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Leichtenberg CS, van Tol FR, Gademan MGJ, Krom T, Tilbury C, Horemans HLD, Bussmann JBJ, Verdegaal SHM, Marijnissen WJCM, Nelissen RGHH, Vliet Vlieland TPM. Are pain, functional limitations and quality of life associated with objectively measured physical activity in patients with end-stage osteoarthritis of the hip or knee? Knee 2021; 29:78-85. [PMID: 33582594 DOI: 10.1016/j.knee.2020.12.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/23/2020] [Revised: 10/31/2020] [Accepted: 12/21/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Physical activity is promoted in patients with hip or knee osteoarthritis (OA), yet little is known about its relationship with symptoms, functional limitations and Quality of Life (QoL). We investigated if OA-associated pain, functional limitations and QoL are associated with objectively measured physical activity in patients with end-stage hip/knee OA. METHODS Cross-sectional study including patients scheduled for primary total hip/knee arthroplasty. Patients wore an accelerometer (Activ8) with physical activity assessed over waking hours, and expressed as number of activity daily counts (ADC) per hour, %time spent on physical activity i.e. walking, cycling or running (%PA), and %time spent sedentary (%SB). Pain, functional limitations and joint-specific and general QoL were assessed with the Hip disability/Knee Injury and Osteoarthritis Outcome Score (HOOS/KOOS) and the Short Form (SF)-12. Multivariate linear regression models with the three to Z-scores transformed parameters of physical activity as dependent variables and adjusted for confounding, were conducted. RESULTS 49 hip and 48 knee OA patients were included. In hip and knee OA patients the mean number of ADC, %PA and %SB were 18.79 ± 7.25 and 21.19 ± 6.16, 14 ± 6.4 and 15 ± 5.0, and 66 ± 10.5 and 68 ± 8.7, respectively. In hip OA, better joint-specific and general QoL were associated with more ADC, (β 0.028; 95%CI:0.007-0.048, β0.041; 95%CI:0.010-0.071). Also, better general QoL was associated with the %PA (β 0.040, 95%CI:0.007-0.073). No other associations were found. CONCLUSION Whereas QoL was associated with physical activity in hip OA, pain and functional limitations were not related to objectively measured physical activity in patients with end-stage hip or knee OA.
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Affiliation(s)
- C S Leichtenberg
- Leiden University Medical Center, Department of Orthopaedics, Leiden, the Netherlands
| | - F R van Tol
- Leiden University Medical Center, Department of Orthopaedics, Leiden, the Netherlands
| | - M G J Gademan
- Leiden University Medical Center, Department of Orthopaedics, Leiden, the Netherlands; Leiden University Medical Center, Department of Clinical Epidemiology, Leiden, the Netherlands.
| | - T Krom
- Leiden University Medical Center, Department of Orthopaedics, Leiden, the Netherlands
| | - C Tilbury
- Leiden University Medical Center, Department of Orthopaedics, Leiden, the Netherlands
| | - H L D Horemans
- Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, the Netherlands
| | - J B J Bussmann
- Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, the Netherlands
| | - S H M Verdegaal
- Alrijne Hospital, Department of Orthopaedics, Leiderdorp, the Netherlands
| | - W J C M Marijnissen
- Albert Schweitzer Hospital, Department of Orthopaedics, Dordrecht, the Netherlands
| | - R G H H Nelissen
- Leiden University Medical Center, Department of Orthopaedics, Leiden, the Netherlands
| | - T P M Vliet Vlieland
- Leiden University Medical Center, Department of Orthopaedics, Leiden, the Netherlands; Sophia Rehabilitation Center, The Hague, the Netherlands; Rijnlands Rehabilitation Center, Leiden, the Netherlands
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Krops LA, Geertzen JHB, Horemans HLD, Bussmann JBJ, Dijkstra PU, Dekker R. Feasibility and short-term effects of Activity Coach+: a physical activity intervention in hard-to-reach people with a physical disability. Disabil Rehabil 2020; 43:2769-2778. [PMID: 31999496 DOI: 10.1080/09638288.2020.1717650] [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: 10/25/2022]
Abstract
