Browse by Lectorate "Musculoskeletale Revalidatie"

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Effect van mondspoelmiddelen met essentiële oliën op tandplaque en gingivitis [Effects of mouthwash with essential oils on dental plaque and gingivitis].
Hollaar, V.R.Y. ; Swaaij, BMW van
2022, Article / Letter to editor (Nederlands Tijdschrift voor Tandheelkunde, vol. 129, iss. 10, (2022), pp. 381-384)
Effect of outpatient exercise training programmes in patients with chronic heart failure: a systematic review.
Mooren - van der Meer, S ; Zwerink, M. ; Brussel, M. van ; Valk, P. van der ; Wajon, E. ; Palen, J. van der
2012, Article / Letter to editor (European Journal of Preventive Cardiology, vol. 19, iss. 4, (2012), pp. 795-803)BACKGROUND: Advantages of outpatient exercise training are reduced waiting lists, better compliance, reduced time investment by the patient with reduced travel expenses, and less dependence on other people to participate. Therefore, this systematic review studies the effects of outpatient exercise training programmes compared with usual care on exercise capacity, exercise performance, quality of life, and safety in patients with chronic heart failure. DESIGN: Systematic review with meta-analysis. METHODS: Randomized controlled trials concerning patients with chronic heart failure, with a left ventricular ejection fraction ≤40%, were included. A meta-analysis was performed. RESULTS: Twenty-two studies were included. VO(2)max, 6-min walking test, and quality of life showed significant differences in favour of the intervention group of 1.85 ml/kg/min, 47.9 m, and 6.9 points, respectively. In none of the studies, a significant relationship was found between exercise training and adverse events. CONCLUSION: This meta-analysis illustrates the efficacy and safety of outpatient training programmes for patients with chronic heart failure.
Effect of a metatarsal pad on the forefoot during gait.
Koenraadt, K.L. ; Stolwijk, N.M. ; Wildenberg, D. van den ; Duysens, J. ; Keijsers, N.L.W.
2012, Article / Letter to editor (J Am Podiatr Med Assoc, vol. 102, iss. 1, (2012), pp. 18-24)BACKGROUND: Metatarsal pads are frequently prescribed for patients with metatarsalgia to reduce pain under the distal metatarsal heads. Several studies showed reduced pain and reduced plantar pressure just distal to the metatarsal pad. However, only part of the pain reduction could be explained by the decrease in plantar pressure under the forefoot. Therefore, an alternative hypothesis is proposed that pain relief is related to a widening of the foot and the creation of extra space between the metatarsal heads. This study focused on the effect of a metatarsal pad on the geometry of the forefoot by studying forefoot width and the height of the second metatarsal head. METHODS: Using a motion analysis system, 16 primary metatarsalgia feet and 12 control feet were measured when walking with and without a metatarsal pad. RESULTS: A significant mean increase of 0.60 mm in forefoot width during the stance phase was found when a metatarsal pad was worn. During midstance, the mean increase in forefoot width was 0.74 mm. In addition, walking with a metatarsal pad revealed an increase in the height of the second metatarsal head (mean, 0.62 mm). No differences were found between patients and controls. CONCLUSIONS: The combination of increased forefoot width and the height of the second metatarsal head produced by the metatarsal pad results in an increase in space between the metatarsal heads. This extra space could play a role in pain reduction produced by a metatarsal pad.
Effect evaluation of a self-management programme for employees with complaints of the arm, neck or shoulder: a randomised controlled trial.
Hutting, N. ; Staal, J.B. ; Engels, J.A. ; Heerkens, Y.F. ; Detaille, S.I. ; Nijhuis-van der Sanden, M.W.G.
