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Van Ginderdeuren F, Vandenplas Y, Deneyer M, Vanlaethem S, Buyl R, Kerckhofs E. Effectiveness of airway clearance techniques in children hospitalized with acute bronchiolitis. Pediatr Pulmonol 2017; 52:225-231. [PMID: 27254132 DOI: 10.1002/ppul.23495] [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] [Received: 11/09/2015] [Revised: 05/05/2016] [Accepted: 05/13/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of two airway clearance techniques (ACT's) in children <24 months hospitalized with mild to moderate bronchiolitis. DESIGN One hundred and three children were randomly allocated to receive one 20-min session daily, either assisted autogenic drainage (AAD), intrapulmonary percussive ventilation (IPV), or bouncing (B) (control group), ninety-three finished the study. OUTCOME MEASURES Mean time to recovery in days was our primary outcome measure. The impact of the treatment and the daily improvement was also assessed by a validated clinical and respiratory severity score (WANG score), heart rate (HR), and oxygen saturation (SaO2 ). RESULTS Mean time to recovery was 4.5 ± 1.9 days for the control group, 3.6 ± 1.4 days, P < 0.05 for the AAD group and 3.5 ± 1.3 days, P = 0.03 for the IPV group. Wang scores improved significantly for both physiotherapy techniques compared to the control group. CONCLUSION Both ACT's reduced significantly the length of hospital stay compared to no physiotherapy. Pediatr Pulmonol. 2017;52:225-231. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- F Van Ginderdeuren
- Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels 1090, Belgium.,Department of Physiotherapy, UZ Brussel, Brussels, Belgium
| | - Y Vandenplas
- Department of Pediatrics, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Deneyer
- Department of Pediatrics, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - S Vanlaethem
- Department of Physiotherapy, UZ Brussel, Brussels, Belgium
| | - R Buyl
- Information Research Group, Department of Public Health, Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium
| | - E Kerckhofs
- Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels 1090, Belgium
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Van Ginderdeuren F, Kerckhofs E, Deneyer M, Vanlaethem S, Buyl R, Vandenplas Y. Influence of intrapulmonary percussive ventilation in upright position on gastro-oesophageal reflux in infants. Pediatr Pulmonol 2016; 51:1065-1071. [PMID: 26915299 DOI: 10.1002/ppul.23400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 10/05/2015] [Revised: 12/07/2015] [Accepted: 01/31/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To determine the influence of physiotherapy using intrapulmonary percussive ventilation on gastro-oesophageal reflux (GOR) in infants <1 year. METHODS In this controlled trial with intra-subject design, children were studied using multichannel intraluminal impedance pH (pH-MII) monitoring over 24 hr, during which they received one 20-min session of intrapulmonary percussive ventilation in upright position (IPVR ), 2 hr after their latest feeding. Two hours after each feeding, the number of reflux episodes (RE) over a 20-min period was registered for each infant and a mean per 20 min was calculated in order to obtain a baseline value. The number of RE during IPVR intervention was compared to baseline. RESULTS Fifty infants with a median age of 133 days were recruited of whom 21 were diagnosed with pathological GOR. During IPVR , the incidence of RE in the entire group was significantly lower compared to baseline; median (inter-quartile range [IQR]) 0 (0-1) versus 0.71 (0-1.33) RE, respectively, P = 0.003. The subgroup with abnormal GOR showed also a significant decrease of RE during IPVR ; median (IQR) 0 (0-1) versus 1.17 (0.55-2.16) RE, respectively, P = 0.03. No difference was detected in the group with normal reflux; median (IQR) 0.6 (0-1) compared to 0 (0-1) RE, respectively, P = 0.34. CONCLUSION IPVR does not induce, nor aggravate GOR in infants without and with pathological GOR, respectively, but on the contrary decreases the number of RE in patients with pathological reflux. Pediatr Pulmonol. 2016;51:1065-1071. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- F Van Ginderdeuren
- Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. .,Department of Physiotherapy, UZ Brussel, Brussels, Belgium.