PURPOSE Existing physical activity interventions do not reach a considerable proportion of physically disabled people. This study assessed feasibility and short-term effects of Activity Coach+, a community-based intervention especially targeting this hard-to-reach population. METHODS Feasibility was determined by reach, dropouts, and compliance with the protocol. Physical activity was measured with the Activ8 accelerometer and the adapted SQUASH questionnaire. Health outcomes were assessed by body composition, blood pressure, hand grip force, 10-metre walk test, 6-minute walk test, and the Berg Balance Scale. The RAND-36, Exercise Self-Efficacy Scale, Fatigue Severity Scale, and IMPACT-S were administered. Measurements were performed at baseline and after 2 and 4 months. Changes over time were analysed by Friedman tests. RESULTS Twenty-nine participants enrolled during the first 4 months, of whom two dropped out. Intervention components were employed in 86-100% of the participants. Physical activity did not change after the implementation of Activity Coach+. Body mass index (p = 0.006), diastolic blood pressure (p = 0.032), walking ability (p = 0.002), exercise capacity (p = 0.013), balance (p = 0.014), and vitality (p = 0.049) changed over time. CONCLUSIONS Activity Coach + is feasible in a community setting. Indications for effectivity of Activity Coach + in hard-to-reach people with a physical disability were found.Implications for rehabilitationActivity Coach + was able to reach physically disabled people living in community, a population that is assumed hard-to-reach.Activity Coach + was feasible in a population of persons with a physical disability that was heterogeneous with respect to age and (severity of) disability.The current study provides the first indications for the beneficial health effects of Activity Coach + in hard-to-reach people with a physical disability.
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Affiliation(s)
- L A Krops
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - J H B Geertzen
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - H L D Horemans
- Erasmus University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands
| | - J B J Bussmann
- Erasmus University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands
| | - P U Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands
| | - R Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
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Leving MT, Horemans HLD, Vegter RJK, de Groot S, Bussmann JBJ, van der Woude LHV. Validity of consumer-grade activity monitor to identify manual wheelchair propulsion in standardized activities of daily living. PLoS One 2018; 13:e0194864. [PMID: 29641582 PMCID: PMC5894999 DOI: 10.1371/journal.pone.0194864] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/12/2018] [Indexed: 11/18/2022] Open
Abstract
Background Hypoactive lifestyle contributes to the development of secondary complications and lower quality of life in wheelchair users. There is a need for objective and user-friendly physical activity monitors for wheelchair-dependent individuals in order to increase physical activity through self-monitoring, goal setting, and feedback provision. Objective To determine the validity of Activ8 Activity Monitors to 1) distinguish two classes of activities: independent wheelchair propulsion from other non-propulsive wheelchair-related activities 2) distinguish five wheelchair-related classes of activities differing by the movement intensity level: sitting in a wheelchair (hands may be moving but wheelchair remains stationary), maneuvering, and normal, high speed or assisted wheelchair propulsion. Methods Sixteen able-bodied individuals performed sixteen various standardized 60s-activities of daily living. Each participant was equipped with a set of two Activ8 Professional Activity Monitors, one at the right forearm and one at the right wheel. Task classification by the Active8 Monitors was validated using video recordings. For the overall agreement, sensitivity and positive predictive value, outcomes above 90% are considered excellent, between 70 and 90% good, and below 70% unsatisfactory. Results Division in two classes resulted in overall agreement of 82.1%, sensitivity of 77.7% and positive predictive value of 78.2%. 84.5% of total duration of all tasks was classified identically by Activ8 and based on the video material. Division in five classes resulted in overall agreement of 56.6%, sensitivity of 52.8% and positive predictive value of 51.9%. 59.8% of total duration of all tasks was classified identically by Activ8 and based on the video material. Conclusions Activ8 system proved to be suitable for distinguishing between active wheelchair propulsion and other non-propulsive wheelchair-related activities. The ability of the current system and algorithms to distinguish five various wheelchair-related activities is unsatisfactory.
