015; 10:e0136917. [PMID: 26317437 PMCID: PMC4552655 DOI: 10.1371/journal.pone.0136917] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 08/10/2015] [Indexed: 11/24/2022] Open
Abstract
Dual-task performance is often impaired after stroke. This may be resolved by enhancing patients’ automaticity of movement. This study sets out to test the constrained action hypothesis, which holds that automaticity of movement is enhanced by triggering an external focus (on movement effects), rather than an internal focus (on movement execution). Thirty-nine individuals with chronic, unilateral stroke performed a one-leg-stepping task with both legs in single- and dual-task conditions. Attentional focus was manipulated with instructions. Motor performance (movement speed), movement automaticity (fluency of movement), and dual-task performance (dual-task costs) were assessed. The effects of focus on movement speed, single- and dual-task movement fluency, and dual-task costs were analysed with generalized estimating equations. Results showed that, overall, single-task performance was unaffected by focus (p = .341). Regarding movement fluency, no main effects of focus were found in single- or dual-task conditions (p’s ≥ .13). However, focus by leg interactions suggested that an external focus reduced movement fluency of the paretic leg compared to an internal focus (single-task conditions: p = .068; dual-task conditions: p = .084). An external focus also tended to result in inferior dual-task performance (β = -2.38, p = .065). Finally, a near-significant interaction (β = 2.36, p = .055) suggested that dual-task performance was more constrained by patients’ attentional capacity in external focus conditions. We conclude that, compared to an internal focus, an external focus did not result in more automated movements in chronic stroke patients. Contrary to expectations, trends were found for enhanced automaticity with an internal focus. These findings might be due to patients’ strong preference to use an internal focus in daily life. Future work needs to establish the more permanent effects of learning with different attentional foci on re-automating motor control after stroke.
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Affiliation(s)
- E. C. Kal
- Research & Development, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands
- Faculty of Behavioural and Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - J. van der Kamp
- Faculty of Behavioural and Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
- Institute of Human Performance, University of Hong Kong, Hong Kong
| | - H. Houdijk
- Research & Development, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands
- Faculty of Behavioural and Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - E. Groet
- Research & Development, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands
| | - C. A. M. van Bennekom
- Research & Development, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands
- Coronel Institute for Occupational and Environmental Health, Academic Medical Centre/University of Amsterdam, Amsterdam, The Netherlands
| | - E. J. A. Scherder
- Faculty of Behavioural and Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
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van Velzen JM, van Bennekom CAM, Edelaar MJA, Sluiter JK, Frings-Dresen MHW. How many people return to work after acquired brain injury?: a systematic review. Brain Inj 2010; 23:473-88. [PMID: 19484621 DOI: 10.1080/02699050902970737] [Citation(s) in RCA: 184] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PRIMARY OBJECTIVE To investigate how many people return to work (RTW) after acquiring brain injury (ABI) due to traumatic or non-traumatic causes. Secondary objectives were to investigate the differences in outcome between traumatic and non-traumatic causes, the development of RTW over time and whether or not people return to their former job. METHODS A systematic literature search (1992-2008) was performed using terms of ABI and RTW. The methodological quality of the studies was determined. An overall estimation of percentage RTW 1 and 2 years post-injury was calculated by data pooling. MAIN OUTCOMES AND RESULTS Finally, 49 studies were included. Within 2 years post-injury, 39.3% of the subjects with non-traumatic ABI returned to work. Among people with traumatic ABI, 40.7% returned to work after 1 year and 40.8% after 2 years. No effect of cause or time since injury was found. Some people with traumatic ABI who returned to work were not able to sustain their job over time. Changes of occupation and job demands are common among people with ABI. CONCLUSIONS About 40% of the people with traumatic or non-traumatic ABI are able to return to work after 1 or 2 years. Among those with acquired traumatic brain injury a substantial proportion of the subjects were either not able to return to their former work or unable to return permanently.
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Affiliation(s)
- J M van Velzen
- Academic Medical Center, University of Amsterdam, Department: Coronel Institute of Occupational Health, PO Box 22700, Amsterdam 1100 DE, The Netherlands.
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van Velzen JM, van Bennekom CAM, Edelaar MJA, Sluiter JK, Frings-Dresen MHW. Prognostic factors of return to work after acquired brain injury: A systematic review. Brain Inj 2009; 23:385-95. [DOI: 10.1080/02699050902838165] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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