Browse by Lectorate "Neurorevalidatie"

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Zelfmanagement in de CVA-revalidatie : uitdagingen voor CVA-getroffenen, partners en professionals
Satink, T.
2016, Book (monograph) De doelstelling van het promotieonderzoek is om meer inzicht te krijgen in zelf- management na een beroerte. Hiervoor hebben wij onderzoek gedaan naar de ervaringen en meningen van diverse betrokkenen in de CVA-revalidatie, namelijk de CVA-getroffenen, de partners en professionals. In totaal zijn zes verschillende deelstudies uitgevoerd. In Nederland krijgen ieder jaar ongeveer 45.000 mensen een beroerte, ook wel CVA (Cerebro Vasculair Accident) genoemd. Veel mensen herstellen goed of hebben relatief weinig restverschijnselen. Sommige CVA-getroffenen ondervinden echter permanente beperkingen in dagelijkse activiteiten door sensomotorische, cognitieve en/of emotionele problemen. Daardoor kunnen zij vaak minder participeren in de maatschappij. Voor deze groep heeft een beroerte meestal ook gevolgen voor de partner of andere naasten. Zij krijgen vaak een aanvullende rol als mantelzorger, en deze nieuwe situatie leidt regelmatig tot emotionele en fysieke overbelasting. Zelfmanagement wordt gezien als een belangrijk concept in de CVA-revalidatie om CVA-getroffenen en hun directe naasten te ondersteunen in een betere zorg voor zichzelf en een betekenisvol leven na de beroerte. Hoe CVAgetroffenen, de partners, en professionals in de CVA-revalidatie in Nederland aankijken tegen zelfmanagement na een beroerte is echter nauwelijks bekend. In de literatuur zijn veel verschillende definities te vinden van zelfmanagement. Voor het proefschrift wordt de volgende definitie gebruikt: ‘zelfmanagement is de individuele mogelijkheid om, eventueel in samenwerking met familie, naasten en professionals, de symptomen, behandeling, fysieke, psychosociale, culturele en spirituele consequenties en bijbehorende aanpassingen in leefstijl te managen om te kunnen leven met een chronische aandoening’. Zelfmanagement wordt onderverdeeld in medisch management, rol-management en emotioneel management. Medisch management richt zich op het kunnen managen van de medische aspecten van een chronische ziekte, zoals medicijngebruik, het nemen van rust en gezonde voeding; sociaal of rol-management is het kunnen managen van de gevolgen van een (chronische) ziekte voor het dagelijks leven en richt zich op de betekenisgeving aan het leven en de diverse rollen; emotioneel management richt zich op het kunnen managen van de emotionele gevolgen en veranderingen als gevolg van een (chronische) ziekte zoals bijvoorbeeld onzekerheid en angst. Ondanks dat zelfmanagement principes in verschillende programma’s voor CVAgetroffenen worden toegepast, zijn de meningen en ervaringen van de CVA-getroffenen zélf en hun partners over zelfmanagement na een beroerte nauwelijks beschreven. Ook is weinig bekend over de mening van professionals in de CVA-revalidatie over zelfmanagement. Willen we effectieve zelfmanagement programma’s voor mensen met een beroerte ontwikkelen en implementeren, dan is het van belang en logisch om de opvattingen van CVAgetroffenen, hun partners en professionals in de CVA-revalidatie hierover te onderzoeken. De belangrijkste doelstelling van het proefschrift was daarom om inzicht te krijgen in het zelfmanagement van mensen na een beroerte: wat houdt CVA-getroffenen en hun partners bezig? Wat zijn hun ervaringen ten aanzien van zelfmanagement na een beroerte? Wat zijn hun wensen en behoeften? En hoe managen CVA-getroffenen en hun partners zichzelf na ontslag naar huis? Daarnaast wilden we ook weten hoe de verschillende professionals in de CVA-revalidatie aankijken tegen het concept zelfmanagement en op
What matters in development and sustainment of community dementia friendly initiatives and why? A realist multiple case study
Thijssen, M.C.E. ; Kuijer-Siebelink, W ; Lexis, M.A.S. ; Nijhuis-van der Sanden, M.W.G. ; Daniels, R. ; Graff, M.J.L.
2023, Article / Letter to editor (BMC Public Health, vol. 23, iss. 1, (2023), pp. 296)
What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings
Jellema, S. ; Hees, S.G.M. van ; Zajec, J. ; Sande, R van der ; Nijhuis-van der Sanden, M.W.G. ; Steultjens, E.M.J.
2017, Article / Letter to editor (Clinical Rehabilitation, vol. 31, iss. 7, (2017), pp. 936-947)Objective: Identify the environmental factors that influence stroke-survivors' reengagement in personally valued activities and determine what specific environmental factors are related to specific valued activity types. Data sources: PubMed, CINAHL and PsycINFO were searched until June 2016 using multiple search-terms for stroke, activities, disability, and home and community environments. Review methods: An integrated mixed-method systematic review of qualitative, quantitative and mixed-design studies was conducted. Two researchers independently identified relevant studies, assessed their methodological quality and extracted relevant findings. To validly compare and combine the various findings, all findings were classified and grouped by environmental category and level of evidence. Results: The search yielded 4024 records; 69 studies were included. Most findings came from low-evidence-level studies such as single qualitative studies. All findings were consistent in that the following factors facilitated reengagement post-stroke: personal adapted equipment; accessible environments; transport; services; education and information. Barriers were: others' negative attitudes and behaviour; long distances and inconvenient environmental conditions (such as bad weather). Each type of valued activity, such as mobility or work, had its own pattern of environmental influences, social support was a facilitator to all types of activities. Although in many qualitative studies others' attitudes, behaviour and stroke-related knowledge were seen as important for reengagement, these factors were hardly studied quantitatively. Conclusion: A diversity of environmental factors was related to stroke-survivors' reengagement. Most findings came from low-evidence-level studies so that evidence on causal relationships was scarce. In future, more higher-level-evidence studies, for example on the attitudes of significant others, should be conducted.
What about self-management? Challenges for stroke survivors, spouses and professionals
Satink, T.