2015, Article / Letter to editor (Occupational and Environmental Medicine, vol. 72, iss. 12, (2015), pp. 852-861)OBJECTIVE: To evaluate the effectiveness of a self-management intervention (including an eHealth module), compared with usual care, in employees with chronic non-specific complaints of the arm, neck or shoulder (persisting >3 months). METHODS: Participants were randomised into the self-management group (SG) or usual care group (UCG). The SG participated in 6 self-management sessions and could use an eHealth module; the UCG could use all available usual care. The primary outcome of the study was score on the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Secondary outcomes included: absenteeism, pain in the previous week, quality of life, pain catastrophising, self-efficacy, work style, presenteeism, fatigue, and limitations experienced during work. Data were analysed using generalised estimating equations (GEE) linear regression and Mann-Whitney U tests, and were collected at baseline, 3-month, 6-month, and 12-month follow-up. RESULTS: On the general module of the DASH, no significant difference between SG and the UCG was detected. On most of the other outcome measures, there were no significant between-group differences. In the DASH work module, the between-group effect was -3.82 (95% CI -7.46 to -0.19, p=0.04). For limitations experienced in job-related activities the between-group effect was -1.01 (95% CI -1.97 to -0.04, p=0.04). The mean hours of sport activities in the past 3 months, measured at 12 months, was 1.00 h (95% CI -1.90 to -0.12 h, p=0.03) less in the SG compared with the UCG. CONCLUSIONS: The self-management intervention improved the participants' perceived disability during work. Since no significant between-group differences were found on most outcome measures, the results of this study should be interpreted with caution. TRIAL REGISTRATION NUMBER: Dutch Trial Registration number NTR 3816.
Does motor expertise facilitate amplitude differentiation of lower limb-movements in an asymmetrical bipedal coordination task?
Roelofsen, E.G.J. ; Brown, D.D. ; Nijhuis-van der Sanden, M.W.G. ; Staal, J.B. ; Meulenbroek, R.G.J.
2018, Article / Letter to editor (Human Movement Science, vol. 59, (2018), pp. 201-211)
Development of a self-management program for employees with complaints of the arm, neck, and/or shoulder: an intervention mapping approach
Hutting, N. ; Detaille, S.I. ; Engels, J.A. ; Heerkens, Y.F. ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G.
2015, Article / Letter to editor (Journal of Multidisciplinary Healthcare, vol. 2015, iss. 8, (2015), pp. 307-320)To develop a self-management program with an additional eHealth module, using the six steps of the intervention mapping (IM) protocol, to help employees with complaints of the arm, neck, and/or shoulder (CANS) cope with their problems. In Step 1 of the IM protocol, a needs assessment was performed consisting of a review of the Dutch multidisciplinary guidelines on CANS, and of focus group sessions with employees with CANS (n=15) and with relevant experts (n=17). After the needs assessment, the objectives of the intervention and the determinants of self-management at work were formulated (Step 2). Furthermore, theory-based intervention methods and practical strategies were selected (Step 3), and an intervention program (including the eHealth module) was developed (Step 4). Finally, plans for implementation and evaluation of the program were developed (Steps 5 and 6). Step 1 of the IM protocol revealed that employees with CANS should be stimulated to search for information about the cause of their complaints, about how to deal with their complaints, and in which manner they can influence their complaints themselves. In Step 2, the overall goal of the intervention was defined as "self-management behavior at work" with the aim to alleviate the perceived disability of the participants. Step 3 described how the intervention methods were translated into practical strategies, and goal setting was introduced as an important method for increasing self-efficacy. The product of Step 4 was the final program plan, consisting of 6-weekly group sessions of 2.5 hours each and an eHealth module. In Step 5, a recruitment plan and course materials were developed, a steering committee was set up, trainers were recruited, and the final program was tested. In Step 6, an evaluation plan was developed, which consists of a randomized controlled trial with a 12-month follow-up period and a qualitative evaluation (interviews) with some of the participants.
Development of a self-management intervention for employees with complaints of the arm, neck and/or shoulder (CANS): a focus group study with experts.
Hutting, N. ; Engels, J.A. ; Staal, J.B. ; Heerkens, Y.F. ; Nijhuis-van der Sanden, M.W.G.
2015, Article / Letter to editor (Journal of Occupational Medicine and Toxicology, vol. 10, (2015), pp. 9)BACKGROUND: Many people suffer from complaints of the arm, neck and/or shoulder (CANS). The complaints are persistent and there is a need for intervention programs for those with longstanding CANS. Studies suggest that a behavioural change is needed in employees with CANS. A self-management program with an add-on eHealth module might be an effective option to achieve the behavioural change needed to manage the complaints in employees with CANS. The aim of this study was to determine the content and strategies of the intervention and to gain insight into possible barriers and facilitators for implementation. Therefore, we examined the views of experts on the problems and characteristics associated with employees with CANS as well as their opinion on a self-management program consisting of self-management sessions and an eHealth module. METHODS: A qualitative study was performed consisting of three focus groups involving a total of 17 experts (with experience with CANS, self-management and/or eHealth interventions). Experts were asked their opinion about the content and requirements of a self-management program for employees with CANS, including an eHealth module. Data were analysed using qualitative data analysis. After coding, the emergent themes were used to organise the data into main categories, expressing the ideas and opinions of experts on CANS, self-management and/or eHealth interventions. RESULTS: The experts pointed out that the intervention should focus on increasing employees' self-efficacy and empowerment, and address topics related to the possible risk factors for CANS, symptoms, work environment, social environment and personal factors. The eHealth module should be self-explanatory and attractive, and the information provided should be brief, clear and concise. CONCLUSIONS: Experts appeared to see a role for a self-management program for employees with CANS. They indicated that the combination of group sessions and eHealth can work well. Experts provided valuable information with regard to the content of the self-management intervention and the design of the eHealth module.
