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Debeuf R, De Vlieger D, Defour A, Feyen K, Guida S, Cuypers L, Firouzi M, Tassenoy A, Swinnen E, Beckwée D, Leemans L. Electrotherapy in stroke rehabilitation can improve lower limb muscle characteristics: a systematic review and meta-analysis. Disabil Rehabil 2024:1-17. [PMID: 38557249 DOI: 10.1080/09638288.2024.2334444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/16/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE This review assesses the effect of electrotherapy (e.g. functional electrical stimulation (FES), motor and sensor therapeutic electrical stimulation (TES)) on muscle strength and skeletal muscle characteristics in individuals post-stroke compared to conventional or sham therapy. METHODS A systematic literature search was conducted in MEDLINE, SCOPUS, and Web of Science, focusing on randomized controlled trials investigating the effect of electrotherapy. Data of interest was extracted from eligible studies, and risk of bias was assessed. RESULTS In total, 23 studies (933 people post-stroke) were included, of which 17, which mainly focus on patients in a chronic stage of stroke recovery and the implementation of FES, were incorporated in the meta-analysis. A significant increase in muscle strength was found favoring electrotherapy over conventional therapy (SMD 0.63, 95% CI 0.34-0.91, I2 = 37%, p = 0.07) and over sham therapy (SMD 0.44, 95% CI 0.20-0.68, I2 = 38%, p = 0.08). Three studies investigated the effect on muscle thickness and found a significant increase in favor of electrostimulation when compared to conventional therapy (MD 0.11 cm, 95% CI 0.06-0.16, I2 = 0%, p = 0.50). CONCLUSION Current evidence suggests electrotherapy in combination with physiotherapy has positive effects on lower limb muscle strength and skeletal muscle characteristics in patients recovering from stroke.
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Affiliation(s)
- Ruben Debeuf
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Daan De Vlieger
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Arne Defour
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Karen Feyen
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stefania Guida
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Lotte Cuypers
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Mahyar Firouzi
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Brain, Body and Cognition, Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - An Tassenoy
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Swinnen
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
| | - Lynn Leemans
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Gavrila Laic RA, Firouzi M, Claeys R, Bautmans I, Swinnen E, Beckwée D. A State-of-the-Art of Exoskeletons in Line with the WHO's Vision on Healthy Aging: From Rehabilitation of Intrinsic Capacities to Augmentation of Functional Abilities. Sensors (Basel) 2024; 24:2230. [PMID: 38610440 PMCID: PMC11014060 DOI: 10.3390/s24072230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024]
Abstract
The global aging population faces significant health challenges, including an increasing vulnerability to disability due to natural aging processes. Wearable lower limb exoskeletons (LLEs) have emerged as a promising solution to enhance physical function in older individuals. This systematic review synthesizes the use of LLEs in alignment with the WHO's healthy aging vision, examining their impact on intrinsic capacities and functional abilities. We conducted a comprehensive literature search in six databases, yielding 36 relevant articles covering older adults (65+) with various health conditions, including sarcopenia, stroke, Parkinson's Disease, osteoarthritis, and more. The interventions, spanning one to forty sessions, utilized a range of LLE technologies such as Ekso®, HAL®, Stride Management Assist®, Honda Walking Assist®, Lokomat®, Walkbot®, Healbot®, Keeogo Rehab®, EX1®, overground wearable exoskeletons, Eksoband®, powered ankle-foot orthoses, HAL® lumbar type, Human Body Posturizer®, Gait Enhancing and Motivation System®, soft robotic suits, and active pelvis orthoses. The findings revealed substantial positive outcomes across diverse health conditions. LLE training led to improvements in key performance indicators, such as the 10 Meter Walk Test, Five Times Sit-to-Stand test, Timed Up and Go test, and more. Additionally, enhancements were observed in gait quality, joint mobility, muscle strength, and balance. These improvements were accompanied by reductions in sedentary behavior, pain perception, muscle exertion, and metabolic cost while walking. While longer intervention durations can aid in the rehabilitation of intrinsic capacities, even the instantaneous augmentation of functional abilities can be observed in a single session. In summary, this review demonstrates consistent and significant enhancements in critical parameters across a broad spectrum of health conditions following LLE interventions in older adults. These findings underscore the potential of LLE in promoting healthy aging and enhancing the well-being of older adults.
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Affiliation(s)
- Rebeca Alejandra Gavrila Laic
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
| | - Mahyar Firouzi
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
| | - Reinhard Claeys
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
| | - Ivan Bautmans
- FRIA, Frailty in Ageing, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
| | - Eva Swinnen
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
| | - David Beckwée
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- FRIA, Frailty in Ageing, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
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Roose E, Huysmans E, Leysen L, Mostaqim K, Van Wilgen P, Beckwée D, De Couck M, Timmermans A, Bults R, Nijs J, Lahousse A. Effect of perceived injustice-targeted pain neuroscience education compared with biomedically focused education in breast cancer survivors: a study protocol for a multicentre randomised controlled trial (BCS-PI trial). BMJ Open 2024; 14:e075779. [PMID: 38233049 PMCID: PMC10806532 DOI: 10.1136/bmjopen-2023-075779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/08/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Current treatments for pain in breast cancer survivors (BCSs) are mostly biomedically focused rather than biopsychosocially driven. However, 22% of BCSs with pain are experiencing perceived injustice, which is a known predictor for adverse pain outcomes and opioid prescription due to increased maladaptive pain behaviour. Educational interventions such as pain neuroscience education (PNE) are suggested to target perceived injustice. In addition, motivational interviewing can be an effective behavioural change technique. This trial aims to examine whether perceived injustice-targeted PNE with the integration of motivational interviewing is superior to biomedically focused pain education in reducing pain after 12 months in BCS with perceived injustice and pain. In addition, improvements in quality of life, perceived injustice and opioid use are evaluated, and a cost-effectiveness analysis will finally result in a recommendation concerning the use of perceived injustice-targeted PNE in BCSs with perceived injustice and pain. METHODS AND ANALYSIS This two-arm multicentre randomised controlled trial will recruit female BCS (n=156) with pain and perceived injustice. Participants will be randomly assigned to perceived injustice-targeted PNE or biomedically focused pain education in each centre. Both interventions include an online session, an information leaflet and three one-to-one sessions. The primary outcome (pain), secondary outcomes (quality of life, perceived injustice and outcomes for cost-effectiveness analysis) and explanatory outcomes (pain phenotyping, sleep, fatigue and cognitive-emotional factors) will be assessed at baseline and at 0, 6, 12 and 24 months postintervention using self-reported questionnaires online. Treatment effects over time will be evaluated using linear mixed model analyses. Additionally, a cost-utility analysis will be done from a healthcare payer and societal perspective. ETHICS AND DISSEMINATION The ethical agreement was obtained from the Main Ethics Committee (B.U.N.1432020000068) at the University Hospital Brussels and all other participating hospitals. Study results will be disseminated through presentations, conferences, social media, press and journals. TRIAL REGISTRATION NUMBER NCT04730154.
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Affiliation(s)
- Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- REVAL Research Group, Universiteit Hasselt, Diepenbeek, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Research Foundation-Flanders, (FWO), Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation-Flanders, (FWO), Brussels, Belgium
| | - Paul Van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Transcare Pain Transdisciplinary Pain Treatment Center, Groningen, Netherlands
| | - David Beckwée
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| | - Marijke De Couck
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Rinske Bults
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gotenburg, Sweden
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Moseng T, Vliet Vlieland TPM, Battista S, Beckwée D, Boyadzhieva V, Conaghan PG, Costa D, Doherty M, Finney AG, Georgiev T, Gobbo M, Kennedy N, Kjeken I, Kroon FPB, Lohmander LS, Lund H, Mallen CD, Pavelka K, Pitsillidou IA, Rayman MP, Tveter AT, Vriezekolk JE, Wiek D, Zanoli G, Østerås N. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update. Ann Rheum Dis 2024:ard-2023-225041. [PMID: 38212040 DOI: 10.1136/ard-2023-225041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Hip and knee osteoarthritis (OA) are increasingly common with a significant impact on individuals and society. Non-pharmacological treatments are considered essential to reduce pain and improve function and quality of life. EULAR recommendations for the non-pharmacological core management of hip and knee OA were published in 2013. Given the large number of subsequent studies, an update is needed. METHODS The Standardised Operating Procedures for EULAR recommendations were followed. A multidisciplinary Task Force with 25 members representing 14 European countries was established. The Task Force agreed on an updated search strategy of 11 research questions. The systematic literature review encompassed dates from 1 January 2012 to 27 May 2022. Retrieved evidence was discussed, updated recommendations were formulated, and research and educational agendas were developed. RESULTS The revised recommendations include two overarching principles and eight evidence-based recommendations including (1) an individualised, multicomponent management plan; (2) information, education and self-management; (3) exercise with adequate tailoring of dosage and progression; (4) mode of exercise delivery; (5) maintenance of healthy weight and weight loss; (6) footwear, walking aids and assistive devices; (7) work-related advice and (8) behaviour change techniques to improve lifestyle. The mean level of agreement on the recommendations ranged between 9.2 and 9.8 (0-10 scale, 10=total agreement). The research agenda highlighted areas related to these interventions including adherence, uptake and impact on work. CONCLUSIONS The 2023 updated recommendations were formulated based on research evidence and expert opinion to guide the optimal management of hip and knee OA.
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Affiliation(s)
- Tuva Moseng
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Theodora P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Simone Battista
- University of Genoa Department of Neuroscience Ophthalmological Rehabilitation Genetics and Mother and Child Health, Genova, Italy
| | - David Beckwée
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussel, Belgium
| | - Vladimira Boyadzhieva
- UMHAT "St. Iv. Rilski" Clinic of Rheumatology, Medical University Sofia, Sofia, Bulgaria
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomechanical Reserch Centre, Leeds, UK
| | - Daniela Costa
- Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Michael Doherty
- Department of Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Andrew G Finney
- Research Institute for Primary Care and Health Sciences, Keele University School of Medicine, Keele, UK
- School of Nursing and Midwifery, Keele University, Keele, UK
| | - Tsvetoslav Georgiev
- Clinic of Rheumatology, University Hospital St. Marina, First Department of Internal Medicine, Medical University Varna, Varna, Bulgaria
| | - Milena Gobbo
- Positivamente Centro de Psicología, Madrid, Spain
| | - Norelee Kennedy
- School of Allied Health, Faculty of Education and Health Sciences and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Ingvild Kjeken
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Féline P B Kroon
- Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- Department of Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
| | - L Stefan Lohmander
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
| | - Hans Lund
- Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway
| | | | - Karel Pavelka
- Institute of Rheumatology, Department of Rheumatology, Charles University First Faculty of Medicine, Praha, Czech Republic
| | - Irene A Pitsillidou
- EULAR Patient Research Partner, Cyprus League Against Rheumatism, Nicosia, Cyprus
| | - Margaret P Rayman
- Department of Nutritional Sciences, University of Surrey Faculty of Health and Medical Sciences, Guildford, UK
| | - Anne Therese Tveter
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | | | - Dieter Wiek
- EULAR Patient Research Partner, Deutsche Rheuma-Liga, Bonn, Germany
| | - Gustavo Zanoli
- Orthopaedic Ward, Casa di Cura Santa Maria Maddalena, Novara, Italy
| | - Nina Østerås
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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Beckwée D, Nijs J, Bierma-Zeinstra SMA, Leemans L, Leysen L, Puts S, Rice D, Schiphof D, Bautmans I. Exercise therapy for knee osteoarthritis pain: how does it work? A study protocol for a randomised controlled trial. BMJ Open 2024; 14:e074258. [PMID: 38199628 PMCID: PMC10806725 DOI: 10.1136/bmjopen-2023-074258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 11/28/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Muscle strengthening training (MST) and behavioural graded activity (BGA) show comparable effects on knee osteoarthritic (KOA) pain, but the mechanisms of action remain unclear. Both exercise-induced anti-inflammation and central sensitisation are promising pathways for pain relief in response to exercise therapy in patients with KOA: MST has the potential to decrease inflammation and BGA has the potential to decrease central sensitisation. Hence, this study aims to examine inflammation and central sensitisation as mediators for the effect of MST and/or BGA on pain in patients with KOA. METHODS AND ANALYSIS The Knee OsteoArthritis PAIN trial started on 10 January 2020 (anticipated end: April 2024). The three-arm clinical trial aims to recruit 90 KOA patients who will be randomly allocated to 12 weeks of (1) MST, (2) BGA or (3) care as usual. Assessments will be performed at baseline, 13 and 52 weeks after finishing the intervention. Outcomes, including pain (Knee injury and Osteoarthritis Outcome Score), were chosen in line with the OARSI recommendations for clinical trials of rehabilitation interventions for OA and the IMMPACT/OMERACT recommendations for the assessment of physical function in chronic pain clinical trials. Inflammation as well as features of central sensitisation (including conditioned pain modulation, offset analgesia, temporal summation of pain and event-related potentials following electrical stimulation), will be considered as treatment mediators. A multiple mediators model will be estimated with a path-analysis using structural equation models. In July 2023, all 90 KOA patients have been included and 42 participants already finished the study. ETHICS AND DISSEMINATION This study obtained ethics approval (B.U.N. 143201941843). Unravelling the mechanisms of action of exercise therapy in KOA will not only be extremely valuable for researchers, but also for exercise immunology and pain scientists and clinicians. TRIAL REGISTRATION NUMBER NCT04362618.