| | - E Kerckhofs
- Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Deneyer
- Department of Pediatrics, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - S Vanlaethem
- Department of Physiotherapy, UZ Brussel, Brussels, Belgium
| | - R Buyl
- Department of Public Health, Biostatistics and Medical Informatics, Information Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Y Vandenplas
- Department of Pediatrics, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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Abstract
Objective: To evaluate the psychometric properties of the Modified Fatigue Impact Scale (MFIS) in four different European countries. Methods: Individuals with definite multiple sclerosis (MS) were selected from centres in Italy (n=50), Spain (n=30), Slovenia (n=50) and Belgium (n=51) and completed the MFIS and the Fatigue Severity Scale (FSS) twice (interval ≤ 3 days). Results: In all four samples, the MFIS demonstrated a good reproducibility (intraclass correlation coefficient ≥ 0.84), with no significant differences between countries (P=0.77). Moderate correlations were found between the MFIS and FSS. No significant correlations were found between the MFIS and age, gender, type of MS, duration of the disease or EDSS score. Factor analysis of all samples (n=181) could not completely confirm the original assumptions concerning the physical, cognitive and psychosocial component. The total score, the physical and the cognitive subscale of the scale were homogeneous (Cronbach’s alpha 0.92, 0.88 and 0.92, respectively), but the psychosocial subscale had a Cronbach’s alpha of 0.65. Conclusions: No cultural or linguistic differences were found in the psychometric properties of the Belgian, Italian, Slovenian or Spanish version of the MFIS. We recommend this scale for research purposes and in clinical practice. Due to the limited value of the psychosocial subscale, we recommend interpreting this subscale with caution.
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Affiliation(s)
- D Kos
- Department Physical Therapy, Rehabilitation Research, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.
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Gatti R, Agosta F, Sarasso E, Gemma M, Meani A, Volonté M, Cattrysse E, Kerckhofs E, Falini A, Comi G, Filippi M. Brain structural and functional changes after action observation therapy addressed to freezing of gait of subjects with Parkinson's disease. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3229] [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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Swinnen E, Baeyens JP, Van Nieuwenhoven J, Ilsbroukx S, Michielsen M, Clijsen R, Buyl R, Goossens M, Knaepen K, Meeusen R, Kerckhofs E. Neurological gait rehabilitation: the influence of walking speed, body weight support and robot assistance on the trunk and pelvis kinematics. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1428] [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: 11/24/2022]
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Gatti R, Rocca M, Fumagalli S, Cattrysse E, Kerckhofs E, Filippi M. Mirror neuron system recruitment during observation and simultaneous observation and execution of tasks with different characteristics. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3227] [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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Heremans E, Nieuwboer A, Spildooren J, Vandenbossche J, Deroost N, Soetens E, Kerckhofs E, Vercruysse S. Cognitive aspects of freezing of gait in Parkinson’s disease: a challenge for rehabilitation. J Neural Transm (Vienna) 2013; 120:543-57. [DOI: 10.1007/s00702-012-0964-y] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 12/19/2012] [Indexed: 10/27/2022]
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Vandenbossche J, Deroost N, Soetens E, Coomans D, Spildooren J, Vercruysse S, Nieuwboer A, Kerckhofs E. Freezing of gait in Parkinson's disease: disturbances in automaticity and control. Front Hum Neurosci 2013; 6:356. [PMID: 23335895 PMCID: PMC3541536 DOI: 10.3389/fnhum.2012.00356] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [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: 10/19/2012] [Accepted: 12/24/2012] [Indexed: 11/13/2022] Open
Abstract
Recent studies emphasize a key role of controlled operations, such as set-shifting and inhibition, in the occurrence of freezing of gait (FOG) in Parkinson's disease (PD). However, FOG can also be characterized as a de-automatization disorder, showing impairments in both the execution and acquisition of automaticity. The observed deficits in automaticity and executive functioning indicate that both processes are malfunctioning in freezers. Therefore, to explain FOG from a cognitive-based perspective, we present a model describing the pathways involved in automatic and controlled processes prior to a FOG episode. Crucially, we focus on disturbances in automaticity and control, regulated by the frontostriatal circuitry. In complex situations, non-freezing PD patients may compensate for deficits in automaticity by switching to increased cognitive control. However, as both automatic and controlled processes are more severely impaired in freezers, this hampers cognitive compensation in FOG, resulting in a potential breakdown. Future directions for cognitive rehabilitation are proposed, based on the cognitive model we put forward.
