1
|
Stevens J, de Groot J, Luijmes M, Bouwens J, Rippen H, Hoogervorst-Schilp J, Fuijkschot J. Study protocol of a national multicentre prospective evaluation study assessing the validity and impact of the Dutch Paediatric Early Warning Score (PEWS) in the Netherlands. BMJ Paediatr Open 2024; 8:e002214. [PMID: 38325899 PMCID: PMC10860074 DOI: 10.1136/bmjpo-2023-002214] [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: 08/22/2023] [Accepted: 12/21/2023] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Early recognition of clinical deterioration and timely intervention are important to improve morbidity and mortality in paediatric care. The Paediatric Early Warning Score (PEWS) is a scoring system aiming to identify hospitalised children at risk for deterioration. Currently, there is a large heterogeneity of PEWS systems in the Netherlands, with a considerable number remaining unvalidated or self-designed. Therefore, a consensus-based Dutch PEWS has been developed in a national study using the Core Outcome Measures in Effectiveness Trials initiative. The Dutch PEWS is a uniform system that integrates a core set of vital parameters together with pre-existing risk factors and uses risk stratification to proactively follow-up on patients at risk (so-called 'watcher patients'). This study aims to validate the Dutch PEWS and to determine its impact on improving patient safety in various hospital settings. METHODS AND ANALYSIS This national study will be a large multicentre evaluation study, in which the Dutch PEWS will be implemented and evaluated in 12 hospitals in the Netherlands. In this study, a mixed methods methodology will be used and evaluated on predefined outcome measures. To examine the validity of the Dutch PEWS, statistical analyses will be undertaken on quantitative data retrieved from electronic health records. Surveys among physicians and nurses; semistructured interviews with healthcare providers and parents; and daily evaluation forms are being conducted to determine the impact of the Dutch PEWS. The study is being conducted from December 2020 to June 2024.
Collapse
Affiliation(s)
- Jikke Stevens
- Pediatrics, Radboudumc, Nijmegen, Gelderland, The Netherlands
| | - Janke de Groot
- Kennisinstituut van de Federatie Medisch Specialisten, Utrecht, The Netherlands
| | - Marie Luijmes
- Pediatrics, Radboudumc, Nijmegen, Gelderland, The Netherlands
| | - Janneke Bouwens
- Pediatrics, Radboudumc, Nijmegen, Gelderland, The Netherlands
| | - Hester Rippen
- Stichting Kind En Ziekenhuis, Utrecht, The Netherlands
| | | | | |
Collapse
|
2
|
Verhoeff M, Weil LI, Chu H, Vermeeren Y, de Groot J, Burgers JS, Jeurissen PPT, Zwerwer LR, van Munster BC. Clusters of medical specialties around patients with multimorbidity - employing fuzzy c-means clustering to explore multidisciplinary collaboration. BMC Health Serv Res 2023; 23:975. [PMID: 37689648 PMCID: PMC10492354 DOI: 10.1186/s12913-023-09961-z] [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] [Received: 11/29/2022] [Accepted: 08/24/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Hospital care organization, structured around medical specialties and focused on the separate treatment of individual organ systems, is challenged by the increasing prevalence of multimorbidity. To support the hospitals' realization of multidisciplinary care, we hypothesized that using machine learning on clinical data helps to identify groups of medical specialties who are simultaneously involved in hospital care for patients with multimorbidity. METHODS We conducted a cross-sectional study of patients in a Dutch general hospital and used a fuzzy c-means clustering algorithm for the analysis. We explored the patients' membership degrees in each cluster to identify subgroups of medical specialties that provide care to the same patients with multimorbidity. We used retrospectively collected electronic health record data from 2017. We extracted data from 22,133 patients aged ≥18 years who had received outpatient clinical care for two or more chronic and/ or oncological diagnoses. RESULTS We found six clusters of medical specialties and identified 22 subgroups. The clusters were labeled based on the specialties that most characterized them: 1. dermatology/ plastic surgery, 2. six specialties (gynecology/ rheumatology/ orthopedic surgery/ urology/ gastroenterology/ otorhinolaryngology), 3. pulmonology, 4. internal medicine/ cardiology/ geriatrics, 5. neurology/ physiatry (rehabilitation)/ anesthesiology, and 6. internal medicine. Most patients had a full or dominant membership to one of these clusters of medical specialties (11 subgroups), whereas fewer patients had a membership to two clusters. The prevalence of specific diagnosis groups, patient characteristics, and healthcare utilization differed between subgroups. CONCLUSION Our study shows that clusters and subgroups of medical specialties simultaneously involved in hospital care for patients with multimorbidity can be identified with fuzzy c-means cluster analysis using clinical data. Clusters and subgroups differed regarding the involved medical specialties, diagnoses, patient characteristics, and healthcare utilization. With this strategy, hospitals and medical specialists can further analyze which subgroups are target populations that might benefit from improved multidisciplinary collaboration.