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Affiliation(s)
- David Beckwée
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Movement Antwerp (MOVANT) research group, Universiteit Antwerpen, Antwerpen, Belgium
- Gerontology and Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Brussel, Belgium
| | - Jo Nijs
- Pain in Motion International Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
- University Hospital Brussels, Brussels, Belgium
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus University Medical Centre, Rotterdam, Netherlands
- Department of Orthopedics and Sports Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lynn Leemans
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Pain in Motion International Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Laurence Leysen
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Pain in Motion International Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Sofie Puts
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Gerontology and Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Brussel, Belgium
- Pain in Motion International Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - David Rice
- Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
- Department of Anaesthesiology and Perioperative Medicine, Waitematā Pain Service, Te Whatu Ora Waitematā, Auckland, New Zealand
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Ivan Bautmans
- Gerontology and Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Brussel, Belgium
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Debeuf R, Fobelets M, Vaneyghen J, Naets B, Minnaert B, De Wachter E, Lambrechts R, Beckwée D, Jansen B, Middag C, Swinnen E. Healthcare professionals' perspectives on development of assistive technology using the comprehensive assistive technology model. Assist Technol 2024; 36:51-59. [PMID: 37115650 DOI: 10.1080/10400435.2023.2202713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
The implementation of technology in healthcare shows promising results and provides new opportunities in rehabilitation. However, the adoption of technology into daily care is largely dependent on the acceptance rate of end-users. This study aims to gather information from healthcare professionals on the development of new assistive technology that match users' needs using the Comprehensive Assistive Technology model. In total 27 healthcare professionals (12 occupational therapists, 8 physiotherapists, 3 nurses, 2 allied health directors, a physician and a speech therapist) attended one of four online focus group discussions. These focus group discussions were structured using a question guide based on three predefined scenarios. Recordings were transcribed and data was analyzed using a thematic analysis (NVivo). Major themes identified in this study were safety, price and usability. Healthcare professionals focused on both functional capabilities of the user, as well as behavioral aspects of usability and attitude toward technology. Furthermore, the need for assistive technology that were catered toward the limitations in activity and user experience, was highlighted extensively. Based on information gathered from healthcare professionals a user-centered approach in development of safe, low-cost devices that maximize both functional outcomes and user acceptance, could potentially increase the adoption of new technology in rehabilitation.
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Affiliation(s)
- Ruben Debeuf
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Maaike Fobelets
- Department of Health Care, Design & Technology, Brussels Expertise Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
- Department of Public Health Sciences, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Joris Vaneyghen
- Department of Health Care, Design & Technology, Brussels Expertise Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
| | - Ben Naets
- Department of Electronics - ICT, Odisee University College of Applied Sciences, Ghert, Belgium
| | - Ben Minnaert
- Department of Electromechanics, Cosys-Lab, University of Antwerp, Antwerp, Belgium
| | - Evelien De Wachter
- Department of Occupational Therapy, Odisee University College of Applied Sciences, Ghent, Belgium
| | - Rik Lambrechts
- Department of Occupational Therapy, Odisee University College of Applied Sciences, Ghent, Belgium
| | - David Beckwée
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
| | - Bart Jansen
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussels, Belgium
- imec, Leuven, Belgium
| | - Catherine Middag
- Department of Health Care, Design & Technology, Brussels Expertise Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
| | - Eva Swinnen
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
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Zaccardi S, Frantz T, Beckwée D, Swinnen E, Jansen B. On-Device Execution of Deep Learning Models on HoloLens2 for Real-Time Augmented Reality Medical Applications. Sensors (Basel) 2023; 23:8698. [PMID: 37960398 PMCID: PMC10648161 DOI: 10.3390/s23218698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023]
Abstract
The integration of Deep Learning (DL) models with the HoloLens2 Augmented Reality (AR) headset has enormous potential for real-time AR medical applications. Currently, most applications execute the models on an external server that communicates with the headset via Wi-Fi. This client-server architecture introduces undesirable delays and lacks reliability for real-time applications. However, due to HoloLens2's limited computation capabilities, running the DL model directly on the device and achieving real-time performances is not trivial. Therefore, this study has two primary objectives: (i) to systematically evaluate two popular frameworks to execute DL models on HoloLens2-Unity Barracuda and Windows Machine Learning (WinML)-using the inference time as the primary evaluation metric; (ii) to provide benchmark values for state-of-the-art DL models that can be integrated in different medical applications (e.g., Yolo and Unet models). In this study, we executed DL models with various complexities and analyzed inference times ranging from a few milliseconds to seconds. Our results show that Unity Barracuda is significantly faster than WinML (p-value < 0.005). With our findings, we sought to provide practical guidance and reference values for future studies aiming to develop single, portable AR systems for real-time medical assistance.
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Affiliation(s)
- Silvia Zaccardi
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, 1050 Brussel, Belgium; (T.F.); (B.J.)
- Rehabilitation Research Group (RERE), Vrije Universiteit Brussel, 1090 Brussel, Belgium; (D.B.); (E.S.)
- IMEC, 3001 Leuven, Belgium
| | - Taylor Frantz
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, 1050 Brussel, Belgium; (T.F.); (B.J.)
- IMEC, 3001 Leuven, Belgium
| | - David Beckwée
- Rehabilitation Research Group (RERE), Vrije Universiteit Brussel, 1090 Brussel, Belgium; (D.B.); (E.S.)
| | - Eva Swinnen
- Rehabilitation Research Group (RERE), Vrije Universiteit Brussel, 1090 Brussel, Belgium; (D.B.); (E.S.)
| | - Bart Jansen
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, 1050 Brussel, Belgium; (T.F.); (B.J.)
- IMEC, 3001 Leuven, Belgium
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Giacomino K, Hilfiker R, Beckwée D, Taeymans J, Sattelmayer KM. Assessment tools and incidence of hospital-associated disability in older adults: a rapid systematic review. PeerJ 2023; 11:e16036. [PMID: 37872951 PMCID: PMC10590575 DOI: 10.7717/peerj.16036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/14/2023] [Indexed: 10/25/2023] Open
Abstract
Background During hospitalization older adults have a high risk of developing functional impairments unrelated to the reasons for their admission. This is termed hospital-associated disability (HAD). This systematic review aimed to assess the incidence of HAD in older adults admitted to acute care with two outcomes: firstly in at least one activity of daily living from a set of functional tasks (e.g., Katz Index) and secondly the incidence of functional decline in an individual functional task (e.g., bathing), and to identify any tools or functional tasks used to assess activities of daily living (ADL) in hospitalized older patients. Methods A rapid systematic review was performed according to the recommendations of the Cochrane Rapid Reviews Methods Group and reported the data according the PRISMA statement. A literature search was performed in Medline (via Ovid), EMBASE, and Cochrane Central Register of Controlled Trials databases on 26 August 2021. Inclusion criteria: older adults (≥65 years), assessment of individual items of activities of daily living at baseline and discharge. Exclusion criterion: studies investigating a specific condition that could affect functional decline and studies that primarily examined a population with cognitive impairment. The protocol was registered on OSF registries (https://osf.io/9jez4/) identifier: DOI 10.17605/OSF.IO/9JEZ4. Results Ten studies were included in the final review. Incidence of HAD (overall score) was 37% (95% CI 0.30-0.43). Insufficient data prevented meta-analysis of the individual items. One study provided sufficient data to calculate incidence, with the following values for patients' self-reported dependencies: 32% for bathing, 27% for dressing, 27% for toileting, 30% for eating and 27% for transferring. The proxy reported the following values for patients' dependencies: 70% for bathing, 66% for dressing, 70% for toileting, 61% for eating and 59% for transferring. The review identified four assessment tools, two sets of tasks, and individual items assessing activities of daily living in such patients. Conclusions Incidence of hospital-associated disability in older patients might be overestimated, due to the combination of disease-related disability and hospital-associated disability. The tools used to assess these patients presented some limitations. These results should be interpreted with caution as only one study reported adequate information to assess the HAD incidence. At the item level, the latter was higher when disability was reported by the proxies than when it was reported by patients. This review highlights the lack of systematic reporting of data used to calculate HAD incidence. The methodological quality and the risk of bias in the included studies raised some concerns.
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Affiliation(s)
- Katia Giacomino
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Rehabilitation Research (RERE) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- School of Health Sciences, HES-SO Valais-Wallis, Leukerbad, Valais-Wallis, Switzerland
| | - Roger Hilfiker
- School of Health Sciences, HES-SO Valais-Wallis, Leukerbad, Valais-Wallis, Switzerland
| | - David Beckwée
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Rehabilitation Research (RERE) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jan Taeymans
- Division of Physiotherapy, Department of Health Professions, University of Applied Sciences Bern, Bern, Switzerland
- Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Guida S, Vitale J, Gianola S, Castellini G, Swinnen E, Beckwée D, Gelfi C, Torretta E, Mangiavini L. Effects of tele-prehabilitation on clinical and muscular recovery in patients awaiting knee replacement: protocol of a randomised controlled trial. BMJ Open 2023; 13:e073163. [PMID: 37793919 PMCID: PMC10551960 DOI: 10.1136/bmjopen-2023-073163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND The increasing prevalence of knee osteoarthritis and total knee arthroplasty (TKA) impose a significant socioeconomic burden in developed and developing countries. Prehabilitation (rehabilitation in the weeks immediately before surgery) may be crucial to prepare patients for surgery improving outcomes and reducing assistance costs. Moreover, considering the progress of telemedicine, candidates for TKA could potentially benefit from a tele-prehabilitation programme. We aim to evaluate the effects of a home-based tele-prehabilitation program for patients waiting for total knee replacement. METHODS AND ANALYSIS Forty-eight male patients, aged 65-80, on a waiting list for TKA will be recruited and randomly assigned to the tele-prehabilitation intervention or control groups. Both groups will undergo the same 6-week exercise program (five sessions/week) and the same educational session (one per week). The tele-prehabilitation group will perform asynchronous sessions using a tablet, two accelerometers and a balance board (Khymeia, Padova, Italy), while the control group will use a booklet. The Western Ontario and McMaster Universities Osteoarthritis Index Questionnaire, at the end of the prehabilitation, will be the primary outcome. Secondary outcomes will include self-reported outcomes, performance tests and change in expressions of blood and muscle biomarkers. Ten healthy subjects, aged 18-30, will be also recruited for muscle and blood samples collection. They will not undergo any intervention and their data will be used as benchmarks for the intervention and control groups' analyses. ETHICS AND DISSEMINATION This randomised controlled trial will be conducted in accordance with the ethical principles of the Declaration of Helsinki. This study has been approved by the Ethics Committee of Vita-Salute San Raffaele University (Milan, Italy. No. 50/INT/2022). The research results will be published in peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT05668312.
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Affiliation(s)
- Stefania Guida
- Unit of Clinical Epidemiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jacopo Vitale
- Spine Center, Schulthess Klinik, Zurich, Switzerland
| | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Eva Swinnen
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
| | - David Beckwée
- Rehabilitation Research Deparment, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| | - Cecilia Gelfi
- Laboratory of Proteomics and Lipidomics, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Enrica Torretta
- Laboratory of Proteomics and Lipidomics, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Laura Mangiavini
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
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Roggeman S, Jimenez Garcia BG, Leemans L, Demol J, Geers J, De Smedt A, Putman K, Schiltz M, Beckwée D, De Waele E. Functional performance recovery after individualized nutrition therapy combined with a patient-tailored physical rehabilitation program versus standard physiotherapy in patients with long COVID: a pilot study. Pilot Feasibility Stud 2023; 9:166. [PMID: 37759324 PMCID: PMC10537465 DOI: 10.1186/s40814-023-01392-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Long COVID is suggested to be present in 14 to 43% of COVID 19-survivors. Literature on this new condition states a need for a multidisciplinary approach including physical exercise and nutrition. The aim of the current pilot study is to investigate the feasibility of the proposed protocol to prepare for a randomized controlled study that addresses the effectiveness of a personalized multimodal treatment compared to standard physiotherapy. METHODS This is a protocol of the UNLOCK (Nutrition and LOComotoric rehabilitation in long COVID) study, a pragmatic, single center, randomized controlled pilot trial with two groups. Patients with persisting symptoms related to a SARS-CoV-2 infection will receive either standard physiotherapy or a personalized multimodal treatment for a period of 12 weeks, consisting of individualized physical exercise program combined with individualized nutritional therapy. They will be followed-up at 6, 12, and 18 weeks after randomization. DISCUSSION A multidisciplinary approach for dealing with long COVID is needed. Because of the lack of clear data and the fact that this is a very heterogenic group, we aim to prepare and optimize a randomized controlled study that addresses the effectiveness of a personalized multimodal treatment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05254301 (since February 24, 2022).