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Affiliation(s)
- Jochen Vandenbossche
- Cognitive Psychology, Vrije Universiteit BrusselBrussels, Belgium
- Neurological Rehabilitation, Vrije Universiteit BrusselBrussels, Belgium
- Center for Neurosciences, Vrije Universiteit BrusselBrussels, Belgium
| | - N. Deroost
- Cognitive Psychology, Vrije Universiteit BrusselBrussels, Belgium
- Center for Neurosciences, Vrije Universiteit BrusselBrussels, Belgium
| | - E. Soetens
- Cognitive Psychology, Vrije Universiteit BrusselBrussels, Belgium
- Center for Neurosciences, Vrije Universiteit BrusselBrussels, Belgium
| | - D. Coomans
- Cognitive Psychology, Vrije Universiteit BrusselBrussels, Belgium
| | - J. Spildooren
- Department of Rehabilitation Sciences, Katholieke Universiteit LeuvenLeuven, Belgium
| | - S. Vercruysse
- Department of Rehabilitation Sciences, Katholieke Universiteit LeuvenLeuven, Belgium
| | - A. Nieuwboer
- Department of Rehabilitation Sciences, Katholieke Universiteit LeuvenLeuven, Belgium
| | - E. Kerckhofs
- Neurological Rehabilitation, Vrije Universiteit BrusselBrussels, Belgium
- Center for Neurosciences, Vrije Universiteit BrusselBrussels, Belgium
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Vandenbossche J, Deroost N, Soetens E, Zeischka P, Spildooren J, Vercruysse S, Nieuwboer A, Kerckhofs E. Conflict and freezing of gait in Parkinson's disease: support for a response control deficit. Neuroscience 2012; 206:144-54. [DOI: 10.1016/j.neuroscience.2011.12.048] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 12/25/2011] [Indexed: 11/28/2022]
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Spooren AIF, Janssen-Potten YJM, Kerckhofs E, Bongers HMH, Seelen HAM. Evaluation of a task-oriented client-centered upper extremity skilled performance training module in persons with tetraplegia. Spinal Cord 2011; 49:1049-54. [DOI: 10.1038/sc.2011.54] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Spooren AIF, Janssen-Potten YJM, Kerckhofs E, Bongers HMH, Seelen HAM. ToCUEST: a task-oriented client-centered training module to improve upper extremity skilled performance in cervical spinal cord-injured persons. Spinal Cord 2011; 49:1042-8. [DOI: 10.1038/sc.2011.52] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Vercruysse S, Spildooren J, Heremans E, Kerckhofs E, Swinnen S, Wenderoth N, Vandenberghe W, Nieuwboer A. 269 FREEZING IN PARKINSON'S DISEASE: A PILOT FMRI STUDY. Parkinsonism Relat Disord 2010. [DOI: 10.1016/s1353-8020(10)70270-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Swinnen E, Duerinck S, Baeyens JP, Meeusen R, Kerckhofs E. Effectiveness of robot-assisted gait training in persons with spinal cord injury: A systematic review. J Rehabil Med 2010; 42:520-6. [DOI: 10.2340/16501977-0538] [Citation(s) in RCA: 144] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kerckhofs E. P2.180 Coping style and quality of life in persons with Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70531-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Spooren AIF, Janssen-Potten YJM, Kerckhofs E, Seelen HAM. Outcome of motor training programmes on arm and hand functioning in patients with cervical spinal cord injury according to different levels of the ICF: A systematic review. J Rehabil Med 2009; 41:497-505. [DOI: 10.2340/16501977-0387] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kerckhofs E, Dekoster S, Rawoe S, Duquet W. P2.077 Cognitive function, dual tasking and gait in persons with Parkinson's disease. Parkinsonism Relat Disord 2008. [DOI: 10.1016/s1353-8020(08)70307-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lafosse C, Kerckhofs E, Vereeck L, Troch M, Van Hoydonck G, Moeremans M, Sneyers C, Broeckx J, Dereymaeker L. Postural abnormalities and contraversive pushing following right hemisphere brain damage. Neuropsychol Rehabil 2007; 17:374-96. [PMID: 17474062 DOI: 10.1080/09602010601058854] [Citation(s) in RCA: 19] [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: 10/23/2022]
Abstract
We investigated the presence of postural abnormalities in a consecutive sample of stroke patients, with either left or right brain damage, in relation to their perceived body position in space. The presence or absence of posture-related symptoms was judged by two trained therapists and subsequently analysed by hierarchical classes analysis (HICLAS). The subject classes resulting from the HICLAS model were further validated with respect to posture-related measurements, such as centre of gravity position and head position, as well as measurements related to the postural body scheme, such as the perception of postural and visual verticality. The results of the classification analysis clearly demonstrated a relation between the presence of right brain damage and abnormalities in body geometry. The HICLAS model revealed three classes of subjects: The first class contained almost all the patients without neglect and without any signs of contraversive pushing. They were mainly characterised by a normal body axis in any position. The second