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Affiliation(s)
- Marika T. Leving
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Henricus L. D. Horemans
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Riemer J. K. Vegter
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sonja de Groot
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
| | - Johannes B. J. Bussmann
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Lucas H. V. van der Woude
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Stoof SCM, Hodgins D, Leebeek FWG, Cnossen MH, Horemans HLD, Praet SFE, Kruip MJHA. Sensor-based gait analysis as a simple tool to measure gait in haemophilia patients. Haemophilia 2017; 23:e355-e358. [PMID: 28497894 DOI: 10.1111/hae.13226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 10/19/2022]
Affiliation(s)
- S C M Stoof
- Department of Haematology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - D Hodgins
- European Technology for Business Ltd, Codicote, UK
| | - F W G Leebeek
- Department of Haematology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M H Cnossen
- Department of Paediatric Haematology, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - H L D Horemans
- Department of Rehabilitation Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - S F E Praet
- Department of Rehabilitation Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M J H A Kruip
- Department of Haematology, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Abstract
This study assessed whether self-propelled wheelchair driving can be validly detected by a new method using a set of two commonly used accelerometers.In a rehabilitation centre, 10 wheelchair-bound persons with spinal cord injury (SCI) (aged 29-63 years) performed a series of representative daily activities according to a protocol including self-propelled wheelchair driving and other activities. Two ActiGraph GT3X+ accelerometers were used; one was attached at the wrist, the other to the spokes of the wheelchair wheel. Based on the movement intensity of the two accelerometers, a custom-made algorithm in MatLab differentiated between self-propelled wheelchair driving and other activities (e.g. being pushed or arm movements not related to wheelchair driving). Video recordings were used for reference. Validity scores between the accelerometer output and the video analyses were expressed in terms of agreement, sensitivity and specificity scores.Overall agreement for the detection of self-propelled wheelchair driving was 85%; sensitivity was 88% and specificity 83%. Disagreement between accelerometer output and video analysis was largest for wheelchair driving at very low speed on a treadmill, wheelchair driving on a slope on a treadmill, and being pushed in the wheelchair whilst making excessive arm movements.Valid detection of self-propelled wheelchair driving is provided by two accelerometers and a simple algorithm. Disagreement with the video analysis was largest during three atypical daily activities.
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Affiliation(s)
- H Kooijmans
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Janssen WGM, Bussmann JBJ, Horemans HLD, Stam HJ. Analysis and decomposition of accelerometric signals of trunk and thigh obtained during the sit-to-stand movement. Med Biol Eng Comput 2005; 43:265-72. [PMID: 15865138 DOI: 10.1007/bf02345965] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Piezoresistive accelerometer signals are frequently used in movement analysis. However, their use and interpretation are complicated by the fact that the signal is composed of different acceleration components. The aim of the study was to obtain insight into the components of accelerometer signals from the trunk and thigh segments during four different sit-to-stand (STS) movements (self-selected, slow, fast and fullflexion). Nine subjects performed at least six trials of each type of STS movement. Accelerometer signals from the trunk and thigh in the sagittal direction were decomposed using kinematic data obtained from an opto-electronic device. Each acceleration signal was decomposed into gravitational and inertial components, and the inertial component of the trunk was subsequently decomposed into rotational and translational components. The accelerometer signals could be reliably reconstructed: mean normalised root mean square (RMS) trunk: 6.5% (range 3-12%), mean RMS thigh: 3% (range 2-5%). The accelerometric signals were highly characteristic and repeatable. The influence of the inertial component was significant, especially on the timing of the specific event of maximum trunk flexion in the accelerometer signal. The effect of inertia was larger in the trunk signal than in the thigh signal and increased with higher speeds. The study provides insight into the acceleration signal, its components and the influence of the type of STS movement and supports its use in STS movement analysis.