Collapse
Affiliation(s)
- Marlies Verhoeff
- Department of Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Knowledge Institute of the Federation of Medical Specialists, Utrecht, the Netherlands
| | - Liann I Weil
- Department of Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Hung Chu
- Donald Smits Center for Information and Technology, University of Groningen, Groningen, the Netherlands
| | - Yolande Vermeeren
- Department of Internal Medicine, Gelre Hospitals, Apeldoorn/ Zutphen, the Netherlands
| | - Janke de Groot
- Knowledge Institute of the Federation of Medical Specialists, Utrecht, the Netherlands
| | - Jako S Burgers
- Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
| | - Patrick P T Jeurissen
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Leslie R Zwerwer
- Donald Smits Center for Information and Technology, University of Groningen, Groningen, the Netherlands
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Barbara C van Munster
- Department of Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
3
|
Fuijkschot J, Stevens J, Teheux L, de Loos E, Rippen H, Meurs M, de Groot J. Development of the national Dutch PEWS: the challenge against heterogeneity and implementation difficulties of PEWS in the Netherlands. BMC Pediatr 2023; 23:387. [PMID: 37550704 PMCID: PMC10405440 DOI: 10.1186/s12887-023-04219-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/28/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND For the early recognition of deteriorating patients several Pediatric Early Warning Score (PEWS) systems have been developed with the assumption that early detection can prevent further deterioration. Although PEWS are widely being used in hospitals in the Netherlands, there is no national consensus on which score to use and how to embed the score into a PEWS system. This resulted in a substantial heterogeneity of PEWS systems, of which many are unvalidated or self-designed. The primary objective of this study was to develop a pragmatic consensus-based PEWS system that can be utilized in all Dutch hospitals (University Medical Centers, teaching hospitals, and general hospitals). METHODS This study is an iterative mixed-methods study. The methods from the Core Outcome Measures in Effectiveness Trials (COMET) initiative were used and consisted of two Delphi rounds, two inventories set out to all Dutch hospitals and a focus group session with parents. The study was guided by five expert meetings with different stakeholders and a final consensus meeting that resulted in a core PEWS set. RESULTS The first Delphi round was completed by 292 healthcare professionals, consisting of pediatric nurses and physicians. In the second Delphi round 217 healthcare professionals participated. Eventually, the core PEWS set was been developed comprising of the parameters work of breathing, respiratory rate, oxygen therapy, heart rate and capillary refill time, and AVPU (Alert, Verbal, Pain, and Unresponsive). In addition, risk stratification was added to the core set with standardized risk factors consisting of [1] worried signs from healthcare professionals and parents and [2] high-risk treatment, with the option to add applicable local defined risk factors. Lastly, the three categories of risk stratification were defined (standard, medium, and high risk) in combination with standardized actions of the professionals for each category. CONCLUSION This study demonstrates a way to end a country's struggle with PEWS heterogeneity by co-designing a national Dutch PEWS system. Currently, the power of the system is being investigated in a large multi-center study in the Netherlands.
Collapse
Affiliation(s)
- Joris Fuijkschot
- Radboud University Medical Center, Radboudumc Amalia Childrens Hospital, Nijmegen, The Netherlands.
| | - Jikke Stevens
- Radboud University Medical Center, Radboudumc Amalia Childrens Hospital, Nijmegen, The Netherlands
| | - Lara Teheux
- Radboud University Medical Center, Radboudumc Amalia Childrens Hospital, Nijmegen, The Netherlands
| | - Erica de Loos
- Dutch Hospital Association, Utrecht, The Netherlands
| | - Hester Rippen
- Dutch Foundation Child & Hospital, Utrecht, The Netherlands
| | - Maaike Meurs
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Janke de Groot
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Knowledge Institute for Medical Specialists, Utrecht, The Netherlands
| |
Collapse
|
4
|
Verhoeff M, de Groot J, Burgers JS, van Munster BC. Development and internal validation of prediction models for future hospital care utilization by patients with multimorbidity using electronic health record data. PLoS One 2022; 17:e0260829. [PMID: 35298467 PMCID: PMC8929569 DOI: 10.1371/journal.pone.0260829] [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] [Received: 03/24/2021] [Accepted: 11/17/2021] [Indexed: 12/05/2022] Open
Abstract
Objective To develop and internally validate prediction models for future hospital care utilization in patients with multiple chronic conditions. Design Retrospective cohort study. Setting A teaching hospital in the Netherlands (542 beds) Participants All adult patients (n = 18.180) who received care at the outpatient clinic in 2017 for two chronic diagnoses or more (including oncological diagnoses) and who returned for hospital care or outpatient clinical care in 2018. Development and validation using a stratified random split-sample (n = 12.120 for development, n = 6.060 for internal validation). Outcomes ≥2 emergency department visits in 2018, ≥1 hospitalization in 2018 and ≥12 outpatient visits in 2018. Statistical analysis Multivariable logistic regression with forward selection. Results Evaluation of the models’ performance showed c-statistics of 0.70 (95% CI 0.69–0.72) for the hospitalization model, 0.72 (95% CI 0.70–0.74) for the ED visits model and 0.76 (95% 0.74–0.77) for the outpatient visits model. With regard to calibration, there was agreement between lower predicted and observed probability for all models, but the models overestimated the probability for patients with higher predicted probabilities. Conclusions These models showed promising results for further development of prediction models for future healthcare utilization using data from local electronic health records. This could be the first step in developing automated alert systems in electronic health records for identifying patients with multimorbidity with higher risk for high healthcare utilization, who might benefit from a more integrated care approach.