Development and validation of two clinical prediction models to inform clinical decision-making for lumbar spinal fusion surgery for degenerative disorders and rehabilitation following surgery: protocol for a prospective observational study.
Rushton, A.B. ; Verra, M.L. ; Emms, A. ; Heneghan, N.R. ; Falla, D. ; Reddington, M. ; Cole, A.A. ; Willems, P. ; Benneker, L. ; Selvey, D. ; Hutton, M. ; Heymans, M.W. ; Staal, J.B. et al. sine al.
2018, Article / Letter to editor (BMJ Open, vol. 8, iss. 5, (2018))
Development and proof of concept of a blended physiotherapeutic intervention for patients with non-specific low back pain.
Kloek, C.J.J. ; TIlburg, M.L. van ; Staal, J.B. ; Veenhof, C. ; Bossen, D.
2019, Article / Letter to editor (Physiotherapy, (2019))
Development and measurement properties of the Dutch version of the Stanford Presenteeism Scale (SPS-6).
Hutting, N. ; Engels, J.A. ; Heerkens, Y.F. ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G.
2014, Article / Letter to editor (Journal of Occupational Rehabilitation, vol. 24, iss. 2, (2014), pp. 268-277)OBJECTIVE: To develop a Dutch version of the Stanford Presenteeism Scale (SPS-6) and examine the reliability and discriminant, discriminative and structural validity of the Dutch SPS-6 (DSPS-6). METHODS: The original SPS-6 (English-language) was translated and adapted to the Dutch culture. Thirty participants filled in the DSPS-6 at baseline (T0) and after 5 days (T1). Internal consistency (Cronbach's alpha), test-retest reliability (Spearman's correlation coefficient, Spearman's rho), item-to-total correlations, discriminant validity (association with job stress and job satisfaction), discriminative validity (patients reporting a (work) disability compared with those indicating that they had no disability; Spearman's rho, t tests), structural validity (Varimax rotation with Kaiser Normalization) and floor and ceiling effects were examined. RESULTS: Cronbach's alpha for the DSPS-6 was 0.89. Test-retest Spearman's rho was 0.82 (p < 0.01). Item-to-total correlations ranged from 0.60 to 0.82. Subjects reporting a work disability had significantly lower DSPS scores (discriminative validity). Spearman's rho for the DSPS-6 score and job satisfaction were 0.38 (p = 0.05; at T0) and 0.27 (at T1), respectively. Spearman's rho for the association between the DSPS-6 and job stress were -0.52 (p = 0.01; at T0) and -0.42 (p = 0.05; at T1), respectively (discriminant validity). The two factors derived from the principal components analysis account for 77.5 % of the variance of responses (structural validity). A ceiling effect was present. CONCLUSIONS: The DSPS-6 showed good reliability and structural validity. The discriminative validity of the DSPS-6 is partly supported. The concept of presenteeism is not sufficiently distinct from the constructs of job stress and job satisfaction (discriminant validity). The results of the present study show that the adaptation of the SPS-6 into Dutch was successful. Further research on the reliability, validity and responsiveness of the DSPS-6 in a larger group of participants is recommended.
Development and internal validation of a machine learning prediction model for low back pain non-recovery in patients with an acute episode consulting a physiotherapist in primary care
Knoop, J. ; Lankveld, W.G.J.M. van ; Beijer, L.J. ; Geerdink, F.J.B ; Heymans, M.W. ; Hoogeboom, T.J. ; Hoppenbrouwers, S.J.B.A. ; van Overmeeren, E. ; Soer, R ; Veenhof, C. ; Vissers, K.C.P ; van der Wees, P. J. ; Sappelli, M. ; Staal, J.B. et al. sine al.