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Affiliation(s)
- Stijn Roggeman
- Department of Physical Medicine and Rehabilitation, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, 101, 1090, Brussels, Belgium
| | - Berenice Gabriela Jimenez Garcia
- Department of Clinical Nutrition and Dietetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, 101, 1090, Brussels, Belgium
- Research Group Rehabilitation Research (RERE), Vrije Universiteit Brussel, Laarbeeklaan, 103, 1090, Brussels, Belgium
| | - Lynn Leemans
- Department of Clinical Nutrition and Dietetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, 101, 1090, Brussels, Belgium
- Research Group Rehabilitation Research (RERE), Vrije Universiteit Brussel, Laarbeeklaan, 103, 1090, Brussels, Belgium
| | - Joy Demol
- Department of Clinical Nutrition and Dietetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, 101, 1090, Brussels, Belgium
| | - Janne Geers
- Department of Clinical Nutrition and Dietetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, 101, 1090, Brussels, Belgium
| | - Ann De Smedt
- Department of Physical Medicine and Rehabilitation, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, 101, 1090, Brussels, Belgium
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel (VUB), Laarbeeklaan, 103, 1090, Brussels, Belgium
| | - Koen Putman
- Interuniversity Centre for Health Economics Research (I-CHER), Vrije Universiteit Brussel (VUB), Laarbeeklaan, 103, 1090, Brussels, Belgium
| | - Marc Schiltz
- Department of Physical Medicine and Rehabilitation, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, 101, 1090, Brussels, Belgium
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel (VUB), Laarbeeklaan, 103, 1090, Brussels, Belgium
| | - David Beckwée
- Research Group Rehabilitation Research (RERE), Vrije Universiteit Brussel, Laarbeeklaan, 103, 1090, Brussels, Belgium.
| | - Elisabeth De Waele
- Department of Clinical Nutrition and Dietetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, 101, 1090, Brussels, Belgium
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Roose E, Huysmans E, Lahousse A, Mostaqim K, van Gerven L, Vissers M, Nijs J, Van Wilgen P, Beckwée D, Timmermans A, Bults R, Leysen L. Perceived Injustice in Cancer Survivors: Population-Specific Cut-Off Score and Relations with Personal Factors, Symptoms and Quality of Life-A Cross-Sectional Study. J Clin Med 2023; 12:5780. [PMID: 37762721 PMCID: PMC10531632 DOI: 10.3390/jcm12185780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Fatigue and pain are the most common side effects impacting quality of life (QoL) in cancer survivors. Recent insights have shown that perceived injustice (PI) can play a substantial role in these side effects, but research on cancer survivors is scarce. Furthermore, guidelines for recognizing clinically relevant levels of PI in cancer survivors are missing. The aims of this study are to provide a clinically relevant cut-off for PI and to explore relationships between personal characteristics, symptoms, and QoL with PI. This multicenter, cross-sectional study uses the Injustice Experience Questionnaire (IEQ), Numeric Pain Rating Scale (NPRS), Patient-Specific Complaints (PSC), Multidimensional Fatigue Index (MFI), and European Organization for Research and Treatment of Cancer QoL Questionnaire-C30 (EORTC-QLQ-C30). A clinical cut-off for PI was identified based on the 75th percentile of IEQ scores. Univariate and multivariate regressions explored the relationship between PI and personal characteristics (sex, age, cancer type, treatment type), symptoms (pain intensity, fatigue), and QoL (daily activity complaints, cancer-related QoL). Cancer survivors (n = 121) were included, and a cut-off of 20 was identified. Significant indirect associations were found between chemotherapy, NPRS, PSC, MFI, and EORTC-QLQ-C30 with PI. In the multivariate model, only MFI (B = 0.205; 95% CI: 0.125-0.018) and age (B = 0.086; 95% CI: -0.191-0.285) maintained a significant association with PI.
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Affiliation(s)
- Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Rehabilitation Research Group, Department of Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- REVAL, Universiteit Hasselt, Agoralaan-gebouw A, 3590 Diepenbeek, Belgium;
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Rehabilitation Research Group, Department of Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- Research Foundation–Flanders (FWO), Leuvensesteenweg 38, 1000 Brussels, Belgium
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
| | - Lotte van Gerven
- The Berekuyl Academy, Molenweg 4, 3849 Hierden, The Netherlands; (L.v.G.); (M.V.)
| | - Moniek Vissers
- The Berekuyl Academy, Molenweg 4, 3849 Hierden, The Netherlands; (L.v.G.); (M.V.)
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Huvudbyggnad Vasaparken, Universitetsplatsen 1, 41345 Gothenburg, Sweden
| | - Paul Van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Transcare Pain Transdisciplinary Pain Treatment Center, 9711 Groningen, The Netherlands
| | - David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Annick Timmermans
- REVAL, Universiteit Hasselt, Agoralaan-gebouw A, 3590 Diepenbeek, Belgium;
| | - Rinske Bults
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
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De Dobbeleer L, Beckwée D, Arnold P, Baudry S, Beyer I, Demarteau J, Lieten S, Punie Y, Bautmans I. Comparison between Two Different Handgrip Systems and Protocols on Force Reduction in Handgrip Assessment. Gerontology 2023; 69:1259-1268. [PMID: 37276855 DOI: 10.1159/000530227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 03/15/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Fatigue resistance (FR) can be assessed as the time during which grip strength (GS) drops to 50% of its maximum during a sustained maximal voluntary contraction. For the first time, we compared force-time characteristics during FR test between two different handgrip systems and investigated age- and clinical-related differences in order to verify if a briefer test protocol (i.e., until 75%) could be sufficiently informative. METHODS A cohort of young healthy controls (Y, <30 y, 24 ± 3 y, 54% women), middle-aged (MA, 30-65 y, 47 ± 11 y, 54% women), and older (OLD, >65 y, 77 ± 7 y, 50% women) community-dwelling persons, and hospitalized geriatric patients (HOSP, 84 ± 5 y, 50% women) performed the FR test. For this purpose, an adapted vigorimeter (original rubber bulb of the Martin Vigorimeter connected to a Unik 5000 pressure gauge) here defined as "pneumatic handgrip system" (Pneu) and Dynamometer G200 system (original Jamar Dynamometer handle with an in-build strength gauge) here defined as "hydraulic handgrip system" (Hydr) were used. Force-time curves were analysed from 100% to 75% and from 75% to 50% of the initial maximal GS during the FR test. The area under the curve (GW) was calculated by integrating the actual GS at each time interval (i.e., 1/5,000 s) and corrected for body weight (GW/body weight). RESULTS For both systems, we found fair associations between FR100-50 and FR100-75 (Pneu mean difference = 50.1 s [95% CI: 47.9-52.4], r2 = 0.48; Hydr mean difference = 28.4 s [95% CI: 27.0-29.7], r2 = 0.52, all p < 0.001) and also moderate associations between GW(100-50)/body weight and GW(100-75)/body weight (Pneu mean difference = 32.1 kPa*s/kg [95% CI: 30.6-33.6], r2 = 0.72; Hydr mean difference = 8.1 kg*s/kg [95% CI: 7.7-8.6], r2 = 0.68, all p < 0.001). Between MA and OLD, we found a significant age-related difference in the GW results in the first 25% strength decay for Pneu (10.2 ± 0.6 kPa*s/kg against 7.1 ± 1.2 kPa*s/kg, respectively). CONCLUSION The brief test protocol is valid. Differences within the first 25% strength decay in GW between OLD and HOSP were identified when using Pneu but not when using Hydr. Therefore, a brief FR test protocol using a continuous registration of the strength decay seems to be sufficiently informative in a clinical setting to appraise muscle fatigability, however, only when using a Pneu system.
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Affiliation(s)
- Liza De Dobbeleer
- Gerontology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - David Beckwée
- Gerontology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Wilrijk, Belgium
- SOMT University of Physiotherapy, Amersfoort, The Netherlands
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Pauline Arnold
- Gerontology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- SOMT University of Physiotherapy, Amersfoort, The Netherlands
| | - Stéphane Baudry
- Laboratory of Applied Biology, Research Unit in Applied Neurophysiology (LAB Neuro), Faculté des Sciences de la Motricité, Université Libre de Bruxelles, Brussels, Belgium
| | - Ingo Beyer
- Gerontology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Jeroen Demarteau
- Gerontology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- SOMT University of Physiotherapy, Amersfoort, The Netherlands
| | - Siddhartha Lieten
- Gerontology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Ynes Punie
- SOMT University of Physiotherapy, Amersfoort, The Netherlands
| | - Ivan Bautmans
- Gerontology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
- SOMT University of Physiotherapy, Amersfoort, The Netherlands
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Meert L, Mertens MG, Meeus M, Vervullens S, Baert I, Beckwée D, Verdonk P, Smeets RJEM. Identification of Metabolic Factors and Inflammatory Markers Predictive of Outcome after Total Knee Arthroplasty in Patients with Knee Osteoarthritis: A Systematic Review. Int J Environ Res Public Health 2023; 20:ijerph20105796. [PMID: 37239524 DOI: 10.3390/ijerph20105796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To identify metabolic factors and inflammatory markers that are predictive of postoperative total knee arthroplasty (TKA) outcome. METHOD A systematic search of the existing literature was performed using the electronic databases PubMed, Web of Science and Embase until the 1st of August 2022. Studies that evaluated the influence of metabolic or inflammatory markers (I) on postsurgical outcome (O) in end-stage knee osteoarthritis patients awaiting primary TKA (P) were included in this review. RESULTS In total, 49 studies were included. Risk of bias of the included studies was low for one study, moderate for 10 studies and high for the remaining 38 studies. Conflicting evidence was found for the influence of body mass index, diabetes, cytokine levels and dyslipidaemia on pain, function, satisfaction and quality of life at more than six months after TKA. CONCLUSIONS Several limitations such as not taking into account known confounding factors, the use of many different outcome measures and a widely varying follow-up period made it challenging to draw firm conclusions and clinical implications. Therefore large-scaled longitudinal studies assessing the predictive value of metabolic and inflammatory factors pre-surgery in addition to the already evidenced risk factors with follow-up of one year after TKA are warranted.
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Affiliation(s)
- Lotte Meert
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Michel Gcam Mertens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
| | - Sophie Vervullens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Isabel Baert
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Pain in Motion, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - David Beckwée
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Peter Verdonk
- Antwerp Orthopaedic Center, AZ Monica Hospitals, 2018 Antwerp, Belgium
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University and CIR Revalidatie, 5628 WB Eindhoven, The Netherlands
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Lahousse A, Reynebeau I, Nijs J, Beckwée D, van Wilgen P, Fernández-de-Las-Peñas C, Mostaqim K, Roose E, Leysen L. The effect of psychologically informed practice with behavioural graded activity in cancer survivors: systematic review and meta-analysis. J Cancer Surviv 2023:10.1007/s11764-022-01270-4. [PMID: 36701101 PMCID: PMC9878499 DOI: 10.1007/s11764-022-01270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/01/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE This systematic review and meta-analysis aimed to determine the effectiveness of psychologically informed practice (PIP) with behavioural graded activity (BGA) compared to (1) waitlist controls (WLC), (2) other interventions (OI), (3) PIP alone or (4) BGA alone in cancer patients and survivors (CPaS). METHODS PubMed, Web of Science and Embase were screened for randomised controlled trials encompassing BGA + PIP in CPaS. Effect sizes were inventoried for outcomes regarding physical activity (PA), quality of life (QoL) and debilitating symptoms (DS), which were assessed at four time points: post-intervention (PI), follow-up F1 (1 to 3 months), F2 (4 to 6 months) and F3 (> 6 months). The quality of the evidence was classified by the GRADE approach. RESULTS Thirty-three studies were found eligible, comprising 4330 participants. Significant effects with low heterogeneity of PIP + BGA comparing to WLC were found for anxiety (SMD - 1.29 [-1.71; - 0.86]), depression (SMD - 0.79 [- 1.10; - 0.48]), functional impairment (SMD - 0.72 [- 0.95; - 0.50]), PA (self-reported: (SMD - 0.58 [- 0.84; - 0.32]) and objectively measured: (SMD - 0.51 [- 0.90; - 0.13])) and social impairment (SMD - 0.33 [- 0.58; - 0.08]). When comparing PIP + BGA to OI, fatigue (SMD - 0.35 [- 0.51; - 0.20]) and PA (SMD - 0.26 [- 0.41; - 0.11]) at PI, and fatigue (SMD - 0.34 [- 0.58; - 0.10]) at F1 were found significant with low heterogeneity. No significant effects were observed in the meta-analyses of studies comparing PIP + BGA to BGA or PIP alone. CONCLUSIONS PIP with BGA has a favourable effect on DS, PA and QoL in CPaS when compared to non-behavioural interventions such as WLC, usual care and education. However, further research is needed on 'how' and 'when' PIP + BGA should be provided in cancer rehabilitation. IMPLICATIONS FOR CANCER SURVIVORS PIP + BGA has the potential to facilitate CPaS to reach the recommended amount of PA and reduce DS.