2016, Dissertation De doelstelling van het promotieonderzoek is om meer inzicht te krijgen in zelf- management na een beroerte. Hiervoor hebben wij onderzoek gedaan naar de ervaringen en meningen van diverse betrokkenen in de CVA-revalidatie, namelijk de CVA-getroffenen, de partners en professionals. In totaal zijn zes verschillende deelstudies uitgevoerd. In Nederland krijgen ieder jaar ongeveer 45.000 mensen een beroerte, ook wel CVA (Cerebro Vasculair Accident) genoemd. Veel mensen herstellen goed of hebben relatief weinig restverschijnselen. Sommige CVA-getroffenen ondervinden echter permanente beperkingen in dagelijkse activiteiten door sensomotorische, cognitieve en/of emotionele problemen. Daardoor kunnen zij vaak minder participeren in de maatschappij. Voor deze groep heeft een beroerte meestal ook gevolgen voor de partner of andere naasten. Zij krijgen vaak een aanvullende rol als mantelzorger, en deze nieuwe situatie leidt regelmatig tot emotionele en fysieke overbelasting. Zelfmanagement wordt gezien als een belangrijk concept in de CVA-revalidatie om CVA-getroffenen en hun directe naasten te ondersteunen in een betere zorg voor zichzelf en een betekenisvol leven na de beroerte. Hoe CVAgetroffenen, de partners, en professionals in de CVA-revalidatie in Nederland aankijken tegen zelfmanagement na een beroerte is echter nauwelijks bekend. In de literatuur zijn veel verschillende definities te vinden van zelfmanagement. Voor het proefschrift wordt de volgende definitie gebruikt: ‘zelfmanagement is de individuele mogelijkheid om, eventueel in samenwerking met familie, naasten en professionals, de symptomen, behandeling, fysieke, psychosociale, culturele en spirituele consequenties en bijbehorende aanpassingen in leefstijl te managen om te kunnen leven met een chronische aandoening’. Zelfmanagement wordt onderverdeeld in medisch management, rol-management en emotioneel management. Medisch management richt zich op het kunnen managen van de medische aspecten van een chronische ziekte, zoals medicijngebruik, het nemen van rust en gezonde voeding; sociaal of rol-management is het kunnen managen van de gevolgen van een (chronische) ziekte voor het dagelijks leven en richt zich op de betekenisgeving aan het leven en de diverse rollen; emotioneel management richt zich op het kunnen managen van de emotionele gevolgen en veranderingen als gevolg van een (chronische) ziekte zoals bijvoorbeeld onzekerheid en angst. Ondanks dat zelfmanagement principes in verschillende programma’s voor CVAgetroffenen worden toegepast, zijn de meningen en ervaringen van de CVA-getroffenen zélf en hun partners over zelfmanagement na een beroerte nauwelijks beschreven. Ook is weinig bekend over de mening van professionals in de CVA-revalidatie over zelfmanagement. Willen we effectieve zelfmanagement programma’s voor mensen met een beroerte ontwikkelen en implementeren, dan is het van belang en logisch om de opvattingen van CVAgetroffenen, hun partners en professionals in de CVA-revalidatie hierover te onderzoeken. De belangrijkste doelstelling van het proefschrift was daarom om inzicht te krijgen in het zelfmanagement van mensen na een beroerte: wat houdt CVA-getroffenen en hun partners bezig? Wat zijn hun ervaringen ten aanzien van zelfmanagement na een beroerte? Wat zijn hun wensen en behoeften? En hoe managen CVA-getroffenen en hun partners zichzelf na ontslag naar huis? Daarnaast wilden we ook weten hoe de verschillende professionals in de CVA-revalidatie aankijken tegen het concept zelfmanagement en op
We moeten meer aandacht besteden aan de sociale omgeving van een client
Jellema, S.
2022, Article / Letter to editor (Ergotherapie Magazine, vol. 4, (2022), pp. 9-12)Mensen hebben na een beroerte vaak veel geleerd in een revalidatiecentrum. Ze raken dat echter ook gemakkelijk weer kwijt in de thuissituatie. Hoe kan dat? En wat is de invloed van de omgeving op het weer oppakken van het leven na een beroerte? Die vragen onderzocht ergotherapeut en onderzoeker Sandra Jellema in haar promotieonderzoek. Tipje van de sluier: vooral iemands netwerk blijkt erg belangrijk. Jellema: “Als je doel als ergotherapeut is om participatie mogelijk te maken, dan is de sociale omgeving een belangrijke knop om aan te draaien.”
Valued activities and informal caregiving in stroke: a scoping review.
Jellema, S. ; Wijnen, M.A.M. ; Steultjens, E.M.J. ; Nijhuis-van der Sanden, M.W.G. ; Sande, W.M.M. van der
2019, Article / Letter to editor (Disability and Rehabilitation, vol. 41, iss. 18, (2019), pp. 2223-2234)
Validity and reliability of the mixing ability test as masticatory performance outcome in children with spastic cerebral palsy and children with typical development: A pilot study.
Remijn, L. ; Vermaire, J.A. ; s-van de Sanden, M.W.G. Nijhui ; Groen, B.E. ; Speksnijder, C.M.
2018, Article / Letter to editor (Journal of Oral Rehabilitation, vol. 45, iss. 10, (2018), pp. 790-797)BACKGROUND: The mixing ability test (MAT) as an outcome measure of masticatory performance is largely used in studies with adults, but not yet with children. OBJECTIVE: This study aimed to test the construct validity and the test-retest reliability of the MAT in children with spastic cerebral palsy (CP) and children with typical development (TD). METHOD: The results of the MAT were correlated with tongue movements, mandible movements, relative muscle contraction and clinical observation measured with ultrasound, 3D kinematics, electromyography (EMG) and relevant items of the mastication observation and evaluation (MOE) instrument, respectively. Moreover, the between-groups effect was tested. Test-retest reliability was calculated with an intra-class correlation coefficient (ICC) and standard error of measurement (SEM). RESULTS: Twenty-one children (seven children with spastic CP and 14 children with TD) participated in this study. The MAT scores showed moderate to good correlations with some variables of the tongue movements, horizontal mandible movements and occlusion duration, relative muscle contraction of the left temporalis and all six MOE items (-0.80 < r < 0.49). The MAT scores were significantly higher for children with CP (mean 22.6; SD 2.4) compared to children with TD (mean 19.9; SD 1.9). The test-retest reliability had an ICC of 0.7 and a SEM of 1.16 (±5% of the mean score). CONCLUSION: These results indicate that the MAT is suitable and complementary to ultrasound, 3D kinematics, EMG and observation to compare the masticatory performance between children with CP and children with TD, with an acceptable test-retest reliability.