Collapse
Affiliation(s)
- Marlies Verhoeff
- Department of Internal Medicine, University Center of Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands
- Knowledge Institute of the Federation of Medical Specialists, Utrecht, the Netherlands
- * E-mail:
| | - Janke de Groot
- Knowledge Institute of the Federation of Medical Specialists, Utrecht, the Netherlands
| | - Jako S. Burgers
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Barbara C. van Munster
- Department of Internal Medicine, University Center of Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
5
|
Lankhorst K, Sol M, van den Berg-Emons R, Horemans H, de Groot J. The Preliminary Criterion Validity of the Activ8 Activity Monitor to Measure Physical Activity in Youth Using a Wheelchair. Pediatr Phys Ther 2021; 33:268-273. [PMID: 34417429 DOI: 10.1097/pep.0000000000000821] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to assess the criterion validity of the Activ8 to detect "active wheelchair use" and to distinguish 6 types of wheelchair activities using video recordings as a gold standard. METHODS Ten participants who use a manual wheelchair were participants in this study. Data of 2 participants were used for adapting the algorithm and data of 7 participants were used for assessing the criterion validity. RESULTS Criterion validity for detecting "active wheelchair use" had a relative time difference of 7.4%, agreement of 96%, sensitivity of 98.3%, and positive predictive value of 90%. Results for distinguishing 6 types of wheelchair activities had an agreement of 73%, sensitivity of 67.1%, and positive predictive value of 65.5%. CONCLUSIONS The Activ8 is able to detect "active wheelchair use" in youth using a manual wheelchair. Further development of the algorithm is necessary to distinguish between different types of wheelchair activities.
Collapse
Affiliation(s)
- Kristel Lankhorst
- Research Group Lifestyle and Health (Drs Lankhorst, Sol, and de Groot), HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Institute for Human Movement Studies (Dr Lankhorst), HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine (Dr Sol), UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; Department of Rehabilitation Medicine (Drs Berg-Emons and Horemans), Erasmus University Medical Center, Rotterdam, the Netherlands; Knowledge Institute of the Federation of Medical Specialists (Dr de Groot), Utrecht, the Netherlands
| | | | | | | | | |
Collapse
|
6
|
Lankhorst K, Takken T, Zwinkels M, van Gaalen L, Velde ST, Backx F, Verschuren O, Wittink H, de Groot J. Sports Participation, Physical Activity, and Health-Related Fitness in Youth With Chronic Diseases or Physical Disabilities: The Health in Adapted Youth Sports Study. J Strength Cond Res 2021; 35:2327-2337. [PMID: 31210643 DOI: 10.1519/jsc.0000000000003098] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Lankhorst, K, Takken, T, Zwinkels, M, van Gaalen, L, Velde, St, Backx, F, Verschuren, O, Wittink, H, and de Groot, J. Sports participation, physical activity, and health-related fitness in youth with chronic diseases or physical disabilities: the health in adapted youth sports study. J Strength Cond Res 35(8): 2327-2337, 2021-Youth with chronic diseases or physical disabilities (CDPD) often show reduced fitness and physical activity (PA) levels and participate less in organized sports compared with healthy peers. The purpose of this study was to examine the associations between participation in sports and health-related fitness and PA in youth with CDPD. A total of 163 subjects (mean age 14 years; range 8-19 years) with CDPD were included in this cross-sectional study, with 81 participating in organized sports and 82 not. Subjects were recruited between October 2014 and November 2016. Aerobic and anaerobic fitness, agility, and muscle strength were assessed in the laboratory, whereas PA was monitored in daily life using accelerometry during 1 week. Linear regression analyses were used to assess the associations of sports participation (independent variable) with health-related fitness and PA (dependent variables). Results show that youth with CDPD participating in organized sports 2 times a week performed better on all outcome measures. They reached a higher peak oxygen uptake (difference of 4.9 ml O2·kg-1·min-1, P = 0.001) compared with their peers not participating in sports. Also, anaerobic fitness, agility, muscle strength, and PA were all positively associated with sports participation. Moreover, the association between sports participation and aerobic fitness was mediated by PA for 31% (P = 0.045). In conclusion, participation in sports is associated with both higher levels of PA and health-related fitness in youth with CDPD. Promotion and stimulation of participation in sports seems a good way to promote health-related fitness as well as a healthy active lifestyle in youth with CDPD.