2022, Article / Letter to editor (BMC Musculoskeletal Disorders, (2022))Background While low back pain occurs in nearly everybody and is the leading cause of disability worldwide, we lack instruments to accurately predict persistence of acute low back pain. We aimed to develop and internally validate a machine learning model predicting non-recovery in acute low back pain and to compare this with current practice and ‘traditional’ prediction modeling. Methods Prognostic cohort-study in primary care physiotherapy. Patients (n = 247) with acute low back pain (≤ one month) consulting physiotherapists were included. Candidate predictors were assessed by questionnaire at baseline and (to capture early recovery) after one and two weeks. Primary outcome was non-recovery after three months, defined as at least mild pain (Numeric Rating Scale > 2/10). Machine learning models to predict non-recovery were developed and internally validated, and compared with two current practices in physiotherapy (STarT Back tool and physiotherapists’ expectation) and ‘traditional’ logistic regression analysis. Results Forty-seven percent of the participants did not recover at three months. The best performing machine learning model showed acceptable predictive performance (area under the curve: 0.66). Although this was no better than a’traditional’ logistic regression model, it outperformed current practice. Conclusions We developed two prognostic models containing partially different predictors, with acceptable performance for predicting (non-)recovery in patients with acute LBP, which was better than current practice. Our prognostic models have the potential of integration in a clinical decision support system to facilitate data-driven, personalized treatment of acute low back pain, but needs external validation first.
De ROM.app. Schoudermobiliteit valide en betrouwbaar meten
Seeger, J. ; Nieuwenhuijzen, P.H.J.A.
2019, Article / Letter to editor (Fysiopraxis, vol. 28, iss. 4, (2019), pp. 18-21)
Current Prehabilitation Programs Do Not Improve the Postoperative Outcomes of Patients Scheduled for Lumbar Spine Surgery: A Systematic Review With Meta-analysis.
Janssen, E.R.C. ; Punt, I.M. ; Clemens, M.J. ; Staal, J.B. ; Hoogeboom, T.J. ; Willems, P.C.
2021, Article / Letter to editor (Journal of Orthopaedic and Sports Physical Therapy, vol. 51, iss. 3, (2021), pp. 103-114)OBJECTIVE: To assess the effectiveness of prehabilitation in patients with degenerative disorders of the lumbar spine who are scheduled for spine surgery. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: Seven electronic databases were systematically searched for randomized controlled trials or propensity-matched cohorts. STUDY SELECTION CRITERIA: Studies that measured the effect of prehabilitation interventions (ie, exercise therapy and cognitive behavioral therapy [CBT]) on physical functioning, pain, complications, adverse events related to prehabilitation, health-related quality of life, psychological outcomes, length of hospital stay, use of analgesics, and return to work were included. DATA SYNTHESIS: Data were extracted at baseline (preoperatively) and at short-term (6 weeks or less), medium-term (greater than 6 weeks and up to 6 months), and long-term (greater than 6 months) follow-ups. Pooled effects were analyzed as mean differences and 95% confidence intervals (CIs). Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RESULTS: Cognitive behavioral therapy interventions were no more effective than usual care for all outcomes. Pooled effect sizes were -2.0 (95% CI: -4.4, 0.4) for physical functioning, -1.9 (95% CI: -5.2, 1.4) for back pain, and -0.4 (95% CI: -4.1, 0.4) for leg pain. Certainty of evidence for CBT ranged from very low to low. Only 1 study focused on exercise therapy and found a positive effect on short-term outcomes. CONCLUSION: There was very low-certainty to low-certainty evidence of no additional effect of CBT interventions on outcomes in patients scheduled for lumbar surgery. Existing evidence was too limited to draw conclusions about the effects of exercise therapy. J Orthop Sports Phys Ther 2021;51(3):103-114. Epub 25 Dec 2020. doi:10.2519/jospt.2021.9748.
Cross-cultural adaptation and measurement properties of the Dutch knee self efficacy scale (K-SES)
Lankveld, W.G.J.M. van ; Melick, N. van ; Habets, B. ; Pronk, Y. ; Staal, J.B. ; Cingel, Robert van
2019, Article / Letter to editor (BMC Sports Science, Medicine and Rehabilitation, vol. 7, iss. 11, (2019), pp. 3)
Could Virtual Reality play a role in the rehabilitation after COVID-19 infection?