class were all neglect patients but predominantly without any contraversive pushing. The third class contained right brain damaged patients, all showing neglect and mostly exhibiting contraversive pushing. The patients in the third class showed a clear resistance to bringing the weight over to the ipsilesional side when the therapist attempted to make the subject achieve a vertical posture across the midline. The clear correspondence between abnormalities of the observed body geometry and the tilt of the subjective postural and visual vertical suggests that a patient's postural body geometry is characterised by leaning towards the side of space where he/she feels aligned with an altered postural body scheme. The presence of contraversive pushing after right brain damage points in to a spatial higher-order processing deficit underlying the higher frequency and severity of the axial postural abnormalities found after right brain lesions.
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Affiliation(s)
- C Lafosse
- Scientific Unit Rehabilitation Centre Hof ter Schelde, Antwerp, Belgium.
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Kos D, Duportail M, D'hooghe M, Nagels G, Kerckhofs E. Multidisciplinary fatigue management programme in multiple sclerosis: a randomized clinical trial. Mult Scler 2007; 13:996-1003. [PMID: 17623738 DOI: 10.1177/1352458507078392] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To establish the efficacy of a multidisciplinary fatigue management programme (MFMP) in MS. Method Fifty-one subjects with MS were randomly allocated to group A, who only received the four weeks MFMP, or group B receiving a placebo intervention programme first and the MFMP after 6 months. In both groups, assessment was performed at baseline, 3 weeks and 6 months after the programmes and included Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), MS Self-Efficacy scale (MSSE), Mental Health Inventory (MHI) and Impact on Participation and Autonomy (IPA). Results The MFIS showed a significant change over time ( F(4,152) = 3.346, P = 0.012), which was similar in both groups (time*group interaction: F(4,152) = 1.094, P = 0.361). A clinically relevant reduction of MFIS score of 10 points or more was found in 17% of individuals following the MFMP, compared to 44% after the placebo intervention programme ( P = 0.06). Compared to no intervention, a significant effect of the MFMP after 6 months ( P = 0.003) was found in five participants (31%). No significant changes in FSS, MSSE, MHI and IPA, in both groups, were found. Conclusion Although an additional effect was found, the multidisciplinary fatigue management programme showed no efficacy in reducing the impact of fatigue compared to a placebo intervention programme. Multiple Sclerosis 2007; 13: 996—1003. http://msj.sagepub.com
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Affiliation(s)
- D Kos
- Department of Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium, Department of Occupational Therapy, National MS Centre, Melsbroek, Belgium.
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Abstract
Fatigue is one of the most common and most disabling symptoms of multiple sclerosis (MS). Although numerous studies have tried to reveal it, no definite pathogenesis factor behind this fatigue has been identified. Fatigue may be directly related to the disease mechanisms (primary fatigue) or may be secondary to non-disease-specific factors. Primary fatigue may be the result of inflammation, demyelination, or axonal loss. A suggested functional cortical reorganization may result in a higher energy demand in certain brain areas, culminating in an increase of fatigue perception. Higher levels of some immune markers were found in patients with MS-related fatigue, whereas other studies rejected this hypothesis. There may be a disturbance in the neuroendocrine system related to fatigue, but it is not clear whether this is either the result of the interaction with immune activation or the trigger of this process. Fatigue may be secondary to sleep problems, which are frequently present in MS and in their turn result from urinary problems, spasms, pain, or anxiety. Pharmacologic treatment of MS (symptoms) may also provoke fatigue. The evidence for reduced activity as a cause of secondary fatigue in MS is inconsistent. Psychological functioning may at least play a role in the persistence of fatigue. Research did not reach consensus about the association of fatigue with clinical or demographic variables, such as age, gender, disability, type of MS, education level, and disease duration. In conclusion, it is more likely to explain fatigue from a multifactor perspective than to ascribe it to one mechanism. The current evidence on the pathogenesis of primary and secondary fatigue in MS is limited by inconsistency in defining specific aspects of the concept fatigue, by the lack of appropriate assessment tools, and by the use of heterogeneous samples. Future research should overcome these limitations and also include longitudinal designs.