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Affiliation(s)
- Astrid Lahousse
- Research Foundation - Flanders (FWO), Brussels, Belgium.
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Iris Reynebeau
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - David Beckwée
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Paul van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Transcare Transdisciplinary Pain Management Centre, Groningen, the Netherlands
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcon, Madrid, Spain
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Puts S, Liberman K, Leysen L, Forti L, Muyldermans E, Vaes P, Nijs J, Beckwée D, Bautmans I. Exercise-induced effects on inflammatory markers and brain-derived neurotrophic factor in patients with knee osteoarthritis. A systematic review with meta-analysis. Exerc Immunol Rev 2023; 29:22-53. [PMID: 37358362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Background In the pathogenesis of knee osteoarthritis (KOA), inflammatory mediators play an important role. However, the precise underlying mechanism by which regular exercise therapy (ET) exert effects on the immune system in KOA patients is unknown. Objectives The aim of this systematic review was to investigate the basal and acute effects of ET on inflammatory biomarkers and brain derived neurotrophic factor (BDNF) in KOA patients. Methods PubMed, Web Of Science and PEDro were systematically searched for appropriate studies. If possible, a meta-analysis was performed or an approximation of the effect size (ES) was calculated. Risk of bias was scored using the Cochrane ROB 2.0 or ROBINS-tools. Results Twenty-one studies involving 1374 participants were included. Fifteen articles focused on basal exercise effects, four on acute effects, and two on both. Biomarker analysis (n=18) was performed in synovial fluid (n=4) or serum/plasma (n=17). A meta-analysis demonstrated that basal CRP was reduced in KOA patients 6-18 weeks weeks after ET (MD: -0.17;95%CI[-0.31;-0.03]), while IL-6 (MD: 0.21;95%CI[-0.44;0.85]), and TNF-α (MD: -0.57;95%CI[-1.47;0.32]), levels did not significantly change. Also, sTNFR1/2 did not change significantly after ET. For other biomarkers, insufficient data were available to perform a meta-analysis. Nevertheless, a low degree of evidence was found for a decrease in IL-6 (ES:-0.596 & -0.259 & -0.513), an increase in sTNFR1 (ES:2.325), a decrease in sTNFR2 (ES:-0.997) and an increase in BDNF (ES:1.412). Locally, intra-articular IL-10 (ES:9.163) increased, and IL1β (ES:-6.199) and TNF-α decreased (ES:-2.322) after ET. An acute exercise session elicited a myokine response (ES IL-6:0.314), and an increase in BDNF (no ES-data). No inflammatory effect (ES CRP:0.052; ES TNF-α:-0.019 & 0.081) following an acute bout of training was found. However, a single bout of exercise elicited a decrease in intra-articular IL-10 (no ES-data). Conclusion ET can induce circulatory and intra-articular anti-inflammatory effects in patients with KOA. The antiinflammatory properties have important implications for informing these patients and clinicians about the underlying effects of ET.
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Affiliation(s)
- Sofie Puts
- Gerontology department, Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Frailty in Ageing (FRIA) research group, Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Pain in Motion Research Group (PAIN), Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Rehabilitation Research Group (RERE), Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
| | - Keliane Liberman
- Gerontology department, Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Frailty in Ageing (FRIA) research group, Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Rehabilitation Research Group (RERE), Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090 Brussels, Belgium
| | - Louis Forti
- Frailty in Ageing (FRIA) research group, Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
| | - Eveline Muyldermans
- Rehabilitation Research Group (RERE), Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
| | - Peter Vaes
- Rehabilitation Research Group (RERE), Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - David Beckwée
- Frailty in Ageing (FRIA) research group, Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Rehabilitation Research Group (RERE), Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Universiteitsplein 1, BE-2610 Wilrijk, Belgium
| | - Ivan Bautmans
- Gerontology department, Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Frailty in Ageing (FRIA) research group, Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium
- Geriatrics department, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, BE-1090 Brussels, Belgium
- SOMT University of Physiotherapy, Softwareweg 5, 3821 BN Amersfoort, The Netherlands
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Roose E, Leysen L, Nijs J, Adrieanssens N, Pas R, van Wilgen P, Bults R, Lahousse A, Beckwée D. The mediating effect of pain catastrophizing and perceived injustice in the relationship of pain on health-related quality of life in breast cancer survivors. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01495-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Lahousse A, Mostaqim K, Roose E, Nijs J, Beckwée D, Demunter S, Ghijselings H, Rheel E, Leysen L. The effect of prehabilitation in cancer patients: systematic review and meta-analysis. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01457-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Roose E, Huysmans E, Lahousse A, Nijs J, van Wilgen P, Beckwée D, Timmermans A, De Couck M, Bults R, Vissers M, van Gerven L, Leysen L. Perceived injustice in cancer survivors: an exploration and a population-specific cut-off score. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01487-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Lahousse A, Ivakhnov S, Nijs J, Beckwée D, Cools W, Fernandez-de-las-Penas C, Roose E, Leysen L. The mediating effect of perceived injustice and pain catastrophizing in the relationship of pain on fatigue and sleep in breast cancer survivors: a cross-sectional study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01484-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Beckwée D, Cuypers L, Lefeber N, De Keersmaecker E, Scheys E, Van Hees W, Perkisas S, De Raedt S, Kerckhofs E, Bautmans I, Swinnen E. Skeletal muscle changes in the first three months of stroke recovery: a systematic review. J Rehabil Med 2022; 54:jrm00308. [PMID: 35848335 PMCID: PMC9575591 DOI: 10.2340/jrm.v54.573] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Rehabilitation is important in the first months after a stroke for recovery of functional ability, but it is also challenging, since distinct recovery trajectories are seen. Therefore, studying the early changes in muscle characteristics over time (e.g. muscle strength, muscle mass and muscle volume), which are known to be associated with functional abilities, may deepen our understanding of underlying recovery mechanisms of stroke survivors. OBJECTIVE This systematic review aims to describe the longitudinal changes in skeletal muscles, including muscle strength, muscle mass and muscle volume, during the first 3 months post-stroke. METHODS Electronic searches were conducted in Medline, Scopus and CENTRAL. Longitudinal cohort studies or controlled interventional trials that report data about patients in the first 3 months after stroke were identified. Skeletal muscle characteristics should be measured at least twice within 3 months post-stroke by objective, quantitative assessment methods (e.g. dynamometry, ultrasound, computed tomography). Effect sizes were calculated as Hedges' g using standardized mean differences. RESULTS A total of 38 studies (1,097 subjects) were found eligible. Results revealed an average increase on the paretic side for upper and lower limb muscle strength (small to moderate effect sizes), whereas muscle thickness decreased (moderate to large effect sizes). Similar, but smaller, effects were found on the non-paretic side. There were insufficient data available to draw conclusions about lean muscle mass and muscle cross-sectional area. No studies aimed at investigating distinct trajectories of the muscle changes. CONCLUSION Muscle strength and thickness changes during the first 3 months after stroke in both the paretic and non-paretic side. Future studies should aim to understand "how" the stroke-induced muscle strength changes are achieved. Exploring existing data from longitudinal studies, by using cluster analyses, such as pattern recognition, could add to the current knowledge-base.
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Affiliation(s)
- David Beckwée
- Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in ageing (FRIA) research department, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium.
| | - Lotte Cuypers
- Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
| | - Nina Lefeber
- Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium; Movement and Nutrition for Health and Performance research group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Emma De Keersmaecker
- Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Scheys
- Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
| | - Wout Van Hees
- Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stany Perkisas
- Ziekenhuis Netwerk Antwerpen (ZNA), University Center for Geriatrics, Antwerp, Belgium
| | - Sylvie De Raedt
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium; Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Eric Kerckhofs
- Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
| | - Ivan Bautmans
- Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in ageing (FRIA) research department, Vrije Universiteit Brussel, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Eva Swinnen
- Department of Physiotherapy, Human Physiology and Anatomy, Research unit Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in ageing (FRIA) research department, Vrije Universiteit Brussel, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
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Affiliation(s)
- Eva Swinnen
- Rehabilitation Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium/Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium/Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Emma De Keersmaecker
- Rehabilitation Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium/Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium/Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - David Beckwée
- Rehabilitation Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium/Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium/Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium/Research Group MOVANT, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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22
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Lahousse A, Ivakhnov S, Nijs J, Beckwée D, Cools W, Fernandez de Las Penas C, Roose E, Leysen L. The Mediating Effect of Perceived Injustice and Pain Catastrophizing in the Relationship of Pain on Fatigue and Sleep in Breast Cancer Survivors: A Cross-Sectional Study. Pain Med 2022; 23:1299-1310. [PMID: 35020939 DOI: 10.1093/pm/pnac006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Multidimensional aspects of pain have raised awareness about cognitive appraisals, such as perceived injustice (PI) and pain catastrophizing (PC). It has been demonstrated that they play an important role in patients' pain experience. However, the mediating effect of these appraisals has not been investigated in breast cancer survivors (BCS), nor have they been related to fatigue and sleep. METHODS Cross-sectional data from 128 BCS were analysed by structural path analysis with the aim to examine the mediating effect of PI and PC in the relationship of pain on fatigue and sleep. RESULTS The indirect mediating effects of PI on fatigue (CSI*PI = 0.21; P < 0.01 and VAS*PI = 1.19; P < 0.01) and sleep (CSI*PI = 0.31; P < 0.01 and VAS*PI = 1.74; P < 0.01) were found significant for both pain measures (Central Sensitization Inventory (CSI) and Visual Analogue Scale (VAS)). PC, on the other hand, only mediated the relationship between pain measured by VAS and fatigue (VAS*PC = 0.80; P = 0.03). Positive associations were found, indicating that higher pain levels are positively correlated with PI and PC, which go hand in hand with higher levels of fatigue and sleep problems. CONCLUSION PI is an important mediator in the relationship of pain on fatigue and sleep, while PC is a mediator on fatigue after cancer treatment. These findings highlight that both appraisals are understudied and open new perspectives regarding treatment strategies in BCS.