Validity and reliability of the Mastication Observation and Evaluation (MOE) instrument.
Remijn, L. ; Speyer, R. ; Groen, B.E. ; Limbeek, J. van ; -van der Sanden, M.W.G. Nijhuis
2014, Article / Letter to editor (Research in Developmental Disabilities, vol. 35, iss. 7, (2014), pp. 1551-1561)The Mastication Observation and Evaluation (MOE) instrument was developed to allow objective assessment of a child's mastication process. It contains 14 items and was developed over three Delphi rounds. The present study concerns the further development of the MOE using the COSMIN (Consensus based Standard for the Selection of Measurement Instruments) and investigated the instrument's internal consistency, inter-observer reliability, construct validity and floor and ceiling effects. Consumption of three bites of bread and biscuit was evaluated using the MOE. Data of 59 healthy children (6-48 mths) and 38 children (bread) and 37 children (biscuit) with cerebral palsy (24-72 mths) were used. Four items were excluded before analysis due to zero variance. Principal Components Analysis showed one factor with 8 items. Internal consistency was >0.70 (Chronbach's alpha) for both food consistencies and for both groups of children. Inter-observer reliability varied from 0.51 to 0.98 (weighted Gwet's agreement coefficient). The total MOE scores for both groups showed normal distribution for the population. There were no floor or ceiling effects. The revised MOE now contains 8 items that (a) have a consistent concept for mastication and can be scored on a 4-point scale with sufficient reliability and (b) are sensitive to stages of chewing development in young children. The removed items are retained as part of a criterion referenced list within the MOE.
Validity and reliability of serratus anterior hand held dynamometry
Ijspeert, J ; Kerstens, H.C.J.W. ; Janssen, R. ; Geurts, A.C.H. ; Alfen, N. van ; Groothuis, JT
2020, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 20, iss. 1, (2020))Background Strength testing of the serratus anterior muscle with hand held dynamometry (HDD) in supine subjects has low reproducibility, and is influenced by compensatory activity of other muscles like the pectoralis major and upper trapezius. Previously, two manual maximum voluntary isometric contraction tests of the serratus anterior muscle were reported that recruited optimal surface electromyography (sEMG) activity in a sitting position. We adapted three manual muscle tests to make them suitable for HHD and investigated their validity and reliability. Methods Twenty-one healthy adults were examined by two assessors in one supine and two seated positions. Each test was repeated twice. Construct validity was determined by evaluating force production (assessed with HHD) in relation to sEMG of the serratus anterior, upper trapezius and pectoralis major muscles, comparing the three test positions. Intra- and interrater reliability were determined by calculating intra-class correlation coefficients (ICC) smallest detectable change (SDC) and standard error of measurement (SEM). Results Serratus anterior muscle sEMG activity was most isolated in a seated position with the humerus in 90 degrees anteflexion in the scapular plane. This resulted in the lowest measured force levels in this position with a mean force of 296 N (SEM 15.8 N). Intrarater reliability yielded an ICC of 0.658 (95% CI 0.325; 0.846) and an interrater reliability of 0.277 (95% CI -0.089;0.605). SDC was 127 Newton, SEM 45.8 Newton. Conclusion The results indicate that validity for strength testing of the serratus anterior muscle is optimal with subjects in a seated position and the shoulder flexed at 90 degrees in the scapular plane. Intrarater reliability is moderate and interrater reliability of this procedure is poor. However the high SDC values make it difficult to use the measurement in repeated measurements.
Validation of a Danish translation of an occupational therapy guideline for interventions in apraxia: A pilot study.
Hansen, T. ; Steultjens, E. ; Satink, T.
2009, Article / Letter to editor (Scandinavian Journal of Occupational Therapy, vol. 16, iss. 4, (2009), pp. 205-215)The objective of this study was to produce a valid Danish translation of the Dutch "Occupational therapy guideline for assessment and treatment of apraxia in CVA clients"; to investigate the inter-rater reliability of the assessment instrument in terms of ADL observations; and to determine the content validity of the translation. The inter-rater reliability was investigated using video observations and multiple raters, who also judged the content validity quantitatively. For the scores of the patient's occupational performance the study found moderate to good inter-rater reliability for three of four variables and poor to fair inter-rater reliability for one variable, indicated by intra-class correlation coefficient and Kappa statistic. For the conclusion variables the results demonstrated fair inter-rater reliability for five of six variables and poor inter-rater reliability for one variable, also indicated by Kappa statistic. The content validity was judged valid for 100 and invalid for 28 of the guideline's defined elements. The conclusion, taking the complexity of the ADL observations and the study design into consideration, is that the Danish version can serve as a guideline within Danish occupational therapy practice. However, a translational recheck, further psychometric testing, and a minimum two-day training course is recommended before implementation in practice.
Ultrasound Imaging for Analyzing Lateral Tongue Movements during Mastication in Adults with Cerebral Palsy Compared with Adults without Oral Motor Disabilities.
Remijn, L. ; Weijers, G. ; -van der Sanden, M.W.G. Nijhuis ; Groen, B.E. ; Korte, C.L. de
2015, Article / Letter to editor (Ultrasound in Medicine and Biology, vol. 41, iss. 6, (2015), pp. 1784-1793)Described here is an ultrasound technique used to study tongue movements, particularly lateral tongue movements, during mastication. A method to analyze spatial and temporal tongue movements was developed, and the feasibility of using this method was evaluated. Biplane ultrasound images of tongue movements of four adults without oral motor disability and two adults with oral motor disability as a result of cerebral palsy, were acquired. Tongue movements were analyzed in the coronal and sagittal planes using B-mode and M-mode ultrasonography. Inter-rater and intra-rater agreement for manual tracing of tongue contours was good (ICC = 0.81 and 0.84, respectively). There were significant differences between the two adult groups in movement frequency in the horizontal direction in both coronal and sagittal planes. In the coronal plane, differences in movement frequency and range of vertical movement were detected. Data obtained from sagittal images, with the exception of vertical frequency, indicated no differences between the groups. The protocol developed in this study (using B-mode and M-mode) proved to be valid and reliable. By using this protocol with individuals with and without oral motor disability, we were able to illustrate the clinical application of our protocol to evaluation of differences in tongue movements during mastication.
Uitkomsten van de ‘Cognitive Orientation to daily Occupational Performance’ (CO-OP) voor kinderen met DCD: Multipele Casestudie – Kwalitatief deel
Lindenschot, M. ; Kottorp, A. ; Steultjens, E.M.J.