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Affiliation(s)
- D Kos
- Vrije Universiteit Brussel, Department of Rehabilitation Research, Brussels, Belgium.
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Kerckhofs E, Verckist D. 1.139 Sleep disturbance and daytime sleepiness in Flemish persons with Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70410-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kerckhofs E, Simons K, Vanroy C, De Meulenaere A, Senden N, Daphne K, Van Buggenhout M, Dedeyn P, Pickut B, Truijen S. 3.302 Balance performance and fall incidents in persons with Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70888-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lafosse C, Kerckhofs E, Troch M, Vereeck L, Van Hoydonck G, Moeremans M, Broeckx J, Vandenbussche E. Contraversive Pushing and Inattention of the Contralesional Hemispace. J Clin Exp Neuropsychol 2006; 27:460-84. [PMID: 15962692 DOI: 10.1080/13803390490520463] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [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: 10/23/2022]
Abstract
The aim of this study was to investigate, in 114 stroke patients, the frequency of occurrence of a largely unknown neurological disorder, characterized by a postural imbalance due to a 'pushing away' reaction of the body towards the contralesional side of space, in function of hemispheric lesion localization and gender. The study also investigate the relation of this contraversive pushing with active movement, somatosensory perception deficits and, in particular, inattention of contralesional hemispace and body. The similarity of the presence of contraversive pushing and the syndrome of spatial hemineglect together with a gender-related differentiation suggest the existence of a "pusher syndrome", in which the pathophysiology points in the direction of a spatial higher-order processing deficit, related to spatial inattention, underlying the higher frequency and severity of contraversive pushing after right brain lesions.
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Affiliation(s)
- C Lafosse
- Scientific Unit Rehabilitation Centre Hof ter Schelde, Antwerp, Belgium.
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Spooren AIF, Janssen-Potten YJM, Post MWM, Kerckhofs E, Nene A, Seelen HAM. Measuring change in arm hand skilled performance in persons with a cervical spinal cord injury: responsiveness of the Van Lieshout Test. Spinal Cord 2006; 44:772-9. [PMID: 16819555 DOI: 10.1038/sj.sc.3101957] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [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: 11/09/2022]
Abstract
OBJECTIVES To asses whether the Van Lieshout Test (VLT) is responsive to measure changes in arm hand skilled performance (AHSP) over time during active rehabilitation in persons with cervical spinal cord injury (C-SCI) and in different subgroups of persons with C-SCI according to lesion completeness and to lesion level. STUDY DESIGN Longitudinal cohort study. SETTING Spinal Cord Injury Units in eight rehabilitation centres across the Netherlands. METHODS In the present study, data from a national SCI cohort study are used. Data from the VLT, the Grasp Release Test (GRT), the Functional Independence Measure (FIM) and the Quadriplegia Index of Function (QIF) were recorded at three moments during active rehabilitation: at the start of active rehabilitation (t1), 3 months after t1 (t2) and at discharge (t3). Data have been analysed using three responsiveness measures, that is, the standardized response mean, the effect size and comparison of test scores measured at different times. RESULTS The VLT is responsive for the intervals t1-3, t1-2 and t2-3. The VLT can be used to measure changes in AHSP in persons with a C-SCI with an American Spinal Injury Association Impairment Scale (AIS) A or B score or an AIS C or D score, as well as in persons with a C3-C6 lesion or a C7-T1 lesion. The responsiveness of the VLT is significantly correlated to the GRT, but not to the FIM and the QIF. CONCLUSION The VLT is responsive in measuring changes in AHSP during rehabilitation in persons with C-SCI.