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Affiliation(s)
- Astrid Lahousse
- Research Foundation-Flanders (FWO), Brussels, Belgium.,Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.,Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium
| | - Sergei Ivakhnov
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.,Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Unit of Physiotherapy, University of Gothenburg, Gothenburg, Sweden
| | - David Beckwée
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Wilfried Cools
- Interfaculty Center Data processing and Statistics, Brussels Health Campus
| | - César Fernandez de Las Penas
- Department of Physical Therapy Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcon, Madrid, Spain
| | - Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.,Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.,Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium
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23
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Leemans L, Nijs J, Antonis L, Wideman TH, Bandt HD, Franklin Z, Mullie P, Moens M, Joos E, Beckwée D. Do psychological factors relate to movement-evoked pain in people with musculoskeletal pain? A systematic review and meta-analysis. Braz J Phys Ther 2022; 26:100453. [PMID: 36279767 PMCID: PMC9597124 DOI: 10.1016/j.bjpt.2022.100453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/21/2022] [Accepted: 10/06/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND A growing body of evidence has demonstrated the importance of implementing movement-evoked pain in conventional pain assessments, with a significant role for psychological factors being suggested. Whether or not to include these factors in the assessment of movement-evoked pain has not yet been determined. OBJECTIVES The aim of this systematic review is to explore the association between psychological factors and movement-evoked pain scores in people with musculoskeletal pain. METHODS For this systematic review with meta-analysis, four electronic databases (PubMed, Medline, WOS, and Scopus) were searched. Cross-sectional studies, longitudinal cohort studies, and randomized controlled trials investigating the association between movement-evoked pain and psychological factors in adults with musculoskeletal pain were considered. Meta-analysis was conducted for outcomes with homogeneous data from at least 2 studies. Fischer-Z transformations were used as the measure of effect. Quality of evidence was assessed using the National Institutes of Health's Quality assessment tool for observational cohort and cross-sectional studies and Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RESULTS Meta-analyses and grading the quality of evidence revealed moderate evidence for a relation between movement-evoked pain and depressive symptoms (Fisher-z=0.27; 95%CI: 0.17, 0.36; 5 studies (n=440)), pain-related fear (Fisher-z=0.35; 95%CI: 0.26, 0.44; 6 studies (n=492)), and pain catastrophizing (Fisher-z=0.47; 95%CI: 0.36, 0.58; 4 studies (n=312)) in people with musculoskeletal pain. CONCLUSIONS Movement-evoked pain is weakly to moderately associated to depressive symptoms, pain-related fear, and pain catastrophizing in people with musculoskeletal pain.
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Affiliation(s)
- Lynn Leemans
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium,Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Corresponding author at: Rehabilitation Research Department and Pain in Motion International Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.
| | - Jo Nijs
- Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Department of Physical Medicine and Physical Therapy, University Hospital Brussels, Belgium,Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Luna Antonis
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium,Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Hester den Bandt
- Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Department of Physical Therapy, University of Applied Sciences Rotterdam, Rotterdam, the Netherlands
| | - Zoe Franklin
- Department of Sport and Exercise Sciences, Centre for Musculoskeletal Science and Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Patrick Mullie
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium,Belgian Defense, COS Well-Being, Queen Elisabeth Barracks, Evere, Belgium
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium,Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium,Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
| | - Erika Joos
- Physical Medicine & Rehabilitation Department, UZ Brussel, Brussels, Belgium
| | - David Beckwée
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium,Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium,Department Rehabilitation Sciences and Physical Therapy
- Research Group MOVANT, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
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24
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Debeuf R, Swinnen E, Plattiau T, De Smedt A, De Waele E, Roggeman S, Schiltz M, Beckwée D, De Keersmaecker E. The Effect of physical therapy on impairments in COVID-19 patients from intensive care to home rehabilitation: A rapid review. J Rehabil Med 2021; 54:jrm00242. [PMID: 34633050 PMCID: PMC8862642 DOI: 10.2340/jrm.v53.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Guidelines regarding physical therapy for COVID-19 patients are often based on expert opinion. Recent clinical trials have reported effects on several rehabilitation outcomes in COVID-19 patients. This review summarizes the effects of physical therapy in COVID-19 patients. DATA SOURCES PubMed, Web of Science and Scopus databases were systematically searched for studies investigating the effect of any physical therapy modality on impairments in adult COVID-19 patients. Included studies were (non)-randomized controlled trials, pre-experimental studies, and cohort studies in which a pre-post analysis was performed. DATA EXTRACTION After the screening process, data of interest were extracted from eligible studies and their risk of bias was assessed. Included outcome measures were divided into 3 groups: pulmonary function, physical function, and psychosocial function. DATA SYNTHESIS A total of 15 studies were included in this review. Physical therapy seems to have positive effects on pulmonary function, physical function, and psychosocial function. However, these effects differ between clinical settings (e.g. home care, intensive care unit, inpatient units). Due to the low-to-moderate quality of the included studies, no robust conclusions can be drawn. CONCLUSION Further high-quality research is required, taking into account the different clinical settings, in order to draw conclusions about the effectiveness of physical therapy on impairments in COVID-19 patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Emma De Keersmaecker
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium.
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25
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Trinidad-Fernández M, Cuesta-Vargas A, Vaes P, Beckwée D, Moreno FÁ, González-Jiménez J, Fernández-Nebro A, Manrique-Arija S, Ureña-Garnica I, González-Sánchez M. Human motion capture for movement limitation analysis using an RGB-D camera in spondyloarthritis: a validation study. Med Biol Eng Comput 2021; 59:2127-2137. [PMID: 34467447 PMCID: PMC8440303 DOI: 10.1007/s11517-021-02406-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
Abstract
A human motion capture system using an RGB-D camera could be a good option to understand the trunk limitations in spondyloarthritis. The aim of this study is to validate a human motion capture system using an RGB-D camera to analyse trunk movement limitations in spondyloarthritis patients. Cross-sectional study was performed where spondyloarthritis patients were diagnosed with a rheumatologist. The RGB-D camera analysed the kinematics of each participant during seven functional tasks based on rheumatologic assessment. The OpenNI2 library collected the depth data, the NiTE2 middleware detected a virtual skeleton and the MRPT library recorded the trunk positions. The gold standard was registered using an inertial measurement unit. The outcome variables were angular displacement, angular velocity and lineal acceleration of the trunk. Criterion validity and the reliability were calculated. Seventeen subjects (54.35 (11.75) years) were measured. The Bending task obtained moderate results in validity (r = 0.55-0.62) and successful results in reliability (ICC = 0.80-0.88) and validity and reliability of angular kinematic results in Chair task were moderate and (r = 0.60-0.74, ICC = 0.61-0.72). The kinematic results in Timed Up and Go test were less consistent. The RGB-D camera was documented to be a reliable tool to assess the movement limitations in spondyloarthritis depending on the functional tasks: Bending task. Chair task needs further research and the TUG analysis was not validated. Comparation of both systems, required software for camera analysis, outcomes and final results of validity and reliability of each test.
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Affiliation(s)
- Manuel Trinidad-Fernández
- Departamento de Fisioterapia, Instituto de Biomedicina de Málaga (IBIMA), Universidad de Málaga, Grupo de Clinimetría (F-14), Málaga, Spain
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Antonio Cuesta-Vargas
- Departamento de Fisioterapia, Instituto de Biomedicina de Málaga (IBIMA), Universidad de Málaga, Grupo de Clinimetría (F-14), Málaga, Spain.
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Peter Vaes
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - David Beckwée
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium
| | - Francisco-Ángel Moreno
- MAPIR-UMA Group, Department Ingeniería de Sistemas Y Automática, Instituto de Investigación Biomédico de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Javier González-Jiménez
- MAPIR-UMA Group, Department Ingeniería de Sistemas Y Automática, Instituto de Investigación Biomédico de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Antonio Fernández-Nebro
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA) Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Sara Manrique-Arija
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA) Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Inmaculada Ureña-Garnica
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA) Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Manuel González-Sánchez
- Departamento de Fisioterapia, Instituto de Biomedicina de Málaga (IBIMA), Universidad de Málaga, Grupo de Clinimetría (F-14), Málaga, Spain
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26
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Rodriguez-Lopez C, Beckwée D, Luyten FP, Van Assche D, Van Roie E. Reduced knee extensor torque production at low to moderate velocities in postmenopausal women with knee osteoarthritis. Scand J Med Sci Sports 2021; 31:2144-2155. [PMID: 34409660 DOI: 10.1111/sms.14035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
This study aimed to determine deficits in knee extensor muscle function through the torque-time and torque-velocity relationships and whether these deficits are associated with reduced functional performance in postmenopausal women with knee osteoarthritis (KOA). A clinical sample of postmenopausal women with established KOA (n = 18, ≥55 years) was compared to an age-matched healthy control sample (CON) (n = 26). The deficits in different parameters of the knee extensor torque-time (maximal isometric torque and rate of torque development) and torque-velocity relationship (maximum muscle power, maximal velocity and torque at 0-500°·s-1 ) were assessed through a protocol consisting of isometric, isotonic and isokinetic tests. Functional performance was evaluated with sit-to-stand and stair-climbing tasks using a sensor-based technology (ie, time- and power-based outcomes). Postmenopausal women with KOA showed reduced maximal isometric torque (Hedge's g effect size (g) = 1.05, p = 0.001) and rate of torque development (g = 0.77-1.17, all p ≤ 0.02), combined with impaired torque production at slow to moderate velocities (g = 0.92-1.70, p ≤ 0.004), but not at high or maximal velocities (g = 0.16, p > 0.05). KOA were slower (g = 0.81-0.92, p ≤ 0.011) and less powerful (g = 1.11-1.29, p ≤ 0.001) during functional tasks. Additionally, knee extensor deficits were moderately associated with power deficits in stair climbing (r = 0.492-0.659). To conclude, knee extensor muscle weakness was presented in postmenopausal women with KOA, not only as limited maximal and rapid torque development during isometric contractions, but also dynamically at low to moderate velocities. These deficits were related to impaired functional performance. The assessment of knee extensor muscle weakness through the torque-time and torque-velocity relationships might enable individual targets for tailored exercise interventions in KOA.
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Affiliation(s)
- Carlos Rodriguez-Lopez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium.,Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
| | - Frank P Luyten
- Department of Development & Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
| | - Dieter Van Assche
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Evelien Van Roie
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
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27
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Gielen E, Beckwée D, Delaere A, De Breucker S, Vandewoude M, Bautmans I. Nutritional interventions to improve muscle mass, muscle strength, and physical performance in older people: an umbrella review of systematic reviews and meta-analyses. Nutr Rev 2021; 79:121-147. [PMID: 32483625 DOI: 10.1093/nutrit/nuaa011] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [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: 02/07/2023] Open
Abstract
CONTEXT Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an increased risk of adverse outcomes such as falls, disability, and death. The Belgian Society of Gerontology and Geriatrics has developed evidence-based guidelines for the prevention and treatment of sarcopenia. This umbrella review presents the results of the Working Group on Nutritional Interventions. OBJECTIVE The aim of this umbrella review was to provide an evidence-based overview of nutritional interventions targeting sarcopenia or at least 1 of the 3 sarcopenia criteria (ie, muscle mass, muscle strength, or physical performance) in persons aged ≥ 65 years. DATA SOURCES Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed and Web of Science databases were searched for systematic reviews and meta-analyses reporting the effect of nutritional supplementation on sarcopenia or muscle mass, strength, or physical performance. DATA EXTRACTION Two authors extracted data on the key characteristics of the reviews, including participants, treatment, and outcomes. Methodological quality of the reviews was assessed using the product A Measurement Tool to Assess Systematic Reviews. Three authors synthesized the extracted data and generated recommendations on the basis of an overall synthesis of the effects of each intervention. Quality of evidence was rated with the Grading of Recommendations Assessment, Development and Evaluation approach. DATA ANALYSIS A total of 15 systematic reviews were included. The following supplements were examined: proteins, essential amino acids, leucine, β-hydroxy-β-methylbutyrate, creatine, and multinutrient supplementation (with or without physical exercise). Because of both the low amount and the low to moderate quality of the reviews, the level of evidence supporting most recommendations was low to moderate. CONCLUSIONS Best evidence is available to recommend leucine, because it has a significant effect on muscle mass in elderly people with sarcopenia. Protein supplementation on top of resistance training is recommended to increase muscle mass and strength, in particular for obese persons and for ≥ 24 weeks. Effects on sarcopenia as a construct were not reported in the included reviews.
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Affiliation(s)
- Evelien Gielen
- Department of Geriatrics, UZ Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - David Beckwée
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium.,Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium.,Department of Geriatric Physiotherapy, SOMT University of Physiotherapy, Amersfoort, The Netherlands
| | - Andreas Delaere
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Geriatric Physiotherapy, SOMT University of Physiotherapy, Amersfoort, The Netherlands
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28
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Leysen L, Cools W, Nijs J, Adriaenssens N, Pas R, van Wilgen CP, Bults R, Roose E, Lahousse A, Beckwée D. The mediating effect of pain catastrophizing and perceived injustice in the relationship of pain on health-related quality of life in breast cancer survivors. Support Care Cancer 2021; 29:5653-5661. [PMID: 33569674 DOI: 10.1007/s00520-021-06011-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/19/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND The importance of cognitive appraisals in the effectiveness of pain coping is well established. Two key variables in these appraisal processes are pain catastrophizing (PC) and perceived injustice (PI), which are known to increase the risk of long-term disability and aggravate the pain-related distress through maladaptive behavioral responses. However, to date, the mediating effects of these appraisals have not been examined concurrently in the breast cancer survivor (BCS) population, nor have they been related to health-related quality of life (HRQoL). METHODS Using cross-sectional data from 110 BCS, structural path analyses were used to examine the mediating effects of PC and PI in the relationship of pain on the HRQoL in BCS. RESULTS Results demonstrated a significant direct effect of pain and PI on HRQoL combined with a significant indirect effect through PI, but not through PC. An increase in pain is suggested to result in a decrease in quality of life. On the other hand, an increase in pain also is suggested to increase the PI. A similar relation with PC was not retained as significant. CONCLUSION The relative salience of PI as a mediator of HRQoL underscores the fact that PI is not only understudied but also underappreciated and undertreated in the BCS population. The results of our study warrant replication across longitudinal studies but continue to expand upon the evidence of the multifactorial nature of pain coping in BCS.