2013, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 6, iss. 2, (2013), pp. 26-36)
Uitkomsten van de ‘Cognitive Orientation to daily Occupational Performance’ (CO-OP) voor kinderen met DCD : Multipele Casestudie - Kwantitatief deel
Lindenschot, M. ; Kottorp, A. ; Steultjens, E.M.J.
2012, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 5, iss. 4, (2012), pp. 24-38)Volgens internationale schattingen is de prevalentie van de diagnose Developmental Coordination Disorder (DCD) minstens 6% voor kinderen in de leeftijd van 5 tot 11 jaar (1). De American Psychiatric Association (APA) heeft DCD gedefinieerd als “The essential feature of DCD is a marked impairment in the development of motor coordination (…) that significantly interferes with academic achievement or activities of daily living” (1). Vrij vertaald naar het Nederlands betekent dit: ‘een aantoonbare verstoring in de ontwikkeling van de motorische coördinatie (…) dat significant interfereert met de schoolse prestaties of met algemene dagelijkse activiteiten’. Vanwege het effect van DCD op het dagelijks leven van kinderen en hun familie (2) is het noodzakelijk dat we interventies toepassen met als doel het dagelijks leven te verbeteren (3).
Treating patients with severe mental illness with narrative exposure therapy for comorbid post-traumatic stress disorder.
Mauritz, MW ; Gaal, B.G.I. van ; Goossens, P. ; Jongedijk, RA ; Vermeulen, H.
2020, Article / Letter to editor (British Journal of Psychiatry Open, vol. 7(1), e12, (2020))
The perspectives of spouses of stroke survivors on self-management – a focus group study.
Satink, T. ; Cup, Edith ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Disability and Rehabilitation, vol. 40, (2018), pp. 176-184)
The perspectives and values of children with a mitochondrial disorder with regard to everyday activities.
Lindenschot, M. ; Steultjens, E.M.J. ; Zajec, J. ; Nijhuis-van der Sanden, M.W.G. ; Koene, S. ; Groot, I. de
2018, Article / Letter to editor (Journal of Developmental and Physical Disabilities, (2018), pp. 1-26)
The evaluation of an e-supported Illness Management and Recovery program for patients with SMI
Beentjes, T.A.A. ; Gaal, B.G.I. van ; Goossens, P. ; Nijhuis-van der Sanden, M.W.G.
2016, Article / Letter to editor (Journal of Advanced Nursing, vol. 72, (2016), pp. 82-83)
Tailored interviewing to uncover the perspectives ofchildren with multiple disabilities on daily activities: Aqualitative analyses of interview methods and interviewerskills
Steultjens, E.M.J. ; Lindenschot, M. ; Diepeveen, S.J.H. ; Zajec, J. ; Groot, I. de ; Nijhuis-van der Sanden, M.W.G. ; Koene, S. ; Graff, Maud
2022, Article / Letter to editor (Australian Occupational Therapy Journal, (2022), pp. 1-15)
Stumbling, struggling, and shame due to spasticity: a qualitative study of adult persons with hereditary spastic paraplegia.
Kerstens, H.C.J.W. ; Satink, T. ; Nijkrake, M.J. ; Swart, B.J.M. de ; Lith, B.J.H. van ; Geurts, A.C.H. ; Nijhuis-van der Sanden, M.W.G.
2019, Article / Letter to editor (Disability and Rehabilitation, vol. 13, (2019), pp. 1-8)
Stroke survivors' experiences of rehabilitation: A systematic review of qualitative studies
Peoples, H ; Satink, T. ; Steultjens, E.M.J.
2011, Article / Letter to editor (Scandinavian Journal of Occupational Therapy, vol. 18, iss. 3, (2011), pp. 163-171)Introduction: The aim was to obtain the best available knowledge on stroke survivors' experiences of rehabilitation. The increase in demands for accountability in health care and acknowledgement of the importance of client participation in health decisions calls for systematic ways of integrating this perspective. Methods and materials: A systematic review of qualitative studies was performed. A literature search in MEDLINE, CINAHL, PsycINFO, and EMBASE was conducted. Suitability for inclusion was based on selected criteria: published qualitative studies written in English from 1990 to 2008 on stroke survivors' experiences of rehabilitation in a clinical setting. Data analysis entailed extracting, editing, grouping, and abstracting findings. Results: Twelve studies were included. One theme, "Power and Empowerment" and six subcategories were identified: 1) Coping with a new situation, 2) Informational needs, 3) Physical and non-physical needs, 4) Being personally valued and treated with respect, 5) Collaboration with health care professionals and 6) Assuming responsibility and seizing control. Discussion: The synthesis showed that stroke survivors' experiences of rehabilitation reflected individual and relational aspects of power and empowerment. The capacity to assume power and empowerment was a dynamic rather than a progressive issue, and enabling empowerment was a matter of weighing contrasting issues against each other, e. g. the right to decide versus the right not to decide.
A Standardized Protocol for Maximum Repetition Rate Assessment in Children
Diepeveen, S.J.H. ; Haaften, L van ; Terband, H ; Swart, B.J.M. de ; Maassen, B
2019, Article / Letter to editor (Folia Phoniatrica et Logopaedica, vol. 71, iss. 5-6, (2019), pp. 238-250)
Social participation perspectives from persons with cognitive problems and their caregivers: a descriptive qualitative study
Donkers, H.W. ; Veen, D.J. van der ; Vernooij-Dassen, M. ; Nijhuis-van der Sanden, M.W.G. ; Graff, Maud
2018, Article / Letter to editor (Ageing and Society, vol. 39, iss. 7, (2018), pp. 1-27)
Social participation of people with cognitive problems and their caregivers: a feasibility evaluation of the Social Fitness Programme
Donkers, H.W. ; Veen, D.J. van der ; Vernooij-Dassen, M. ; Nijhuis-van der Sanden, M.W.G. ; Graff, Maud
2017, Article / Letter to editor (International Journal of Geriatric Psychiatry, vol. 32, iss. 12, (2017), pp. 50-63)
Shared decision-making about tube feeding in children: parents’ experiences
Remijn, C.S.M. ; Platteel, V ; Kalsbeek, C.J.C. ; Kindermann, A
2022, Article / Letter to editor (Disability and Health Journal, vol. 15, iss. 2, (2022))
Setting meaningful goals in rehabilitation: rationale and practical tool.