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Affiliation(s)
- W G M Janssen
- Department of Rehabilitation Medicine, ErasmusMC (University Medical Center), Rotterdam, The Netherlands.
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Hurkmans HLP, Bussmann JBJ, Selles RW, Horemans HLD, Benda E, Stam HJ, Verhaar JAN. Validity of the Pedar Mobile system for vertical force measurement during a seven-hour period. J Biomech 2004; 39:110-8. [PMID: 16271594 DOI: 10.1016/j.jbiomech.2004.10.028] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2004] [Accepted: 10/29/2004] [Indexed: 11/22/2022]
Abstract
Objective measurement of weight bearing during a long-term period can give insight into the postoperative loading of the lower extremity of orthopedic patients to avoid complications. This study investigated the validity of vertical ground reaction force measurements during a long-term period using the Pedar Mobile insole pressure system, by comparing it with a Kistler force platform. In addition, the validity of a new sensor drift correction algorithm to correct for offset drift in the Pedar signal was evaluated. Ground reaction force data were collected during dynamic and static conditions from five healthy subjects every hour for 7 h. A mean offset drift of 14.6% was found after 7 h. After applying the drift correction algorithm the Pedar system showed a high accuracy for the second peak in the ground reaction force-time curve (1.1 to 3.4% difference, p>0.05) and step duration (-2.0 to 4.4% difference, p>0.05). Less accuracy was found for the first peak in the ground reaction force-time curve (5.2 to 12.0% difference; p<0.05 for the first 3 h, p>0.05 for the last 4 h) and, consequently, in the vertical force impulse (5.5 to 11.0% difference, p>0.05). The Pedar Mobile system appeared to be a valid instrument to measure the vertical force during a long-term period when using the drift correction program described in this study.
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Affiliation(s)
- H L P Hurkmans
- Department of Physical Therapy, Erasmus MC-University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
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Horemans HLD, Nollet F, Beelen A, Drost G, Stegeman DF, Zwarts MJ, Bussmann JBJ, de Visser M, Lankhorst GJ. Pyridostigmine in postpolio syndrome: no decline in fatigue and limited functional improvement. J Neurol Neurosurg Psychiatry 2003; 74:1655-61. [PMID: 14638885 PMCID: PMC1757426 DOI: 10.1136/jnnp.74.12.1655] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the effect of pyridostigmine on fatigue, physical performance, and muscle function in subjects with postpoliomyelitis syndrome. METHODS 67 subjects with increased fatigue and new weakness in one quadriceps muscle showing neuromuscular transmission defects, were included in a randomised, double blind, placebo controlled trial of 60 mg pyridostigmine four times a day for 14 weeks. Primary outcome was fatigue (on the "energy" category of the Nottingham health profile). Secondary outcomes included two minute walking distance and quadriceps strength and jitter. Motor unit size of the quadriceps was studied as a potential effect modifier. The primary data analysis compared the changes from baseline in the outcomes in the last week of treatment between groups. RESULTS 31 subjects treated with pyridostigmine and 31 subjects treated with placebo completed the trial. No significant effect of pyridostigmine was found on fatigue. The walking distance improved more in the pyridostigmine group than in the placebo group (by 7.2 m (6.0%); p<0.01). Subgroup analysis showed that a significant improvement in walking performance was only found in subjects with normal sized motor units. Quadriceps strength improved more in the pyridostigmine group than in the placebo group (by 6.7 Nm (7.2%); p = 0.15). No effect of pyridostigmine was found on jitter. CONCLUSIONS Pyridostigmine in the prescribed dose did not reduce fatigue in subjects with postpoliomyelitis syndrome. However, it may have a limited beneficial effect on physical performance, especially in subjects with neuromuscular transmission defects in normal sized motor units.
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Affiliation(s)
- H L D Horemans
- Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, Netherlands.
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