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Affiliation(s)
- Laurence Leysen
- Pain in Motion International Research Group, http://www.paininmotion.be, Brussels, Belgium. .,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium.
| | - Wilfried Cools
- Interfaculty Center Data Processing and Statistics, Brussels Health Campus, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion International Research Group, http://www.paininmotion.be, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Nele Adriaenssens
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium.,Department of Oncology, University Hospital Brussels, Brussels, Belgium
| | - Roselien Pas
- Pain in Motion International Research Group, http://www.paininmotion.be, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium
| | - C Paul van Wilgen
- Pain in Motion International Research Group, http://www.paininmotion.be, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium.,Transcare Pijn - Transdisciplinary Pain Center, Groningen, the Netherlands
| | - Rinske Bults
- Pain in Motion International Research Group, http://www.paininmotion.be, Brussels, Belgium.,Transcare Pijn - Transdisciplinary Pain Center, Groningen, the Netherlands.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussels, Brussels, Belgium
| | - Eva Roose
- Pain in Motion International Research Group, http://www.paininmotion.be, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium
| | - Astrid Lahousse
- Pain in Motion International Research Group, http://www.paininmotion.be, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium
| | - David Beckwée
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Building F-kine, Laarbeeklaan 103, BE-1090, Brussels, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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29
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De Keersmaecker E, Beckwée D, Denissen S, Nagels G, Swinnen E. Virtual reality for multiple sclerosis rehabilitation. Hippokratia 2021. [DOI: 10.1002/14651858.cd013834] [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: 11/09/2022]
Affiliation(s)
- Emma De Keersmaecker
- Faculty of Physical Education and Physiotherapy, Rehabilitation Research Group; Vrije Universiteit Brussel; Brussels Belgium
| | - David Beckwée
- Faculty of Physical Education and Physiotherapy, Rehabilitation Research Group; Vrije Universiteit Brussel; Brussels Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Research Group MOVANT; University of Antwerp; Antwerp Belgium
- Frailty in Ageing Research Department; Vrije Universiteit Brussel; Brussel Belgium
| | - Stijn Denissen
- AIMS lab, Center for Neurosciences; UZ Brussel, Vrije Universiteit Brussel; Brussels Belgium
- icometrix; Leuven Belgium
| | - Guy Nagels
- AIMS lab, Center for Neurosciences; UZ Brussel, Vrije Universiteit Brussel; Brussels Belgium
- icometrix; Leuven Belgium
- St Edmund Hall; University of Oxford; Oxford UK
| | - Eva Swinnen
- Faculty of Physical Education and Physiotherapy, Rehabilitation Research Group; Vrije Universiteit Brussel; Brussels Belgium
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30
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Leemans L, Elma Ö, Nijs J, Wideman TH, Siffain C, den Bandt H, Van Laere S, Beckwée D. Transcutaneous electrical nerve stimulation and heat to reduce pain in a chronic low back pain population: a randomized controlled clinical trial. Braz J Phys Ther 2021; 25:86-96. [PMID: 32434666 PMCID: PMC7817858 DOI: 10.1016/j.bjpt.2020.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/13/2020] [Accepted: 04/06/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Low back pain is the leading cause of disability worldwide. The therapeutic management of patients with chronic LBP is challenging. OBJECTIVES The aim of this study is to evaluate the effects of heat and transcutaneous electrical nerve stimulation combined on pain relief in participants with chronic low back pain. METHODS Fifty participants with chronic (≥3 months) low back pain were randomly assigned to two groups: HeatTens (n=25) and control group (n=25). Primary outcome was pain. Secondary outcomes were pressure pain thresholds, temporal summation, conditioned pain modulation, fear-avoidance and beliefs questionnaire, central sensitization inventory, quality of life, and medication use. The control group received no treatment and continued usual care. After four weeks of treatment, all measurements were repeated. RESULTS Fifty individuals participated in this study. Significant higher pressure pain threshold measures after both 30min and 4 weeks for the lower back region and the second plantar toe were found only in the experimental group. CONCLUSION The combination of heat and transcutaneous electrical nerve stimulation does not reduce pain scores in patients with chronic low back pain. Pressure pain threshold values significantly improved, showing beneficial effects of the experimental treatment. ClinicalTrials.gov: NCT03643731 (https://clinicaltrials.gov/ct2/show/NCT03643731).
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Affiliation(s)
- Lynn Leemans
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group, Belgium.
| | - Ömer Elma
- Pain in Motion International Research Group, Belgium
| | - Jo Nijs
- Pain in Motion International Research Group, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium
| | - Timothy H Wideman
- School of Physical and Occupational Therapy, McGill University, Canada
| | - Carolie Siffain
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group, Belgium
| | - Hester den Bandt
- Pain in Motion International Research Group, Belgium; Department of Physiotherapy, University of Applied Sciences Rotterdam, Rotterdam, The Netherlands
| | - Sven Van Laere
- Interfaculty Center Data Processing and Statistics, Vrije Universiteit Brussel, Belgium
| | - David Beckwée
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
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Trinidad-Fernández M, Beckwée D, Cuesta-Vargas A, González-Sánchez M, Moreno FÁ, González-Jiménez J, Joos E, Vaes P. Differences in movement limitations in different low back pain severity in functional tests using an RGB-D camera. J Biomech 2020; 116:110212. [PMID: 33401131 DOI: 10.1016/j.jbiomech.2020.110212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/25/2020] [Accepted: 12/11/2020] [Indexed: 11/19/2022]
Abstract
Low back pain (LBP) can lead to motor control disturbance which can be one of the causes of reoccurrence of the complaint. It is important to improve our knowledge of movement related disturbances during assessment in LBP and to classify patients according to the severity. The aim of this study is to present differences in kinematic variables using a RGB-D camera in order to classify LBP patients with different severity. A cross-sectional study was carried out. Subjects with non-specific subacute and chronic LBP were screened 6 weeks following an episode. Functional tests were bending trunk test, sock test and sit to stand test. Participants performed as many repetitions as possible during 30 s for each functional test. Angular displacement, velocity and acceleration, linear acceleration, time and repetitions were analysed. Participants were divided into two groups to determine their different LBP severity with a k-means clusters according to the results obtained in Roland Morris questionnaire (RMQ). Comparing different severity groups based on RMQ score (high impact = 17.15, low impact = 7.47), bending trunk test obtained significative differences in linear acceleration (p = 0.002-0.01). The differences of total linear acceleration during the Sit to Stand test were significative (p = 0.004-0.02). Sock test showed not significative differences between groups (p > 0.05). Linear acceleration variables during Sit to Stand test and Bending trunk test were significatively different between the different severity groups. RGB-D camera system and functional tests can detect kinematic differences in different type of LBP according to the functionality. Trial registration: ClinicalTrials.gov NCT03293095 "Functional Task Kinematic in Musculoskeletal Pathology" September 26, 2017.
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Affiliation(s)
- Manuel Trinidad-Fernández
- Rehabilitation Research (RERE) Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium; Physiotherapy Department, Institute of Biomedical Research in Malaga (IBIMA), Clinimetric Group F-14, Universidad de Málaga, 29010 Málaga, Spain
| | - David Beckwée
- Rehabilitation Research (RERE) Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2000 Antwerp, Belgium
| | - Antonio Cuesta-Vargas
- Physiotherapy Department, Institute of Biomedical Research in Malaga (IBIMA), Clinimetric Group F-14, Universidad de Málaga, 29010 Málaga, Spain; School of Clinical Science, Faculty of Health Science, Queensland University Technology, 4072 Brisbane, Australia.
| | - Manuel González-Sánchez
- Physiotherapy Department, Institute of Biomedical Research in Malaga (IBIMA), Clinimetric Group F-14, Universidad de Málaga, 29010 Málaga, Spain
| | - Francisco-Ángel Moreno
- Systems Engineering and Automation Deparment, Institute of Biomedical Research in Malaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain
| | - Javier González-Jiménez
- Systems Engineering and Automation Deparment, Institute of Biomedical Research in Malaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain
| | - Erika Joos
- Physical Medicine & Rehabilitation Department, UZ Brussel, 1090 Brussels, Belgium
| | - Peter Vaes
- Rehabilitation Research (RERE) Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium
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Beckwée D, Lefeber N, Bautmans I, Cuypers L, De Keersmaecker E, De Raedt S, Kerckhofs E, Nagels G, Njemini R, Perkisas S, Scheys E, Swinnen E. Muscle changes after stroke and their impact on recovery: time for a paradigm shift? Review and commentary. Top Stroke Rehabil 2020; 28:104-111. [PMID: 32588773 DOI: 10.1080/10749357.2020.1783916] [Citation(s) in RCA: 2] [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: 02/08/2023]
Abstract
In stroke rehabilitation there is a growing body of evidence that not all patients have the same potential to recover. Understanding the processes that give rise to the heterogeneous treatment responses in stroke survivors will lay foundations for any conceivable advance in future rehabilitation interventions. This review was set out to shine new light on the debate of biomarkers in stroke rehabilitation by linking fundamental insights from biogerontological sciences to neurorehabilitation sciences. In particular, skeletal muscle changes and inflammation are addressed as two potential constructs from which biomarkers for stroke rehabilitation can be derived. Understanding the interplay between these constructs as well as their relation to recovery could enhance stroke rehabilitation in the future. The rationale for the selection of these constructs is three-fold: first, recent stroke literature emphasizes the importance of identifying muscle wasting (also called stroke-induced muscle wasting) in stroke patients, a concept that is widely investigated in geriatrics but less in the stroke population. Second, insights from transdisciplinary research domains such as gerontology have shown that inflammation has severe catabolic effects on muscles, which may impede rehabilitation outcomes such as gait recovery. Last, it has been proven that (high-intensity) muscle strengthening exercises have strong anti-inflammatory effects in a non-stroke population. Therefore, an evidence-based rationale is presented for developing research on individual changes of muscle and inflammation after a stroke.
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Affiliation(s)
- David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Frailty in Ageing Research Department, Vrije Universiteit Brussel , Brussels, Belgium.,Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp , Wilrijk, Belgium
| | - Nina Lefeber
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel , Brussels, Belgium
| | - Lotte Cuypers
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
| | - Emma De Keersmaecker
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
| | - Sylvie De Raedt
- Universitair Ziekenhuis Brussel , Neurology Department, Jette, Belgium
| | - Eric Kerckhofs
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
| | - Guy Nagels
- Universitair Ziekenhuis Brussel , Neurology Department, Jette, Belgium
| | - Rose Njemini
- Frailty in Ageing Research Department, Vrije Universiteit Brussel , Brussels, Belgium
| | - Stany Perkisas
- University Center of Geriatrics, University of Antwerp , Antwerp, Belgium
| | - Ellen Scheys
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium
| | - Eva Swinnen
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
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Nijs J, Ickmans K, Beckwée D, Leysen L. Behavioral Graded Activity + (BGA +) for Osteoarthritis: A Paradigm Shift from Disease-Based Treatment to Personalized Activity Self-Management. J Clin Med 2020; 9:jcm9061793. [PMID: 32526889 PMCID: PMC7357101 DOI: 10.3390/jcm9061793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 12/21/2022] Open
Abstract
Three promising directions for improving care for osteoarthritis (OA) include novel education strategies to target unhelpful illness and treatment beliefs; methods to enhance the efficacy of exercise interventions; and innovative, brain-directed treatments. Here we explain that each of those three promising directions can be combined through a paradigm-shift from disease-based treatments to personalized activity self-management for patients with OA. Behavioral graded activity (BGA) accounts for the current understanding of OA and OA pain and allows a paradigm shift from a disease-based treatment to personalized activity self-management for patients with OA. To account for the implementation barriers of BGA, we propose adding pain neuroscience education to BGA (referred to as BGA+). Rather than focusing on the biomedical (and biomechanical) disease characteristics of OA, pain neuroscience education implies teaching people about the underlying biopsychosocial mechanisms of pain. To account for the lack of studies showing that BGA is “safe” with respect to disease activity and the inflammatory nature of OA patients, a trial exploring the effects of BGA+ on the markers of inflammation is needed. Such a trial could clear the path for the required paradigm shift in the management of OA (pain) and would allow workforce capacity building that de-emphasizes biomedical management for OA.