Dekker, J.J.H. ; Groot, V. de ; Steeg, A.M. ter ; Vloothuis, J. ; Holla, J. ; Collette, E. ; Satink, T. ; Post, L. ; Doodeman, S. ; Littooij, E.
2019, Article / Letter to editor (Clinical Rehabilitation, (2019))
Setting meaningful goals in rehabilitation: A qualitative study on the experiences of clients and clinicians in working with a practical tool.
Littooij, E. ; Doodeman, S. ; Holla, J. ; Ouwerkerk, M. ; Post, L. ; Satink, T. ; Steeg, A.M. ter ; Vloothuis, J. ; Dekker, J ; Groot, V. de
2022, Article / Letter to editor (Clinical Rehabilitation, vol. 36, iss. 3, (2022), pp. 415-428)OBJECTIVE: To evaluate the experience of clients and clinicians in working with a tool to help set goals that are personally meaningful to rehabilitation clients. DESIGN: We have applied the tool in the outpatient rehabilitation setting. Clients' and clinicians' experiences in working with the tool were evaluated in individual, semi-structured interviews and focus group interviews, respectively. Thematic analysis was used to analyze the data. SETTING: A university medical center and a rehabilitation center. SUBJECTS: Clients with a first-time stroke (nn=n8) or multiple sclerosis (nn=n10), and clinicians (nn=n38). INTERVENTION: The tool to help set meaningful goals consisted of a session (i) to explore the client's fundamental beliefs, goals and attitudes and (ii) to identify a meaningful overall rehabilitation goal. The results of that session were used by the multidisciplinary rehabilitation team (iii) to help the client to set specific rehabilitation goals that served to achieve the meaningful overall rehabilitation goal. RESULTS: Both clients and clinicians reported that the tool helped to set a meaningful overall rehabilitation goal and specific goals that became meaningful as they served to achieve the overall goal. This contributed to clients' intrinsic rehabilitation motivation. In some clients, the meaningfulness of the rehabilitation goals facilitated the process of behavior change. Both clients and clinicians made suggestions on how the tool could be further improved. CONCLUSION: In the opinion of both clients and clinicians, the tool does indeed result in goal setting that is personally meaningful. Further development, implementation and evaluation of the tool is warranted.
Setting meaningful goals in rehabilitation: A qualitative study on the experiences of clients and clinicians in working with a practical tool
Littooij, E. ; Doodeman, S. ; Holla, J. ; Ouwerkerk, M. ; Post, L. ; Satink, T. ; ter Steeg, A.M. ; Vloothuis, J. ; Dekker, J ; de Groot, v.
2021, Article / Letter to editor (Clinical Rehabilitation, vol. 36, iss. 3, (2021), pp. 415-428)
Setting meaningful goals in rehabilitation: a practical tool
Dekker, J ; Groot, V. de ; Steeg, A.M. ter ; Vloothuis, J. ; Holla, J. ; Collette, E. ; Satink, T. ; Post, L. ; Doodeman, S. ; Littooij, E.
2021, Article / Letter to editor (International Journal of Behavioral Medicine, vol. 28, iss. SUPPL 1, (2021), pp. S40-S41)
Self-management: challenges for allied healthcare professionals in stroke rehabilitation - a focus group study
Satink, T. ; Cup, Edith ; Swart, B.J.M. de ; Sanden, M.N. van
2015, Article / Letter to editor (Disability and Rehabilitation, vol. 37, iss. 18-19, (2015), pp. 1745-1752)Purpose: Self-management has become an important concept in stroke rehabilitation. This study explored allied healthcare professionals' (AHPs) perceptions and beliefs regarding the self-management of stroke survivors and their knowledge and skills regarding stroke self-management interventions. Method: Four focus group interviews were conducted with 27 professionals. Verbal questions and mind mapping were used to collect data. A constant comparative framework was used for analysis. Results: The AHPs discussed different levels of post-stroke self-management, depending on factors such as pre-stroke skills, recovery-phases post-stroke and cognitive abilities of the stroke patients. They hesitated about stroke clients' capacities to self-manage. AHPs questioned whether their own attitudes and skills were really supportive for stroke clients' self-management and criticised stroke services as being too medically oriented. They recommended that self-management programmes should focus both on clients and caregivers and be delivered at peoples' homes. Conclusion: Professional perceptions and beliefs are important factors to take into account when implementing stroke self-management programmes. Before professionals can enable stroke survivors to self-manage, they first need support in acquiring knowledge and skills regarding post-stroke self-management. Moreover, professionals could benefit from behavioural change models, and professionals recognised that stroke self-management interventions would be most beneficial when delivered post-discharge at people's homes.
Self-Management Support Needs From the Perspectives of Persons With Severe Mental Illness: A Systematic Review and Thematic Synthesis of Qualitative Research
Beentjes, T.A.A. ; Gaal, B.G.I. van ; Achterberg, Theo van ; Goossens, P.
2019, Article / Letter to editor (Journal of the American Psychiatric Nurses Association, (2019))
Self-Management Support Needs from the Perspectives of Persons with Severe Mental Illness: A Systematic Review and Thematic Synthesis of Qualitative Research
Beentjes, T.A.A. ; Gaal, B.G.I. van ; Achterberg, Theo van ; Goossens, P.
2020, Article / Letter to editor (Journal of the American Psychiatric Nurses Association, vol. 26, iss. 5, (2020))
Self-management develops through doing of everyday activities-a longitudinal qualitative study of stroke survivors during two years post-stroke
Satink, T. ; Josephsson, S ; Zajec, J. ; Cup, Edith ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2020, Article / Letter to editor (BMC Neurology, vol. 16, (2020))Background: A description of the complexity of the process of self-management and the way stroke survivors give meaning to their process of self-management post-stroke is lacking. This study explores how stroke survivors managed their lives, gave meaning to their self-management post-stroke and how this evolved over time. Methods: Data was generated through participant observations and interviews of 10 stroke survivors at their homes at 3, 6, 9, 15 and 21 months post-discharge. A constant comparative method was chosen to analyse the data. Results: 'Situated doing' was central in stroke survivors' simultaneous development of self-management and their sense of being in charge of everyday life post-stroke. Doing everyday activities provided the stroke survivors with an arena to explore, experience, evaluate, develop and adapt self-management and being in charge of everyday activities and daily life. The influence of stroke survivors' partners on this development was sometimes experienced as empowering and at other times as constraining. Over time, the meaning of self-management and being in charge changed from the opinion that self-management was doing everything yourself towards self-managing and being in charge, if necessary, with the help of others. Moreover, the sense of self-management and being in charge differed among participants: it ranged from managing only at the level of everyday activities to full role management and experiencing a meaningful and valuable life post-stroke. Conclusions: The findings of this study indicate the doing of activities as an important arena in which to develop self-management and being in charge post-stroke. Stroke self-management programs could best be delivered in stroke survivors' own environment and focus on not only stroke survivors but also their relatives. Furthermore, the focus of such interventions should be on not only the level of activities but also the existential level of self-management post-stroke.