Collapse
Affiliation(s)
- Kristel Lankhorst
- Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tim Takken
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maremka Zwinkels
- Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands ; and
| | - Leendert van Gaalen
- Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
| | - Saskia Te Velde
- Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
| | - Frank Backx
- Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Olaf Verschuren
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands ; and
| | - Harriet Wittink
- Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
| | - Janke de Groot
- Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
- Netherlands Institute for Healthcare Services Research (NIVEL), Utrecht, the Netherlands
| |
Collapse
|
7
|
Smits M, Langelaan M, de Groot J, Wagner C. Examining Causes and Prevention Strategies of Adverse Events in Deceased Hospital Patients: A Retrospective Patient Record Review Study in the Netherlands. J Patient Saf 2021; 17:282-289. [PMID: 30896559 DOI: 10.1097/pts.0000000000000586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To improve patient safety and possibly prevent mortality from adverse events (AEs) in hospitals, it is important to gain insight in their underlying causes. We aimed to examine root causes and potential prevention strategies of AEs in deceased hospital patients. METHODS Data on 571 AEs were used from two retrospective patient record review studies of patients who died during hospitalization in the Netherlands. Trained reviewers assessed contributing factors and potential prevention strategies. The results were analyzed together with data on preventability of the AE and the relationship of the AE with the death of the patient. RESULTS In 47% of the AEs, patient-related causes were identified, in 35% human causes, in 9% organizational causes, and in 3% technical causes. Preventable AEs were caused by technical, organizational, and human causes (78%, 74%, and 74%, respectively) more often than by patient-related causes (33%). In addition, technical factors caused AEs leading to preventable death (78%) relatively often. Recommended strategies to prevent AEs were quality assurance/peer review, evaluation of safety behavior, improving procedures, and improving information and communication structures. CONCLUSIONS Human failures played an important role in the causation of AEs in Dutch hospitals, because they occurred frequently and they were frequently the cause of preventable AEs. To a lesser extent, latent organizational and technical factors were identified. Patient-related factors were often identified, but the preventability of the AEs with these causes was low. For future research into causes of AEs, we recommend combining record review with interviewing.
Collapse
Affiliation(s)
| | - Maaike Langelaan
- From the Nivel, Netherlands Institute for Health Services Research, Utrecht
| | - Janke de Groot
- From the Nivel, Netherlands Institute for Health Services Research, Utrecht
| | | |
Collapse
|
8
|
Lankhorst K, de Groot J, Takken T, Backx F. Sports participation related to injuries and illnesses among ambulatory youth with chronic diseases: results of the health in adapted youth sports study. BMC Sports Sci Med Rehabil 2020; 11:36. [PMID: 31890227 PMCID: PMC6915977 DOI: 10.1186/s13102-019-0145-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/21/2019] [Indexed: 12/22/2022]
Abstract
Background Although sports participation leads to important health enhancement for youth with chronic diseases or physical disabilities (CDPD), it may pose an increased risk for injury or illness. This study investigated the incidence, type, severity and risks to (sports-related) injuries and illnesses among ambulatory youth with CDPD. Methods Over a 12-month period, every 2 weeks, the characteristics of injuries and illnesses were registered by an online questionnaire and phone-based interview. Physical activity level was measured with the Activ8 during 1 week. Complete data was available of 103 youngsters with CDPD (61 boys, 42 girls), with a mean age of 14.4 (SD = 2.7) years. The personal characteristics, the injury and illness rates per 1000 h of PA were investigated per group of organized sports participation per week (0, 1 or ≥ 2 times p/wk). Results Almost half of the youngsters sustained one or more injuries (46%) or illnesses (42%) during 1 year. The injury rate per 1000 h of PA between 0, 1 and ≥ 2 times per week of sports participation was 0.84, 1.88, 133 respectively and the illness rate were 1.87, 1.88 and 1.18 respectively. Differences between the rates were not statically significant. Most reported health problems had no subsequent restriction (49%) or other minor consequences (21%) in school, physical education or sports participation. Most reported health problems were contusions (41%) at the lower extremity (74%) and flu plus fever (58%). Conclusions Participation in sports ≥2 times per week does not pose a significant increased risk in the incidence of injury or illness per 1000 h of PA in youth with CDPD compared to their peers who participate less frequent (once weekly) and compared to non-sports participants. Athletes who participate in sports at least twice weekly get injured mostly during their sporting activities, while peers who do participate in sports once a week or not at all, get injured during less intense physical activities during physical eduction lessons, ADL or non-organized sports and play in leisure time. The social impact of injuries or illnesses was limited.
Collapse
Affiliation(s)
- Kristel Lankhorst
- 1Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, P.O. Box 85083, 3508AB, Utrecht, The Netherlands.,2Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Janke de Groot
- 1Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, P.O. Box 85083, 3508AB, Utrecht, The Netherlands.,3Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.,4Netherlands Institute for Healthcare Services Research (NIVEL), Utrecht, the Netherlands
| | - Tim Takken
- 3Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Frank Backx
- 2Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | | |
Collapse
|
9
|
Zwinkels M, Ketelaar M, Nijboer T, Verschuren O, Te Velde S, de Groot J, Takken T, Visser-Meily A. Effects of a school-based sports program on psychosocial health and attention in youth with physical disabilities. J Pediatr Rehabil Med 2020; 13:37-46. [PMID: 32176664 DOI: 10.3233/prm-180570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Youth with physical disabilities have lower psychosocial health and attention compared to their typically developing peers. Recent research has shown positive associations between sports participation and these outcomes. The purpose of the current study was to explore whether a school-based sports program affects psychosocial health and attention in youth with physical disabilities. METHODS Seventy children and adolescents (mean age (SD) 13.8 (2.9) years, aged 8-19 years, 54% boys) with physical disabilities were included in this quasi-experimental study from schools for special education. The sports group (n= 31) followed a school-based sports program (45 min/week) for six months. The control group followed the regular curriculum. Psychosocial health was assessed with self-perception (Self-Perception Profile for Children) and quality of life (DISABKIDS Chronic Generic Measure, DCGM-37). Attention was measured with experimental tasks on search efficiency, sustained attention, and distractibility. RESULTS Linear regression analyses revealed no differences between the sports and control group for self-perception, quality of life, and attention. CONCLUSION A school-based sports program seems to have no effect on psychosocial health and attention in youth with physical disabilities. Research into the important factors influencing these variables is needed before further resources can be given to improve sports participation for increasing psychosocial health and attention.