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Affiliation(s)
- Jo Nijs
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, BE-1090 Brussels, Belgium; (K.I.); (L.L.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, BE1090 Brussels, Belgium
- Institute of Neuroscience and Physiology, University of Gothenburg, Box 430, SE-405 30 Göteborg, Sweden
- Correspondence: ; Tel.: +32-2477-4489
| | - Kelly Ickmans
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, BE-1090 Brussels, Belgium; (K.I.); (L.L.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, BE1090 Brussels, Belgium
- Flemish Research Foundation (FWO), BE1050 Brussels, Belgium
| | - David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, BE-1090 Brussels, Belgium;
| | - Laurence Leysen
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, BE-1090 Brussels, Belgium; (K.I.); (L.L.)
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, BE-1090 Brussels, Belgium;
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34
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Eechaute C, Leemans L, De Mesmaeker M, De Ridder R, Beckwée D, Struyf F, Roosen F, Buyl R, Putman K, Vaes P. The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains. J Sports Sci 2019; 38:86-93. [PMID: 31707915 DOI: 10.1080/02640414.2019.1682891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/25/2022]
Abstract
The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains. BACKGROUND Lateral ankle sprains (LAS) are very common sports injuries, cause high health care costs and are associated with postural control deficits. From a preventive point of view, clinicians should dispose valid field tests to identify athletes at risk for a LAS. The aim of this study is to evaluate the predictive value of the multiple hop test (MHT) for first-time noncontact LAS. METHODS Non-elite athletes (n = 232) performed the MHT at baseline. During a 12-month follow-up period, all noncontact LAS related to health care costs were recorded. Outcomes of the MHT (completion time, balance errors and perceived difficulty) between the injured and uninjured group were compared and odds ratios (OR) and relative risks (RR) were calculated using a logistic regression analysis. RESULTS Ten first-time noncontact LAS were recorded (4.3%). Injured athletes made significantly more change-in-support strategy (CSS) errors when compared to uninjured athletes (p = .04). The OR of the number of CSS errors was 1.14 (p = .03), the RR 4.1 (p = .04). CONCLUSIONS Athletes scoring > 12 CSS errors, have a four times increased risk for a first-time noncontact LAS. The MHT is a valid field test to identify athletes at risk for a first-time noncontact LAS.
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Affiliation(s)
- Christophe Eechaute
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lynn Leemans
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Margo De Mesmaeker
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roel De Ridder
- Department of Physical Therapy and Rehabilitation, Universiteit Gent, Gent, Belgium
| | - David Beckwée
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Filip Struyf
- Department of Rehabilitation Sciences and Physical Therapy, Universiteit Antwerpen, Wilrijk, Belgium
| | - Filip Roosen
- Department of Physical Therapy and Rehabilitation, Universiteit Gent, Gent, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Informatics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Koen Putman
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Vaes
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
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35
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Leysen L, Lahousse A, Nijs J, Adriaenssens N, Mairesse O, Ivakhnov S, Bilterys T, Van Looveren E, Pas R, Beckwée D. Prevalence and risk factors of sleep disturbances in breast cancersurvivors: systematic review and meta-analyses. Support Care Cancer 2019; 27:4401-4433. [DOI: 10.1007/s00520-019-04936-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 06/11/2019] [Indexed: 01/31/2023]
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36
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Beckwée D, Delaere A, Aelbrecht S, Baert V, Beaudart C, Bruyere O, de Saint-Hubert M, Bautmans I. Exercise Interventions for the Prevention and Treatment of Sarcopenia. A Systematic Umbrella Review. J Nutr Health Aging 2019; 23:494-502. [PMID: 31233069 DOI: 10.1007/s12603-019-1196-8] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The aim of this systematic review is to provide an overview of the efficacy of different exercise interventions to counter sarcopenia in older adults. This review will allow the Belgian Society of Gerontology and Geriatrics and other scientific societies to formulate specific exercise recommendations in their Clinical Guidelines for Sarcopenia. DESIGN We used the method of a systematic umbrella-review. Based on the level of evidence, we formulated specific recommendations for clinical practice. METHODS Two databases (Pubmed and Web Of Science) were searched systematically and methodological quality of the reviews was assessed. Extracted data was than mapped to an exercise category and an overall synthesis (bottom line statements) was formulated for each of these exercise categories. Subsequently, we assigned a rating of the quality of the evidence supporting each bottom line statement. RESULTS We identified 14 systematic reviews or meta-analyses, encompassing four exercise categories: resistance training, resistance training + nutritional supplementation, multimodal exercise programmes and bloodflow restriction training. Importantly, very few systematic reviews or meta-analyses clearly mentioned baseline sarcopenia status. There is high quality evidence for a positive and significant effect of resistance training on muscle mass, muscle strength, and physical performance. The added effect of nutritional supplementation for resistance training on muscle function appears limited. Blood flow restriction training is a novel training method that has a significant impact on muscle strength. CONCLUSION Since sarcopenia is affecting all skeletal muscles in the body, we recommend training the large muscle groups in a total body approach. Although low-intensity resistance training (≤50% 1RM) is sufficient to induce strength gains, we recommend a high-intensity resistance training program (i.e. 80% 1RM) to obtain maximal strength gains. Multimodal exercises and blood flow restriction resistance training may be considered as well.
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Affiliation(s)
- D Beckwée
- Ivan Bautmans, Gerontology (GERO) and Frailty in Ageing research (FRIA) departments, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090 Brussels, Belgium, Email address: , Phone number: +32 2 477 42 07
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Leysen L, Adriaenssens N, Nijs J, Pas R, Bilterys T, Vermeir S, Lahousse A, Beckwée D. Chronic Pain in Breast Cancer Survivors: Nociceptive, Neuropathic, or Central Sensitization Pain? Pain Pract 2018; 19:183-195. [DOI: 10.1111/papr.12732] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 07/07/2018] [Accepted: 07/29/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Laurence Leysen
- Pain in Motion International Research Group; Brussels Belgium
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - Nele Adriaenssens
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- Department of Oncology; University Hospital Brussels; Brussels Belgium
| | - Jo Nijs
- Pain in Motion International Research Group; Brussels Belgium
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- Department of Physical Medicine and Physiotherapy; University Hospital Brussels; Brussels Belgium
| | - Roselien Pas
- Pain in Motion International Research Group; Brussels Belgium
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - Thomas Bilterys
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - Sofie Vermeir
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - Astrid Lahousse
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
| | - David Beckwée
- Department of Physiotherapy, Human Physiology and Anatomy; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- Frailty in Ageing Research Department; Vrije Universiteit Brussel; Brussels Belgium
- Department of Rehabilitation Sciences and Physiotherapy; Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp Belgium
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De Spiegeleer A, Beckwée D, Bautmans I, Petrovic M. Pharmacological Interventions to Improve Muscle Mass, Muscle Strength and Physical Performance in Older People: An Umbrella Review of Systematic Reviews and Meta-analyses. Drugs Aging 2018; 35:719-734. [DOI: 10.1007/s40266-018-0566-y] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Werbrouck A, Swinnen E, Kerckhofs E, Buyl R, Beckwée D, De Wit L. How to empower patients? A systematic review and meta-analysis. Transl Behav Med 2018; 8:660-674. [DOI: 10.1093/tbm/iby064] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Amber Werbrouck
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Rehabilitation Research (RERE), Vrije Universiteit Brussel, Brussel, Belgium
| | - Eva Swinnen
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Rehabilitation Research (RERE), Vrije Universiteit Brussel, Brussel, Belgium
| | - Eric Kerckhofs
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Rehabilitation Research (RERE), Vrije Universiteit Brussel, Brussel, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussel, Belgium
| | - David Beckwée
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Rehabilitation Research (RERE), Vrije Universiteit Brussel, Brussel, Belgium
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Liesbet De Wit
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
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Beckwée D, Bautmans I, Lefeber N, Lievens P, Scheerlinck T, Vaes P. Effect of Transcutaneous Electric Nerve Stimulation on Pain after Total Knee Arthroplasty: A Blind Randomized Controlled Trial. J Knee Surg 2018; 31:189-196. [PMID: 28460406 DOI: 10.1055/s-0037-1602134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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] [Indexed: 02/07/2023]
Abstract
Transcutaneous electric nerve stimulation (TENS) has proven to be effective for postsurgical pain relief. However, there is a lack of well-constructed clinical trials investigating the effect of TENS after total knee arthroplasty (TKA). In addition, previous investigations reported that low- and high-frequency TENSs produced analgesic tolerance after 4 or 5 days of treatment. The aim of this study is to explore the effect of burst TENS on pain during hospitalization after TKA and to investigate whether burst TENS produces analgesic tolerance after 4 or 5 days of treatment. This stratified, triple blind, randomized controlled trial was approved by the University Hospital Brussels. Sixty-eight subjects were screened for eligibility before surgery; 54 were found eligible and 53 were included in the analyses. Patients were allocated to either a burst TENS or sham burst TENS group. TENS was applied daily during continuous passive mobilization. Knee pain intensity, knee range of motion, and analgesic consumption were assessed daily. Patients received burst TENS (N = 25) or sham burst TENS (N = 28). No significant differences in knee pain intensity were found between the groups (p > 0.05). Within the TENS and the sham TENS groups, the difference in knee pain before and after treatment did not evolve over time (p > 0.05). This study found no effects of burst TENS compared with sham burst TENS on pain during hospitalization after TKA.
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Affiliation(s)
- David Beckwée
- Department of Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Frailty in Ageing Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ivan Bautmans
- Department of Frailty in Ageing Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nina Lefeber
- Department of Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Pierre Lievens
- Department of Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Thierry Scheerlinck
- Department of Orthopaedic Surgery and Traumatology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Peter Vaes
- Department of Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium
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Vermeiren S, Vella-Azzopardi R, Beckwée D, Habbig AK, Scafoglieri A, Jansen B, Bautmans I. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc 2017; 17:1163.e1-1163.e17. [PMID: 27886869 DOI: 10.1016/j.jamda.2016.09.010] [Citation(s) in RCA: 493] [Impact Index Per Article: 70.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/16/2016] [Accepted: 09/16/2016] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Frailty is one of the most important concerns regarding our aging population. Evidence grows that the syndrome is linked to several important health outcomes. A general overview of frailty concepts and a comprehensive meta-analysis of their relation with negative health outcomes still lacks in literature, making it difficult for health care professionals and researchers to recognize frailty and the related health risks on the one hand and on the other hand to appropriately follow up the frailty process and take substantiated action. Therefore, this study aims to give an overview of the predictive value of the main frailty concepts for negative health outcomes in community-dwelling older adults. METHODS This review and meta-analysis assembles prospective studies regarding the relation between frailty and any potential health outcome. Frailty instruments were subdivided into frailty concepts, so as to make comprehensive comparisons. Odds ratios (ORs), hazard ratios (HRs), and relative risk (RR) scores were extracted from the studies, and meta-analyses were conducted in OpenMeta Analyst software. RESULTS In total, 31 articles retrieved from PubMed, Web of Knowledge, and PsycInfo provided sufficient information for the systematic review and meta-analysis. Overall, (pre)frailty increased the likelihood for developing negative health outcomes; for example, premature mortality (OR 2.34 [1.77-3.09]; HR/RR 1.83 [1.68-1.98]), hospitalization (OR 1.82 [1.53-2.15]; HR/RR 1.18 [1.10-1.28]), or the development of disabilities in basic activities of daily living (OR 2.05 [1.73-2.44]); HR/RR 1.62 [1.50-1.76]). CONCLUSION Overall, frailty increases the risk for developing any discussed negative health outcome, with a 1.8- to 2.3-fold risk for mortality; a 1.6- to 2.0-fold risk for loss of activities of daily living; 1.2- to 1.8-fold risk for hospitalization; 1.5- to 2.6-fold risk for physical limitation; and a 1.2- to 2.8-fold risk for falls and fractures. The analyses presented in this study can be used as a guideline for the prediction of negative outcomes according to the frailty concept used, as well as to estimate the time frame within which these events can be expected to occur.