Self-made & sound: e-health self-management support programs for patients with chronic conditions
Gaal, B.G.I. van ; Bredie, S.J.H. ; Goossens, P. ; Repping-Wuts, H ; Dulmen, S. van ; Nijhuis-van der Sanden, M.W.G.
2016, Article / Letter to editor (Journal of Advanced Nursing, vol. 72, (2016), pp. 82)
Room for improvement in non-pharmacological systemic sclerosis care?—a cross-sectional online survey of 650 patients
Stöcker, J.K. ; Vonk, M.C. ; Hoogen, F.H.C. van den ; Nijhuis-van der Sanden, M.W.G. ; Staal, J.B. ; Satink, T. ; Ende, C.H.M.
2020, Article / Letter to editor (Rheumatology, vol. 4, iss. 1, (2020), pp. 1-9)
Role of Environmental Factors on Resuming Valued Activities Poststroke: A Systematic Review of Qualitative and Quantitative Findings
Jellema, S. ; Sande, R van der ; Hees, S.G.M. van ; Zajec, J. ; Steultjens, E.M.J. ; Nijhuis-van der Sanden, M.W.G.
2016, Article / Letter to editor (Archives of Physical Medicine and Rehabilitation, vol. 97, iss. 6, (2016), pp. 991-1002)Objective: To investigate how reengagement in valued activities poststroke is influenced by environmental factors. Data Sources: PubMed, CINAHL, and PsycINFO were searched to June 2015 using multiple search terms for stroke, activities, disability, and home and community environments, with the following constraints: English, humans, and adults. Study Selection: Studies were included that contained data on how reengagement in valued activities of community-dwelling stroke survivors was influenced by the environment. Two reviewers independently selected the studies. The search yielded 3726 records; 39 studies were eventually included. Data Extraction: Findings were extracted from qualitative, quantitative, and mixed-design studies. Two reviewers independently assessed study quality using the Oxford Critical Appraisal Skills Programme lists and independently extracted results. Data Synthesis: Thematic analysis was conducted on qualitative data, revealing 9 themes related to the iterative nature of the process of reengagement and the associated environmental factors. During the process of reengagement, environmental factors interact with personal and disease-related factors in a gradual process of shaping or abandoning valued activities. The sociocultural context in this case determines what activities are valued and can be resumed by stroke survivors. Social support; activity opportunities and obligations; familiar and accessible environments; resources and reminders; and a step-by-step return facilitate stroke survivors to explore, adapt, resume, and maintain their activities. Social support is helpful at all stages of the process and particularly is important in case stroke survivors are fearful to explore their activity possibilities. The quantitative data identified largely endorsed these findings. No quantitative data were found in respect to the iterative nature of the process, familiar environments, or accessibility. Conclusions: Reengagement in valued activities is a gradual process. In each stage of the process, several environmental factors play a role. During rehabilitation, professionals should pay attention to the role physical and social environmental factors have in reengagement poststroke and find ways to optimize stroke survivors' environments. (C) 2016 by the American Congress of Rehabilitation Medicine
Richtlijnen: Lust of last?
Sturkenboom, Ingrid ; Steultjens, E.M.J.
2012, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 5, iss. 1, (2012), pp. 52-56)Sinds evidence-based practice ingevoerd wordt in de gezondheidszorg heeft het ontwikkelen en implementeren van richtlijnen veel aandacht gekregen. Er zijn voor zeer veel verschillende aspecten van de zorg hoogwaardige richtlijnen beschikbaar. Ergotherapie is als discipline vertegenwoordigd in een groot aantal multidisciplinaire richtlijnen (www.artsennet.nl). Hierin wordt beschreven wat er bekend is over de wetenschappelijke onderbouwing van ergotherapie-interventies. Ook kent de beroepsgroep sinds een aantal jaren monodisciplinaire richtlijnen voor de gehele ergotherapiebehandeling zoals: de Ergotherapierichtlijn beroerte, inclusief de apraxierichtlijn (Cup & Steultjens, 2005; Stehmann, Van Heugten e.a, 2003), Valpreventie voor thuiswonende ouderen (Theune & Steultjens, 2005), Ergotherapie aan huis bij ouderen met dementie en hun mantelzorgers (Melick, Graff et al., 1998; Graff, Melick et al., 2010), Ergotherapie bij de ziekte van Parkinson en hun mantelzorgers (Sturkenboom et al., 2008) en de ergotherapierichtlijn vermoeidheid bij mensen met neurologische aandoeningen (Evenhuis , Eyssen et al., 2012). Door zorgverzekeraars, de overheid en patiëntenorganisaties worden richtlijnen beschouwd als kwaliteitscriteria van goede zorg. Dit leidt tot de verwachting dat de beroepsgroep conform de richtlijnen werkt. Wij zijn beide actief in het ontwikkelen en implementeren van ergotherapierichtlijnen en krijgen regelmatig uit de praktijk informatie over het werken met richtlijnen. We signaleren dat er zowel grote voordelen zijn aan het hebben van richtlijnen maar ook nadelen, omdat het werken conform richtlijnen nog al wat vraagt van een behandelaar. We vragen ons daarom af of richtlijnen nu een lust of een last zijn.
Resuming valued activities after stroke: the influence of the environment
Jellema, S.
2022, Dissertation
Reproducibility of 3D kinematics and surface electromyography measurements of mastication.