Collapse
Affiliation(s)
- Maremka Zwinkels
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Tanja Nijboer
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | | | - Janke de Groot
- HU University of Applied Sciences, Utrecht, The Netherlands
| | - Tim Takken
- Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anne Visser-Meily
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
10
|
Lankhorst K, Oerbekke M, van den Berg-Emons R, Takken T, de Groot J. Instruments Measuring Physical Activity in Individuals Who Use a Wheelchair: A Systematic Review of Measurement Properties. Arch Phys Med Rehabil 2019; 101:535-552. [PMID: 31606452 DOI: 10.1016/j.apmr.2019.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 04/05/2019] [Revised: 08/31/2019] [Accepted: 09/06/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To systematically review the evidence evaluating validity or reliability of self-reported and device-based instruments, to measure physical activity (PA) in individuals who use a wheelchair, and to make recommendations for the selection of PA outcomes tools. DATA SOURCES PubMed, Embase, and CINAHL were systematically searched. STUDY SELECTION Studies reporting measurement properties of instruments to assess PA in individuals who use a wheelchair. DATA EXTRACTION The Consensus-Based Standards for the Selection of Health Status Measurement Instruments checklist was used to assess the methodological quality of the included studies. The measurement properties of instruments assessing PA were examined. DATA SYNTHESIS The search yielded 5341 records, 61 were considered relevant, 21 articles were included. A best evidence synthesis was performed on 9 studies including 4 self-reported instruments and 13 studies including 8 device-based instruments. One study evaluated both self-reported and device-based instruments. The overall methodological quality of all studies ranged from poor to excellent. Variable levels of evidence were found for both the validity and reliability for self-reported instruments and for criterion validity for device-based instruments. CONCLUSIONS The Physical Activity Scale for Individuals with Disabilities (PASIPD) and The Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) seem the most promising self-reported instruments for measuring the intensity of PA. Device-based instruments that can be used for measuring both the intensity and type of PA are the GENEActiv, Actigraph GT3X+, Actiheart, or the Physical Activity Monitor System (PAMS), showing moderate evidence for a positive rating of criterion validity. For measuring the type of PA, the PAMS and VitaMove are suitable, showing both good evidence for a positive rating of criterion validity.
Collapse
Affiliation(s)
- Kristel Lankhorst
- Research Group Lifestyle and Health, Hogeschool Utrecht, University of Applied Sciences, Utrecht; Shared Utrecht Pediatric Exercise Laboratory, Utrecht.
| | | | - Rita van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus Medical Center, University Medical Centre Rotterdam
| | - Tim Takken
- University Medical Center Utrecht, Wilhelmina Children's Hospital Utrecht; Shared Utrecht Pediatric Exercise Laboratory, Utrecht
| | - Janke de Groot
- Research Group Lifestyle and Health, Hogeschool Utrecht, University of Applied Sciences, Utrecht; Shared Utrecht Pediatric Exercise Laboratory, Utrecht; Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| |
Collapse
|
11
|
Te Velde SJ, Lankhorst K, Zwinkels M, Verschuren O, Takken T, de Groot J. Associations of sport participation with self-perception, exercise self-efficacy and quality of life among children and adolescents with a physical disability or chronic disease-a cross-sectional study. Sports Med Open 2018; 4:38. [PMID: 30112621 PMCID: PMC6093823 DOI: 10.1186/s40798-018-0152-1] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 07/27/2018] [Indexed: 12/13/2022]
Abstract
Background Little evidence is available about how sports participation influences psychosocial health and quality of life in children and adolescents with a disability or chronic disease. Therefore, the aim of the current study is to assess the association of sports participation with psychosocial health and with quality of life, among children and adolescents with a disability. Methods In a cross-sectional study, 195 children and adolescents with physical disabilities or chronic diseases (11% cardiovascular, 5% pulmonary, 8% metabolic, 8% musculoskeletal/orthopaedic, 52% neuromuscular and 9% immunological diseases and 1% with cancer), aged 10–19 years, completed questionnaires to assess sports participation, health-related quality of life (DCGM-37), self-perceptions and global self-worth (SPPC or SPPA) and exercise self-efficacy. Results Regression analyses showed that those who reported to participate in sports at least twice a week had more beneficial scores on the various indicators compared to their peers who did not participate in sport or less than twice a week. Those participating in sports scored better on all scales of the DCGM-37 scale, on the scales for feelings of athletic competence and children but not adolescents participating in sports reported greater social acceptance. Finally, we found a strong association between sport participation and exercise self-efficacy. Conclusions This study provides the first indications that participating in sports is beneficial for psychosocial health among children and adolescents with a disability. However, more insight is needed in the direction of the relationships.