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Affiliation(s)
- Sofie Vermeiren
- Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Roberta Vella-Azzopardi
- Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - David Beckwée
- Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Rehabilitation Sciences Research Department (RERE), Vrije Universiteit Brussel, Brussels, Belgium
| | - Ann-Katrin Habbig
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Fundamental Rights and Constitutionalism Research Group (FRC), Vrije Universiteit Brussel (VUB), Elsene, Belgium
| | - Aldo Scafoglieri
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Experimental Anatomy (EXAN), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Bart Jansen
- Department of Electronics and Informatics ETRO, Vrije Universiteit Brussel (VUB), Elsene, Belgium
| | - Ivan Bautmans
- Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
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Leysen L, Beckwée D, Nijs J, Pas R, Bilterys T, Vermeir S, Adriaenssens N. Risk factors of pain in breast cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2017; 25:3607-3643. [DOI: 10.1007/s00520-017-3824-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/03/2017] [Indexed: 01/29/2023]
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Beckwée D, Leysen L, Meuwis K, Adriaenssens N. Prevalence of aromatase inhibitor-induced arthralgia in breast cancer: a systematic review and meta-analysis. Support Care Cancer 2017; 25:1673-1686. [PMID: 28204994 DOI: 10.1007/s00520-017-3613-z] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 02/06/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although aromatase inhibitors have proven to be an effective treatment of hormone receptor-positive breast cancer in postmenopausal women, aromatase inhibitor-induced arthralgia (AIA) is an adverse event associated with low compliance with treatment. The aim of this literature study is to assess the prevalence of AIA and to provide an overview of significant predictors for the development of AIA. METHODS A systematic review was conducted using PubMed, Cochrane Library and Web of Science. A meta-analysis was performed and heterogeneity has been investigated by moderator analyses. The meta-analysis was repeated with studies that were considered as best evidence, i.e. studies with an above-average score on the STROBE checklist. RESULTS Twenty-one studies (13,177 participants) were included. Prevalence rates ranged from 0.200 to 0.737. Meta-analysis resulted in a pooled estimate of 0.459 (95% CI = [0.397-0.520) with a high heterogeneity (I 2 = 98%). Moderator analysis showed no differences regarding heterogeneity. Predictors for the development of AIA included a body mass index of 25-30 kg/m2 (OR = 0.33), taxane-based chemotherapy (OR = 4.08), stage III cancer (OR = 0.32) and a duration of menopause of 5-10 years (OR = 1.10) or >10 years (OR = 0.44-3.29) (An OR <1 indicates a predictor of lower risk of AIA). DISCUSSION Despite the established benefits of AI, an important portion of the patients experiences AIA. More research is needed to investigate the efficacy of treatments such as exercise therapy for AIA.
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Affiliation(s)
- David Beckwée
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium. .,Frailty in Ageing Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Laurence Leysen
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.,Pain in Motion Research Group, Brussels, Belgium
| | - Kaipo Meuwis
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Nele Adriaenssens
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
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Swinnen E, Lafosse C, Van Nieuwenhoven J, Ilsbroukx S, Beckwée D, Kerckhofs E. Neurological patients and their lower limb orthotics: An observational pilot study about acceptance and satisfaction. Prosthet Orthot Int 2017; 41:41-50. [PMID: 26246356 DOI: 10.1177/0309364615592696] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although an orthotic device of the lower limb improves the functionality of neurological patients, anecdotally clinical experience suggests that the compliance is rather limited. OBJECTIVES The aim was to determine the satisfaction and acceptance of a lower limb orthotic device. STUDY DESIGN A qualitative observational pilot study with a mix-method design. METHODS Adult neurological patients who had a prescribed lower limb orthotic device were included. One published and clinically used questionnaire about satisfaction (D-Quest) and one ad hoc constructed questionnaire about acceptance of the orthotic device (MIRAD-ACCORT questionnaire) were used for data collection. RESULTS In total, 33 patients participated (28 ankle-foot orthotic device, 3 knee-ankle-foot orthotic device and 2 other types). In general, they were satisfied about their orthotic device and the services. Less than one-fourth of the patients had some negative comments about the 'visual aspects' and the 'ability to hide' of their orthotic device. These, however, had a lower priority when compared with functionality, which was reported as a main advantage and is a reason for continuing the use of their orthotic device. CONCLUSION Patients were satisfied in relation to their lower limb orthotic device. With regard to acceptance, it can be concluded that factors associated with functionality and comfort are more important than the aesthetic and psychological aspects of the orthotic device. Clinical relevance Patients were satisfied with their lower limb orthotic device. Some patients had some negative comments about the 'aesthetics aspects' and the 'ability to hide' their orthotic device. However, improvements in functionality were mostly reported as a main advantage and a reason for continuing the use of their orthotic device.
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Affiliation(s)
- Eva Swinnen
- 1 Vrije Universiteit Brussel, Brussels, Belgium.,2 Erasmus University College, Brussels, Belgium.,3 Center for Neuroscience, Brussels, Belgium
| | | | | | | | | | - Eric Kerckhofs
- 1 Vrije Universiteit Brussel, Brussels, Belgium.,3 Center for Neuroscience, Brussels, Belgium
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Eechaute C, De Ridder R, Maes T, Beckwée D, Swinnen E, Buyl R, Vaes P. Evidence of a different landing strategy in subjects with chronic ankle instability. Gait Posture 2017; 52:62-67. [PMID: 27880888 DOI: 10.1016/j.gaitpost.2016.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 09/08/2016] [Accepted: 11/01/2016] [Indexed: 02/02/2023]
Abstract
The purpose of the study is to evaluate the discriminative validity of the multiple hop test (MHT) for chronic ankle instability (CAI). The dynamic postural control of 51 CAI subjects and 52 uninjured controls was assessed using the MHT. To evaluate dynamic postural control, the type and number of balance errors were analysed and the time to complete the MHT was measured. Between-group differences of time scores and balance errors, identified as being change-in-support strategy errors (CSS) or fixed-support strategy errors (FSS), were assessed. The area under curve of the outcomes was determined and likelihood ratios (LRs) were calculated based upon their most optimal cut off point. When compared to uninjured controls, CAI subjects needed significantly more time to perform the test (p<0.001) and made significantly more CSS errors (p<0.001). When 1 positive outcome (time score or CSS errors) was considered as a criterion, the LR+ was 2 and the LR- 0.08. In the case of 2 positive outcomes (time score and CSS errors), the LR+ was 7.1 and the LR- 0.49. CAI subjects have an impaired dynamic postural control and rely on a different postural strategy to restore balance. The MHT has good discriminative validity for CAI.
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Affiliation(s)
- Christophe Eechaute
- Department of Physical Therapy and Rehabilitation, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Roel De Ridder
- Department of Physical Therapy and Rehabilitation, Universiteit Gent, De Pintelaan 185, 9000 Gent, Belgium.
| | - Tom Maes
- Department of Physical Therapy and Rehabilitation, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - David Beckwée
- Department of Physical Therapy and Rehabilitation, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Eva Swinnen
- Department of Physical Therapy and Rehabilitation, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Informatics, Vrije Universiteit Brussel, Laarbeeklaan, 103, 1090 Brussels, Belgium
| | - Peter Vaes
- Department of Physical Therapy and Rehabilitation, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
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Beckwée D, Degelaen M, Eggermont M, Gonzalez-Rodriguez M, Lefeber N, Vaes P, Bautmans I, Swinnen E. Validity and test-retest reliability of the Stride Analyzer in people with knee osteoarthritis. Gait Posture 2016; 49:155-158. [PMID: 27423404 DOI: 10.1016/j.gaitpost.2016.06.039] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 06/24/2016] [Accepted: 06/29/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Subjects with knee osteoarthritis walk differently compared to healthy subjects. Managing these gait alterations has been proven effective for reducing pain and increasing function. The Stride Analyzer is a low cost gait analysis tool but its clinimetric properties have not been investigated yet in subjects with symptomatic knee osteoarthritis. The aim of this study was to investigate the reliability and validity of the SA compared with the Gold standard (Vicon) in persons with knee OA. METHODS Fifteen subjects with symptomatic knee osteoarthritis were instructed to walk at a self-selected speed in a gait laboratory. Temporospatial (TS) gait parameters were recorded simultaneously by the Stride Analyzer and by a 16-camera-infrared optoelectronic motion capturing system (Vicon). Validity and test-retest reliability of the Stride Analyzer were examined by Bland-Altman plots, intra-class correlation coefficients (ICC) and the standard error of measurement (SEM). RESULTS Test-retest analyses showed good agreement for all TS parameters with ICC values ranging from 0.805 (single limb support right) to 0.949 (velocity) and SEM% values ranging from 0.78% (stance phase right (% of gait cycle)) to 4.52% (double limb support right (% of gait cycle)). Good agreement between Stride Analyzer and Vicon was found for the following TS parameters: velocity (z=1.01), cadence (z=-0.85), stride length (z=1.63) and gait cycle (z=0.86). All other gait parameters showed lower ICC values (<0.689). INTERPRETATION Our results suggest that the Stride Analyzer can be used in the clinical field to perform gait analysis in subjects with symptomatic knee osteoarthritis.
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Affiliation(s)
- David Beckwée
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium; Frailty in Ageing Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.
| | - Marc Degelaen
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium; Center of Movement analysis, Rehabilitation Hospital Inkendaal, 1602 Vlezenbeek, Belgium
| | - Matthias Eggermont
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Miguel Gonzalez-Rodriguez
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Nina Lefeber
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Peter Vaes
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Eva Swinnen
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium; Knowledge center Brussel Integrated Care, Erasmus University College, Laarbeeklaan 121, B-1090 Brussels, Belgium
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Beckwée D, Vaes P, Raeymaeckers S, Shahabpour M, Scheerlinck T, Bautmans I. Exercise in knee osteoarthritis: do treatment outcomes relate to bone marrow lesions? A randomized trial. Disabil Rehabil 2016; 39:1847-1855. [DOI: 10.1080/09638288.2016.1212110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- David Beckwée
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Vaes
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | - Thierry Scheerlinck
- Department of Orthopaedic Surgery and Traumatology, UZ Brussel, Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
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Beckwée D, Vaes P, Shahabpour M, Muyldermans R, Rommers N, Bautmans I. The Influence of Joint Loading on Bone Marrow Lesions in the Knee: A Systematic Review With Meta-analysis. Am J Sports Med 2015; 43:3093-107. [PMID: 25634907 DOI: 10.1177/0363546514565092] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Bone marrow lesions (BMLs) are considered as predictors of pain, disability, and structural progression of knee osteoarthritis. The relationship between knee loading and BMLs is not yet completely understood. PURPOSE To summarize the available evidence regarding the relationship between joint loading and the prevalence and progression of BMLs in the tibiofemoral joint. STUDY DESIGN Meta-analysis. METHODS Three databases (PubMed, Web of Science, and The Cochrane Library) were systematically screened for studies encompassing BMLs and changes in knee loading. A methodological quality assessment was conducted, and a meta-analysis computing overall odds ratios (ORs) was performed where possible. RESULTS A total of 29 studies involving 7641 participants were included. Mechanical loading was categorized as body weight and composition, compartmental load, structural lesion, and physical activity. High compartmental loads and structural lesions increased the risk for BMLs (overall ORs ranging from 1.56 [95% CI, 1.13-2.15] to 8.2 [95% CI, 4.4-15.1]; P = .006). Body weight increased the risk for BMLs to a lesser extent (overall OR, 1.03; 95% CI, 1.01-1.05; P = .007). Contradictory results for the effect of physical activity on BMLs were found. CONCLUSION Augmented compartmental loads and structural lesions increased the risk of the presence or progression of BMLs. Body weight increased the risk for BMLs to a lesser extent. Contradictory results for the effect of physical activity on BMLs may be explained by a dose-response relationship, knee alignment, and structural lesions. CLINICAL RELEVANCE It has been shown that unloading the knee temporarily may induce beneficial effects on osteoarthritis-related structural changes. Therefore, an early recognition of BMLs in the aging athlete's knee may provide information to counter the onset and aggravation of symptomatic knee osteoarthritis by reducing the knee load.
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Affiliation(s)
- David Beckwée
- Department of Rehabilitation Sciences Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Vaes
- Department of Rehabilitation Sciences Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maryam Shahabpour
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Ronald Muyldermans
- Department of Rehabilitation Sciences Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nikki Rommers
- Department of Rehabilitation Sciences Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ivan Bautmans
- Department of Frailty in Ageing Research, Vrije Universiteit Brussel, Brussels, Belgium
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Beckwée D, Vaes P, Shahabpour M, Muyldermans R, Rommers N, Bautmans I. Can MRI visualise mechanical knee load in osteoarthritic knees? A systematic review with meta-analysis. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Eechaute C, Maes T, Buyl R, Beckwée D, Swinnen E, De Ridder R, Vaes P. An impaired dynamic postural control in subjects with chronic ankle instability: a difference in strategy. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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