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Affiliation(s)
- A I F Spooren
- Institute for Rehabilitation Research, iRv, Hoensbroek, The Netherlands
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Lafosse C, Kerckhofs E, Troch M, Vandenbussche E. Upper limb exteroceptive somatosensory and proprioceptive sensory afferent modulation of hemispatial neglect. J Clin Exp Neuropsychol 2003; 25:308-23. [PMID: 12916645 DOI: 10.1076/jcen.25.3.308.13807] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/03/2022]
Abstract
In many paradigms of stimulation techniques aimed at reducing hemispatial neglect, somatosensory and proprioceptive stimulation are often interchanged, although the anatomical and functional pathways transmitting these signals are clearly different. Therefore, we have investigated the effects of one somatosensory stimulation technique, the cyclic pressure application (CPA), and have compared them with the effects of left transcutaneous electrical stimulation (TENS) on the expression of left hemispatial neglect in 13 stroke patients, as assessed by two visuospatial exploration tasks: the Star Cancellation task and Schenkenberg's Line Bisection task. In a first experiment, four treatment conditions were given: TENS, CPA, TENS + CPA, as well as a placebo condition. For each patient, the intensity of the TENS was determined, based on his/her conscious somatosensory threshold for the electrical impulses. In order to determine whether unconscious proprioceptive afferent information instead of exteroceptive somatosensory stimulation is a sufficient condition to improve hemispatial neglect, we carried out a second experiment, only with patients suffering from complete somatosensory loss. The effects of the different treatments were investigated, using the same sequence as for Experiment 1, but, this time, the applied intensity of TENS was manipulated over two conditions : (1) one in which the intensity of TENS stimulation was below the motor (proprioceptive) threshold and (2) one in which the intensity was determined following the degree of proprioceptive stimulation demonstrated by the point at which a visible muscle contraction during the stimulation could be elicited. The results demonstrated that proprioceptive-based TENS stimulation is a sufficient condition to reduce hemispatial neglect, even when a severe somatosensory loss was present.
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Affiliation(s)
- C Lafosse
- Scientific Unit Rehabilitation Centre 'Hof ter Schelde', Antwerp, Belgium.
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van der Veen P, Kempenaers F, Vermijlen S, Van Waeyenberghe C, Kerckhofs E, Bossuyt A, Van den Brande P, Lievens P. Electromagnetic diathermia: a lymphoscintigraphic and light reflection rheographic study of leg lymphatic and venous dynamics in healthy subjects. Lymphology 2000; 33:12-8. [PMID: 10769811] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Because electromagnetic diathermia (ED) has been reported to reduce lymphedema, we opted to examine the effects of ED on leg venous and lymph dynamics in healthy subjects. To examine lymph flow, we performed lymphangioscintigraphy (LAS) in 10 subjects without leg edema and used static images at the injection site and at the inguinal region for "control data." Later, we applied ED (2450 MHz, 200W) and then repeated the LAS using the same dosage and volume. Differences between the first and second sessions were examined using two way ANOVA and the differences between the scores with or without ED were analyzed by a Student's t-test. To examine venous flow, we first tested the left lower leg of 15 healthy subjects on two occasions using light reflection rheography (LRR). Venous refill time was recorded after each individual performed 10 dorsiflexions with the left foot on three occasions with an interval of 3 minutes between each recording. Thereafter, 20 minutes ED (2450 MHz, 200 W) was applied and using the same protocol venous refill time was recorded and repeated after an interval of one week. The 20% level and the declination angle of the refill time was determined and differences between the experimental and control groups analyzed by ANOVA. The results between the first and second sessions were consistent and reproducible with or without the electromagnetic application, with no change of radiotracer transport from the injection site or arrival at the inguinal nodes. There was also a high correlation between the scores for the 50% level and declination angle (r = 0.97) after LRR. Thus, after ED there was an accelerated venous refill time. In conclusion, after ED there was no increase in lymph flow but there was accelerated venous return.
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Affiliation(s)
- P van der Veen
- Department of Rehabilitation Research, Vrije Universiteit Brussel, Belgium
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