Collapse
Affiliation(s)
| | | | - Maremka Zwinkels
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Tim Takken
- Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Janke de Groot
- University of Applied Sciences, Utrecht, the Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | | |
Collapse
|
12
|
Wittink H, Verschuren O, Terwee C, de Groot J, Kwakkel G, van de Port I. Measurement properties of maximal cardiopulmonary exercise tests protocols in persons after stroke: A systematic review. J Rehabil Med 2018; 49:689-699. [PMID: 28862313 DOI: 10.2340/16501977-2260] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To systematically review and critically appraise the literature on measurement properties of cardiopulmonary exercise test protocols for measuring aerobic capacity, VO2max, in persons after stroke. DATA SOURCES PubMed, Embase and Cinahl were searched from inception up to 15 June 2016. A total of 9 studies were identified reporting on 9 different cardiopulmonary exercise test protocols. STUDY SELECTION VO2max measured with cardiopulmonary exercise test and open spirometry was the construct of interest. The target population was adult persons after stroke. We included all studies that evaluated reliability, measurement error, criterion validity, content validity, hypothesis testing and/or responsiveness of cardiopulmonary exercise test protocols. DATA EXTRACTION Two researchers independently screened the literature, assessed methodological quality using the COnsensus-based Standards for the selection of health Measurement INstruments checklist and extracted data on measurement properties of cardiopulmonary exercise test protocols. DATA SYNTHESIS Most studies reported on only one measurement property. Best-evidence synthesis was derived taking into account the methodological quality of the studies, the results and the consistency of the results. CONCLUSION No judgement could be made on which protocol is "best" for measuring VO2max in persons after stroke due to lack of high-quality studies on the measurement properties of the cardiopulmonary exercise test.
Collapse
Affiliation(s)
- Harriet Wittink
- Research Group Lifestyle and Health, Utrecht University of Applied Sciences, 3584 CS, Utrecht, The Netherlands.
| | | | | | | | | | | |
Collapse
|
13
|
Zwinkels M, Verschuren O, Balemans A, Lankhorst K, Te Velde S, van Gaalen L, de Groot J, Visser-Meily A, Takken T. Effects of a School-Based Sports Program on Physical Fitness, Physical Activity, and Cardiometabolic Health in Youth With Physical Disabilities: Data From the Sport-2-Stay-Fit Study. Front Pediatr 2018; 6:75. [PMID: 29632853 PMCID: PMC5879083 DOI: 10.3389/fped.2018.00075] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/12/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To investigate the effects of a school-based once-a-week sports program on physical fitness, physical activity, and cardiometabolic health in children and adolescents with a physical disability. METHODS This controlled clinical trial included 71 children and adolescents from four schools for special education [mean age 13.7 (2.9) years, range 8-19, 55% boys]. Participants had various chronic health conditions including cerebral palsy (37%), other neuromuscular (44%), metabolic (8%), musculoskeletal (7%), and cardiovascular (4%) disorders. Before recruitment and based on the presence of school-based sports, schools were assigned as sport or control group. School-based sports were initiated and provided by motivated experienced physical educators. The sport group (n = 31) participated in a once-a-week school-based sports program for 6 months, which included team sports. The control group (n = 40) followed the regular curriculum. Anaerobic performance was assessed by the Muscle Power Sprint Test. Secondary outcome measures included aerobic performance, VO2 peak, strength, physical activity, blood pressure, arterial stiffness, body composition, and the metabolic profile. RESULTS A significant improvement of 16% in favor of the sport group was found for anaerobic performance (p = 0.003). In addition, the sport group lost 2.8% more fat mass compared to the control group (p = 0.007). No changes were found for aerobic performance, VO2 peak, physical activity, blood pressure, arterial stiffness, and the metabolic profile. CONCLUSION Anaerobic performance and fat mass improved following a school-based sports program. These effects are promising for long-term fitness and health promotion, because sports sessions at school eliminate certain barriers for sports participation and adding a once-a-week sports session showed already positive effects for 6 months. CLINICAL TRIAL REGISTRATION This trial was registered with the Dutch Trial Registry (NTR4698).