Remijn, L. ; Groen, B.E. ; Speyer, R. ; Limbeek, J. van ; -van der Sanden, M.W.G. Nijhuis
2016, Article / Letter to editor (Physiology and Behavior, vol. 155, (2016), pp. 112-121)The aim of this study was to determine the measurement reproducibility for a procedure evaluating the mastication process and to estimate the smallest detectable differences of 3D kinematic and surface electromyography (sEMG) variables. Kinematics of mandible movements and sEMG activity of the masticatory muscles were obtained over two sessions with four conditions: two food textures (biscuit and bread) of two sizes (small and large). Twelve healthy adults (mean age 29.1 years) completed the study. The second to the fifth chewing cycle of 5 bites were used for analyses. The reproducibility per outcome variable was calculated with an intraclass correlation coefficient (ICC) and a Bland-Altman analysis was applied to determine the standard error of measurement relative error of measurement and smallest detectable differences of all variables. ICCs ranged from 0.71 to 0.98 for all outcome variables. The outcome variables consisted of four bite and fourteen chewing cycle variables. The relative standard error of measurement of the bite variables was up to 17.3% for 'time-to-swallow', 'time-to-transport' and 'number of chewing cycles', but ranged from 31.5% to 57.0% for 'change of chewing side'. The relative standard error of measurement ranged from 4.1% to 24.7% for chewing cycle variables and was smaller for kinematic variables than sEMG variables. In general, measurements obtained with 3D kinematics and sEMG are reproducible techniques to assess the mastication process. The duration of the chewing cycle and frequency of chewing were the best reproducible measurements. Change of chewing side could not be reproduced. The published measurement error and smallest detectable differences will aid the interpretation of the results of future clinical studies using the same study variables.
Reproducibility and validity of patient-rated assessment of speech, swallowing, and saliva control in Parkinson’s Disease
Zwarts, Machiel ; Kalf, Johanna ; Bloem, Bastiaan ; Borm, George ; Munneke, Marten ; Swart, B.J.M. de
2012, Article / Letter to editor (Archives of Physical Medicine and Rehabilitation, vol. 2011, iss. 92, (2012), pp. 1152-1158)To report on the development and psychometric evaluation of the Radboud Oral Motor Inventory for Parkinsons Disease (ROMP), a newly developed patient-rated assessment of speech, swallowing, and saliva control in patients with Parkinsons disease (PD). To evaluate reproducibility, 60 patients completed the ROMP twice within a mean of 24±12 days. To study validity, another cohort of 118 patients who had completed the ROMP was assessed by both a neurologist (HY stage, Unified Parkinsons Disease Rating Scale III) and speech-language pathologist (severity of dysarthria, dysphagia, drooling) who were blinded to ROMP scores. Confirmatory factor analysis identified the 3 a priori-designed ROMP domains of speech, swallowing, and saliva control. Internal consistency was .95 for the total ROMP and .87 to .94 for the 3 domains or subscales. Intraclass correlation coefficients for reproducibility were .94 and .83 to .92 for the subscales. Construct validity was substantial to good with correlations ranging from .36 to .82. The ROMP differentiated significantly (P<.001) between patients indicated for speech therapy (based on independent assessment) and those who were not and between mild, moderate, and severe PD according to HY stage. The ROMP provides a reliable and valid instrument to evaluate patient-perceived problems with speech, swallowing, and saliva control in patients with PD or AP.
Reply to Dziewas, R.; Bath, P.M. Endpoints in Dysphagia Trials. Comment on "Speyer et al. Neurostimulation in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analyses of Randomised Controlled Trials-Part I: Pharyngeal and Neuromuscular Electrical Stimulation. J. Clin. Med. 2022, 11, 776".
Speyer, R. ; Sutt, A.L. ; Bergström, L. ; Hamdy, S. ; Heijnen, B.J. ; Remijn, L. ; Wilkes-Gillan, S. ; Cordier, R.
2022, Article / Letter to editor (J Clin Med, vol. 11, iss. 12, (2022))Our systematic review and meta-analysis of pharyngeal electrical stimulation (PES) and neuromuscular electrical stimulation (NMES) in patients with oropharyngeal dysphagia (OD) is the first paper (Part I) [...].
The reliability and validity of the perceive, recall, plan and perform assessment in children with a mitochondrial disorder.
Lindenschot, M. ; Koene, S. ; Nott, M.T. ; -van der Sanden, M.W.G. Nijhuis ; Groot, I.J.M. de ; Steultjens, E.M.J. ; Graff, M.J.L.
2022, Article / Letter to editor (Disability and Rehabilitation, (2022), pp. 1-14)PURPOSE: To investigate the reliability and validity of the Perceive, Recall, Plan and Perform System of Task Analysis (PRPP-Assessment) by parent-provided videos of children with mitochondrial disorders. METHODS: Videos of 13 children performing 3-7 activities each were the subject of study, resulting in 65 activities. These were scored using the PRPP-Assessment by 11 raters. Internal consistency was calculated with Cronbach's alpha. Intra-rater reliability was evaluated by Bland-Altman Plots on 44 PRPP-Assessment scores. Inter-rater reliability was calculated with ICC(Agreement) on 128 PRPP-Assessment scores. Construct validity was assessed by comparing the PRPP-Assessment scores to the Canadian Occupational Performance Measure using Cohen's Kappa. PRPP-Assessments scores were evaluated with a multi-faceted Rasch Analysis. RESULTS: Internal consistency was high (0.92). Intra-rater reliability was sufficient to be good (92-96% within the 95%-Limits of the Agreement). The ICC(Agreement) for stage 1 Mastery Score showed acceptable inter-rater reliability (0.646). Stage 2 of the PRPP-Assessment showed low ICCs due to a lack of variability within the sample. Four out of six hypotheses on validity were accepted. Rasch's analysis demonstrated sound goodness-of-fit, and supported the validity of the PRPP-Assessment. CONCLUSION: The PRPP-Assessment by parent-provided videos in this heterogenic group showed sufficient to good psychometric properties. In practice, careful task selection and formulating criterion is recommended.Implications for RehabilitationPRPP-Assessment by parent-provided videos is reliable and valid in the complex, heterogenous group of children with mitochondrial disordersThe PRPP-Assessment is suitable for children with mitochondrial disorders as it showed to contain familiar, functional and meaningful tasks and activities that fit with their level of functioningProfessionals should be aware that parents might not be used to the criterium-based frame of reference of the PRPP-AssessmentWhen applying the PRPP-Assessment, it is recommended to be careful in task selection and formulating the criterion.
Reliability and responsiveness of the Observable Movement Quality scale for children with mild to moderate motor impairments
Dekkers, L.M.A. ; de Swart, B.J.M. ; Jonker, M. ; Erp, P. ; Wisman, A. ; van der Wees, P. J. ; Nijhuis-vander Sanden, M.W.G ; Janssen, A.J.W.M.