Smits, M. ; Staal, J.B. ; Goor, H. van
2020, Article / Letter to editor (BMJ Open Sport & Exercise Medicine, vol. 6, iss. 1, (2020), pp. e000943)Post-COVID-19 patients, particularly those who needed high care, are expected to have high needs for physical, psychological and cognitive rehabilitation. Yet, the resources needed to provide rehabilitation treatment are expected to be inadequate because healthcare systems faced a shortage of high-quality treatment of these symptoms already before the COVID-19 crisis emerged in patients with comparable needs. In this viewpoint, we discuss the potential of Virtual Reality (VR) administering fast, tailor-made rehabilitation at a distance, and offering a solution for the impending surge of demand for rehabilitation after COVID-19. VR consists of a head-mounted display (HMD) that can bring the user by computer-generated visuals into an immersive, realistic multi-sensory environment. Several studies on VR show its potential for rehabilitation and suggest VR to be beneficial in post-COVID-19. The immersion of VR may increase therapy adherence and may distract the patient from experienced fatigue and anxiety. Barriers still have to be overcome to easily implement VR in healthcare. We argue that embedding VR in virtual care platforms would assist in overcoming these barriers and would stimulate the spread of VR therapy, both for post-COVID-19 patients in the present and possibly for other patients with similar rehabilitation needs in the future.
Construct validity of the OCTOPuS stratification algorithm for allocating patients with knee osteoarthritis into subgroups.
Knoop, J. ; Ostelo, R.W.J.G. ; Esch, M. van der ; Zwart, A. de ; Bennell, K.L. ; Leeden, M van der ; Dekker, J
2021, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 22, iss. 1, (2021), pp. 633)BACKGROUND: We recently developed a model of stratified exercise therapy, consisting of (i) a stratification algorithm allocating patients with knee osteoarthritis (OA) into one of the three subgroups ('high muscle strength subgroup' representing a post-traumatic phenotype, 'low muscle strength subgroup' representing an age-induced phenotype, and 'obesity subgroup' representing a metabolic phenotype) and (ii) subgroup-specific exercise therapy. In the present study, we aimed to test the construct validity of this algorithm. METHODS: Data from five studies (four exercise therapy trial cohorts and one cross-sectional cohort) were used to test the construct validity of our algorithm by 63 a priori formulated hypotheses regarding three research questions: (i) are the proportions of patients in each subgroup similar across cohorts? (15 hypotheses); (ii) are the characteristics of each of the subgroups in line with their proposed underlying phenotypes? (30 hypotheses); (iii) are the effects of usual exercise therapy in the 3 subgroups in line with the proposed effect sizes? (18 hypotheses). RESULTS: Baseline data from a total of 1211 patients with knee OA were analyzed for the first and second research question, and follow-up data from 584 patients who were part of an exercise therapy arm within a trial for the third research question. In total, the vast majority (73%) of the hypotheses were confirmed. Regarding our first research question, we found similar proportions in each of the three subgroups across cohorts, especially for three cohorts. Regarding our second research question, subgroup characteristics were almost completely in line with the proposed underlying phenotypes. Regarding our third research question, usual exercise therapy resulted in similar, medium to large effect sizes for knee pain and physical function for all three subgroups. CONCLUSION: We found mixed results regarding the construct validity of our stratification algorithm. On the one hand, it is a valid instrument to consistently allocate patients into subgroups that aligned our hypotheses. On the other hand, in contrast to our hypotheses, subgroups did not differ substantially in effects of usual exercise therapy. An ongoing trial will assess whether this algorithm accompanied by subgroup-specific exercise therapy improves clinical and economic outcomes.
A consensus-based framework for conducting and reporting osteoarthritis phenotype research.
Spil, W.E. van ; Bierma-Zeinstra, S.M.A. ; Deveza, L.A. ; Arden, N.K. ; Bay-Jensen, A.C. ; Kraus, V.B. ; Carlesso, L. ; Christensen, R. ; Esch, M. van der ; Kent, P. ; Knoop, J. ; Ladel, C. ; Little, C.B. ; Loeser, R.F. ; Losina, E. ; Mills, K. ; Mobasheri, A. ; Nelson, A.E. ; Neogi, T. ; Peat, G.M. ; Rat, A.C. ; Steultjens, M. ; Thomas, M.J. ; Valdes, A.M. ; Hunter, D.J. et al. sine al.