Collapse
Affiliation(s)
- Maremka Zwinkels
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Sports, De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Astrid Balemans
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Public Health, VU University Amsterdam, Amsterdam, Netherlands
| | | | - Saskia Te Velde
- HU University of Applied Sciences Utrecht, Utrecht, Netherlands
| | | | - Janke de Groot
- HU University of Applied Sciences Utrecht, Utrecht, Netherlands.,Netherlands Institute for Health Services Research, Utrecht, Netherlands.,Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Anne Visser-Meily
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Tim Takken
- Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, Netherlands
| |
Collapse
|
14
|
Bloemen M, Van Wely L, Mollema J, Dallmeijer A, de Groot J. Evidence for increasing physical activity in children with physical disabilities: a systematic review. Dev Med Child Neurol 2017; 59:1004-1010. [PMID: 28374442 DOI: 10.1111/dmcn.13422] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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] [Accepted: 01/20/2017] [Indexed: 11/27/2022]
Abstract
AIM To summarize the best evidence of interventions for increasing physical activity in children with physical disabilities. METHOD A systematic review was conducted using an electronic search executed in Academic Search Elite, Academic Search Premier, CINAHL, Embase, MEDLINE, PEDro, PsychINFO, and SPORTDiscus up to February 2016. The selection of articles was performed independently by two researchers according to predetermined eligibility criteria. Data extraction, methodological quality, and levels of evidence were independently assessed by two researchers using a data-collection form from the Cochrane Collaboration and according to the guidelines of the American Academy for Cerebral Palsy and Developmental Medicine. RESULTS Seven studies were included. Five randomized controlled trials ranged from strong level I to weak level II studies, and two pre-post design studies were classified as level IV. There is level I evidence for no effect of physical training on objectively measured physical activity, conflicting level II evidence for interventions with a behavioural component on the increase of objectively measured physical activity directly after the intervention, and level II evidence for no effect during follow-up. Results are limited to children with cerebral palsy as no other diagnoses were included. INTERPRETATION Increasing physical activity in children with physical disabilities is very complex and demands further development and research.
Collapse
Affiliation(s)
- Manon Bloemen
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Leontien Van Wely
- Department of Rehabilitation Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Jurgen Mollema
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Annet Dallmeijer
- Department of Rehabilitation Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Janke de Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands.,Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| |
Collapse
|
15
|
Haapala EA, Lankhorst K, de Groot J, Zwinkels M, Verschuren O, Wittink H, Backx FJ, Visser-Meily A, Takken T. The associations of cardiorespiratory fitness, adiposity and sports participation with arterial stiffness in youth with chronic diseases or physical disabilities. Eur J Prev Cardiol 2017; 24:1102-1111. [PMID: 28374647 PMCID: PMC5495431 DOI: 10.1177/2047487317702792] [Citation(s) in RCA: 21] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The evidence on the associations of cardiorespiratory fitness, body adiposity and sports participation with arterial stiffness in children and adolescents with chronic diseases or physical disabilities is limited. Methods Altogether 140 children and adolescents with chronic diseases or physical disabilities participated in this cross-sectional study. Cardiorespiratory fitness was assessed using maximal exercise test with respiratory gas analyses either using shuttle run, shuttle ride, or cycle ergometer test. Cardiorespiratory fitness was defined as peak oxygen uptake by body weight or fat-free mass. Body adiposity was assessed using waist circumference, body mass index standard deviation score and body fat percentage. Sports participation was assessed by a questionnaire. Aortic pulse wave velocity and augmentation index were assessed by a non-invasive oscillometric tonometry device. Results Peak oxygen uptake/body weight (standardised regression coefficient β −0.222, 95% confidence interval (CI) −0.386 to −0.059, P = 0.002) and peak oxygen uptake/fat-free mass (β −0.173, 95% CI −0.329 to −0.017, P = 0.030) were inversely and waist circumference directly (β 0.245, 95% CI 0.093 to 0.414, P = 0.002) associated with aortic pulse wave velocity. However, the associations of the measures of cardiorespiratory fitness with aortic pulse wave velocity were attenuated after further adjustment for waist circumference. A higher waist circumference (β −0.215, 95% CI −0.381 to −0.049, P = 0.012) and a higher body mass index standard deviation score (β 0.218, 95% CI −0.382 to −0.054, P = 0.010) were related to lower augmentation index. Conclusions Poor cardiorespiratory fitness and higher waist circumference were associated with increased arterial stiffness in children and adolescents with chronic diseases and physical disabilities. The association between cardiorespiratory fitness and arterial stiffness was partly explained by waist circumference.
Collapse
Affiliation(s)
- Eero A Haapala
- 1 Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.,2 Institute of Biomedicine, University of Eastern Finland, Finland.,3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands
| | - Kristel Lankhorst
- 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
| | - Janke de Groot
- 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.,4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
| | - Maremka Zwinkels
- 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.,6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands
| | - Olaf Verschuren
- 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.,6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands
| | - Harriet Wittink
- 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands
| | - Frank Jg Backx
- 7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands
| | - Anne Visser-Meily
- 6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands.,7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands
| | - Tim Takken
- 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
| | | |
Collapse
|
16
|
Lankhorst K, van der Ende-Kastelijn K, de Groot J, Zwinkels M, Verschuren O, Backx F, Visser-Meily A, Takken T. Health in Adapted Youth Sports Study (HAYS): health effects of sports participation in children and adolescents with a chronic disease or physical disability. Springerplus 2015; 4:796. [PMID: 26702385 PMCID: PMC4688297 DOI: 10.1186/s40064-015-1589-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 12/04/2015] [Indexed: 12/04/2022]
Abstract
Background In typically developing children, participation in sports has been proven to be positively correlated to both physical and psychosocial health outcomes. In children and adolescents with a physical disability or chronic disease participation in both recreational and competitive sports is often reduced, while for this population an active lifestyle may be even more important in reaching optimal levels of physical and psychosocial health. Therefore, the aim of the Health in Adapted Youth Sports (HAYS) Study is to determine both negative and positive effects of sports on children and adolescents with a chronic disease or physical disability. Methods In this cross-sectional study differences will be compared in regards to physical and psychosocial health, cognitive functioning, school performance, daily physical activity and injuries between children and adolescents with a chronic disease or physical disability who participate in sports and those who do not. Children and adolescents, both ambulatory and wheelchair dependent, in the age of 10–19 years with a physical disability or chronic disease will be included. “Sports” is defined as participation in an organized sport at least two times a week for a duration of 3 months or more prior to the assessment. Parametric and non-parametric statistics will be used to determine the differences between the two groups. Discussion This study provides insight in the effects of sports participation in relation to health, psychosocial functioning, physical activity and school performance in children and adolescents (10–19 years) with a chronic disease or physical disability. Results will guide healthcare professionals working with these children to better guide this population in reaching optimal levels of health and physical activity levels.