2020, Article / Letter to editor (Physical and Occupational Therapy in Pediatrics, vol. 40, iss. 6, (2020), pp. 681-696)
Reflections of patients and therapists on a multidisciplinary rehabilitation programme for persons with brachial plexus injuries
Janssen, R. ; Satink, T. ; Ijspeert, J ; Alfen, N. van ; Groothuis, JT ; Packer, T.L. ; Cup, Edith
2019, Article / Letter to editor (Disability and Rehabilitation, vol. 41, iss. 12, (2019), pp. 1427-1434)Purpose: There is lack of knowledge, evidence, and guidelines for rehabilitation interventions for persons with neuralgic amyotrophy (NA) or brachial plexus pathology. A first pilot study, evaluating the effect of an integrated rehabilitation programme, showed improvements in activity and participation levels. Aim: To gain insight, from the perspective of patients and therapists, into the critical ingredients of the programme, that contributed to improvements in activity and participation. Materials and methods: A qualitative study using semi-structured interviews with eight patients and five therapists (three occupational therapists and two physical therapists). Participants were asked to identify and describe factors regarding the rehabilitation that they perceived as positive and aspects of the programme that could be improved. Data were analysed using a constant comparative approach. Results: Patients reported (1) Time to diagnose: "Finally I'm in the right place;" (2) Awareness: "They gave me a mirror;" (3) Partnership: "There was real contact with the therapists; we made decisions together;" (4) Close collaboration: "Overlapping scopes of practice; doing the same from a different perspective;" and finally (5) Self-management: "Now I can do it myself." Therapists reported (1) "Patients knowledge and understanding is critical to success;" (2) "Activate problem solving and decision making;" (3) "Personalize your therapy; it's more than just giving exercises and information;" (4) "Constant consultation within the team; consistency in messages and approach;" and (5)" Ultimately the patient is in charge." Conclusions: The critical ingredients, correspond well with each other and include a person-centred approach, education, support in problem solving and decision making and an integrated team approach. These ingredients provided the patients with confidence to take responsibility to manage their everyday lives, the ultimate goal of the programme.
Reader ‘Pitch Limiting Voice Treatment'
Swart, B.J.M. de
2018, Book (monograph)
Quantitative ultrasound of the tongue and submental muscles in children and young adults
Engel-Hoek, Lenie van den ; Pillen, S. ; Groot, M. de ; Swart, B.J.M. de ; Alfen, N. van
2012, Article / Letter to editor (Muscle and Nerve, vol. 46, iss. 1, (2012), pp. 31-37)The purpose of this study was to assess the feasibility of quantitative muscle ultrasound (QMUS) to visualize oral muscles and to establish normative data for muscle thickness and echo intensity of submental and tongue muscles in healthy children and young adults. The data were compared with those of 5 patients with Duchenne muscular dystrophy (DMD). Ultrasound images from the suprahyoid region and from the surface of the tongue were made in 53 healthy subjects aged 5 to 30 years. All measurements were feasible in all subjects and patients with good reproducibility except for the mylohyoid muscle. Muscle thickness depended on height, and echo intensity depended on weight. Our findings suggest gradual involvement of oral muscles in DMD. QMUS in oral muscles is feasible in healthy children, adults and patients with DMD. These data show that it is possible to differentiate between healthy persons and patients with DMD.
The Psychometric Evaluation of a Speech Production Test Battery for Children: The Reliability and Validity of the Computer Articulation Instrument
Haaften, L van ; Diepeveen, S.J.H. ; Engel-Hoek, Lenie van den ; Jonker, M. ; Swart, B.J.M. de ; Maassen, B
2019, Article / Letter to editor (Journal of Speech, Language, and Hearing Research, vol. 62, iss. 7, (2019), pp. 2141-2170)
Promotieonderzoek Sandra Jellema Resuming valued activities after stroke: the influence of the environment. Nederlandse samenvatting
Jellema, S.
2022, Article / Letter to editor (Ergotherapie Magazine, vol. 4, (2022), pp. 43-48)Sommige cliënten die ergotherapeut Sandra Jellema tegenkwam waren onnodig inactief. Ze besloot promotieonderzoek te doen naar de invloed van de fysieke, sociale en maatschappelijke omgeving op de waardevolle activiteiten van volwassenen die een CVA doormaakten. Ook zoomde ze in op de invloed die het sociale netwerk heeft op participatie. Dit artikel is een samenvatting van haar proefschrift.
Progressiegericht coachen tijdens EDOMAH
Thijssen, M.C.E. ; van Uden, Merel ; Scheffer, Jeannet ; Lambrechts, Gera
2023, Part of book or chapter of book (Ergotherapie bij ouderen met dementie en hun mantelzorgers: Het EDOMAH-programma)
Prognostic value of a decreased tongue strength for survival time in patients with amyotrophic lateral sclerosis
Swart, B.J.M. de ; Schelhaas, J. ; Weikamp, J. ; Hendriks, J.C.M. ; Geurts, Alexander
2012, Article / Letter to editor (Journal of Neurology, vol. 259, iss. 11, (2012), pp. 2360-2366)Decreased tongue strength (TS) might herald bulbar involvement in patients with amyotrophic lateral sclerosis (ALS) well before dysarthria or dysphagia occur, and as such might be prognostic of short survival. The purpose of this study was to investigate the prognostic value of a decreased TS, in addition to other prognostic factors, such as site of onset, bulbar symptoms, bulbar signs, age, sex, maximum phonation time, time from symptoms to diagnosis, and gastrostomy, for survival time in patients with ALS. TS was measured in four directions in 111 patients who attended the diagnostic outpatient motor neuron clinic of our university hospital. Of these patients, 54 were diagnosed with ALS. TS was considered abnormal if the strength in minimally one direction was at least two standard deviations below the reference values obtained from comparable age category and sex-groups of healthy controls (n = 119). Twenty of the patients with ALS had a decreased TS. Multivariable analysis showed that, in addition to age, TS was an independent prognostic factor for survival time in patients with ALS.
Profiling Speech Sound Disorders for Clinical Validation of the Computer Articulation Instrument
Haaften, L van ; Diepeveen, S.J.H. ; Terband, H ; Vermeij, B ; Engel-Hoek, Lenie van den ; Swart, B.J.M. de ; Maassen, B
2019, Article / Letter to editor (AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, vol. 28, iss. 2, (2019), pp. 844-856)

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