2020, Article / Letter to editor (Arthritis Research & Therapy, vol. 22, iss. 1, (2020), pp. 54)BACKGROUND: The concept of osteoarthritis (OA) heterogeneity is evolving and gaining renewed interest. According to this concept, distinct subtypes of OA need to be defined that will likely require recognition in research design and different approaches to clinical management. Although seemingly plausible, a wide range of views exist on how best to operationalize this concept. The current project aimed to provide consensus-based definitions and recommendations that together create a framework for conducting and reporting OA phenotype research. METHODS: A panel of 25 members with expertise in OA phenotype research was composed. First, panel members participated in an online Delphi exercise to provide a number of basic definitions and statements relating to OA phenotypes and OA phenotype research. Second, panel members provided input on a set of recommendations for reporting on OA phenotype studies. RESULTS: Four Delphi rounds were required to achieve sufficient agreement on 11 definitions and statements. OA phenotypes were defined as subtypes of OA that share distinct underlying pathobiological and pain mechanisms and their structural and functional consequences. Reporting recommendations pertaining to the study characteristics, study population, data collection, statistical analysis, and appraisal of OA phenotype studies were provided. CONCLUSIONS: This study provides a number of consensus-based definitions and recommendations relating to OA phenotypes. The resulting framework is intended to facilitate research on OA phenotypes and increase combined efforts to develop effective OA phenotype classification. Success in this endeavor will hopefully translate into more effective, differentiated OA management that will benefit a multitude of OA patients.
Consensus leeruitkomsten communicatie Resultaten Delphi Onderzoek Kerngroep Communicatievaardigheden
Lakke, S ; Oosterhaven, J. ; Kinds, E. ; Lankveld, W.G.J.M. van
2020, External research report
Concepts of functioning and health important to people with systemic sclerosis: a qualitative study in four European countries
Stamm, T.A. ; Mattsson, M. ; Mihai, C. ; Stöcker, J.K. ; Binder, A. ; Bauernfeind, B. ; Stummvoll, G. ; Gard, G. ; Hesselstrand, R. ; Sandqvist, G. ; Draghicescu, O. ; Gherghe, A.M. ; Voicu, M. ; Machold, K.P. ; Distler, O. ; Smolen, J.S. ; Boström, C. et al. sine al.
2011, Article / Letter to editor (Annals of the Rheumatic Diseases, vol. 70, iss. 6, (2011), pp. 1074-1079)
Clinical Practice Guideline for PhysicalTherapy Assessment and Treatment in Patients With Nonspecific Neck Pain.
Bier, J.D. ; Scholten-Peeters, W.G.M. ; Staal, J.B. ; Pool, J. ; Tulder, M.W. van ; Beekman, E. ; Knoop, J. ; Meerhoff, G. ; Verhagen, A.P.
2018, Article / Letter to editor (Physical Therapy, vol. 98, iss. 3, (2018), pp. 162-171)
Clinical course of pain and disability following primary lumbar discectomy: systematic review and meta-analysis.
Rushton, A. ; Heneghan, N.R. ; Heymans, M.W. ; Staal, J.B. ; Goodwin, P.
2020, Article / Letter to editor (European Spine Journal, vol. 29, iss. 7, (2020), pp. 1660-1670)PURPOSE: To conduct a meta-analysis to describe clinical course of pain and disability in adult patients post-lumbar discectomy (PROSPERO: CRD42015020806). METHODS: Sensitive topic-based search strategy designed for individual databases was conducted. Patients (>n16 years) following first-time lumbar discectomy for sciatica/radiculopathy with no complications, investigated in inception (point of surgery) prospective cohort studies, were included. Studies including revision surgery or not published in English were excluded. Two reviewers independently searched information sources, assessed eligibility at title/abstract and full-text stages, extracted data, assessed risk of bias (modified QUIPs) and assessed GRADE. Authors were contacted to request raw data where data/variance data were missing. Meta-analyses evaluated outcomes at all available time points using the variance-weighted mean in random-effect meta-analyses. Means and 95% CIs were plotted over time for measurements reported on outcomes of leg pain, back pain and disability. RESULTS: A total of 87 studies (nn=n31,034) at risk of bias (49 moderate, 38 high) were included. Clinically relevant improvements immediately following surgery (>nMCID) for leg pain (0-10, mean before surgery 7.04, 50 studies, nn=n14,910 participants) and disability were identified (0-100, mean before surgery 53.33, 48 studies, nn=n15,037). Back pain also improved (0-10, mean before surgery 4.72, 53 studies, nn=n14,877). Improvement in all outcomes was maintained (to 7 years). Meta-regression analyses to assess the relationship between outcome data and a priori potential covariates found preoperative back pain and disability predictive for outcome. CONCLUSION: Moderate-level evidence supports clinically relevant immediate improvement in leg pain and disability following lumbar discectomy with accompanying improvements in back pain. These slides can be retrieved under Electronic Supplementary Material.