Collapse
Affiliation(s)
- Kristel Lankhorst
- Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, The Netherlands ; Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, The Netherlands
| | - Karin van der Ende-Kastelijn
- Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, The Netherlands ; Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, The Netherlands
| | - Janke de Groot
- Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, The Netherlands ; Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, The Netherlands
| | - Maremka Zwinkels
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, The Netherlands ; Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University of Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Olaf Verschuren
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, The Netherlands ; Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University of Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands ; Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank Backx
- Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anne Visser-Meily
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University of Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands ; Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tim Takken
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, The Netherlands ; Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. Box 85090, 3508AB Utrecht, The Netherlands
| | | |
Collapse
|
17
|
Zwinkels M, Verschuren O, Lankhorst K, van der Ende-Kastelijn K, de Groot J, Backx F, Visser-Meily A, Takken T. Sport-2-Stay-Fit study: Health effects of after-school sport participation in children and adolescents with a chronic disease or physical disability. BMC Sports Sci Med Rehabil 2015; 7:22. [PMID: 26445674 PMCID: PMC4594646 DOI: 10.1186/s13102-015-0016-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 09/23/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Children and adolescents with a chronic disease or physical disability have lower fitness levels compared to their non-disabled peers. Low physical fitness is associated with reduced physical activity, increased cardiovascular diseases, and lower levels of both cognitive and psychosocial functioning. Moreover, children and adolescents with a chronic disease or physical disability participate less in both recreational and competitive sports. A variety of intervention studies have shown positive, but only temporary, effects of training programs. Next to issues related to the chronic condition itself, various personal and environmental factors play a key role in determining the extent to which they participate in sports or physical activities. Due to these barriers, sport participation in the immediate after-school hours seems to be a feasible solution to get these children and adolescents physical active structurally. To investigate if an after school sport program can sustain the positive effects of an intervention, a standardized interval training will be given to improve physical fitness levels. High-intensity Interval Training (HIT) is superior to moderate-intensity continuous training in improving physical fitness in patients with chronic diseases. Therefore, the Sport-2-Stay-Fit study will investigate whether after school sport participation can increase the sustainability of a HIT program in children and adolescents with a chronic disease or physical disability. METHODS The Sport-2-Stay-Fit study is a clinical controlled trial. A total of 74 children and adolescents in the age of 6-19 years with a chronic disease or physical disability will be included. This could be either a cardiovascular, pulmonary, metabolic, musculoskeletal or neuromuscular disorder. Both children and adolescents who are ambulatory or propelling a manual wheelchair will be included. All participants will follow a HIT program of eight weeks to improve their physical fitness level. Thereafter, the intervention group will participate in sport after school for six months, while the control group receives assessment only. Measurements will take place before the HIT, directly after, as well as, six months later. The primary objective is anaerobic fitness. Secondary objectives are agility, aerobic fitness, strength, physical activity, cardiovascular health, cognitive functioning, and psychosocial functioning. DISCUSSION If effective, after school sport participation following a standardized interval training could be implemented on schools for special education to get children and adolescents with a chronic disease or physical disability active on a structural basis. TRIAL REGISTRATION This trial is registered at the Dutch Trial Register #NTR4698.
Collapse
Affiliation(s)
- Maremka Zwinkels
- Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands ; Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands ; Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands
| | - Kristel Lankhorst
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands ; Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
| | - Karin van der Ende-Kastelijn
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands ; Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
| | - Janke de Groot
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands ; Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
| | - Frank Backx
- Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anne Visser-Meily
- Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands ; Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tim Takken
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands ; Child Development and Exercise Center, University Medical Center Utrecht, Wilhelmina Children's Hospital, P.O. Box 85090, 3508 AB Utrecht, the Netherlands
| | | |
Collapse
|
18
|
Wittink H, Takken T, de Groot J, Reneman M, Peters R, Vanhees L. Assessing peak aerobic capacity in Dutch law enforcement officers. Int J Occup Med Environ Health 2015; 28:519-31. [DOI: 10.13075/ijomeh.1896.00369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|