Classification of forefoot pain based on plantar pressure measurements.
Keijsers, N.L.W. ; Stolwijk, N.M. ; Louwerens, J.W. ; Duysens, J.
2013, Article / Letter to editor (Clinical Biomechanics, vol. 28, iss. 3, (2013), pp. 350-356)BACKGROUND: Plantar pressure is widely used to evaluate foot complaints. However, most plantar pressure studies focus on the symptomatic foot with foot deformities. The purposes of this study were to investigate subjects without clear foot deformities and to identify differences in plantar pressure pattern between subjects with and without forefoot pain. The second aim was to discriminate between subjects with and without forefoot pain based on plantar pressure measurements using neural networks. METHODS: In total, 297 subjects without foot deformities of whom almost 50% had forefoot pain walked barefoot over a pressure plate. Foot complaints and subject characteristics were assessed with a questionnaire and a clinical evaluation. Plantar pressure was analyzed using a recently developed method, which produced pressure images of the time integral, peak pressure, mean pressure, time of activation and deactivation, and total contact time per pixel. After pre-processing the pressure images with principal component analysis, a forward selection procedure with neural networks was used to classify forefoot pain. FINDINGS: The pressure-time integral and mean pressure were significantly larger under the metatarsals II and III for subjects with forefoot pain. A neural network with 14 input parameters correctly classified forefoot pain in 70.4% of the test feet. INTERPRETATION: The differences in plantar pressure parameters between subjects with and without forefoot pain were small. The reasonable performance of forefoot pain classification by neural networks suggests that forefoot pain is related more to the distribution of the pressure under the foot than to the absolute values of the pressure at fixed locations.
Changes in motor-flexibility following anterior cruciate ligament reconstruction as measured by means of a leg-amplitude differentiation task with haptic and visual feedback.
Roelofsen, E.G.J. ; Cingel, R. van ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G. ; Meulenbroek, R.G.J.
2020, Article / Letter to editor (Clinical Biomechanics, vol. 80, (2020), pp. 105186)BACKGROUND: In the current study changes in lower-limb motor flexibility of patients undergoing Anterior Cruciate Ligament Reconstruction were evaluated in relation to fear of harm. METHODS: Fourteen patients were measured pre- and post-surgery, and data were compared to those of a single measurement in fifteen controls. Lower-limb motor-flexibility was assessed in treadmill-walking and a cyclic leg-amplitude differentiation task augmented with haptic or visual feedback. Flexibility was captured by determining the between-leg coordination-variability (SD of relative phase) and each leg's temporal variability (sample entropy). Patients were post hoc divided into a higher-fear-group (pre-surgery: n = 6, post-surgery: n = 7) and a lower-fear-group (pre-surgery: n = 6, post-surgery: n = 7) by means of a median split of their scores on a self-reported fear of harm scale. Differences in flexibility-measures between the higher-fear-group and the lower-fear-group were also assessed. FINDINGS: No pre- and post-surgery differences, nor differences with the control group, were found in motor-flexibility during treadmill-walking but the post-surgery higher-fear-group did show lower values of SD relative phase. In the leg-amplitude differentiation task the SD of the relative phase decreased but sample entropy increased post-surgery towards levels of the control-group. The pre-surgery higher-fear-group showed lower values of sample entropy in visual conditions. INTERPRETATION: While gait kinematics may not show motor-flexibility changes following anterior cruciate ligament reconstruction, a leg-amplitude differentiation task does show such changes. Differentiating patients on a fear-of-harm scale revealed subtle differences in motor-flexibility. Challenging patients with non-preferred movements such as amplitude differentiation may be a promising tool to evaluate motor-flexibility following ACLR.
De Bland-Altman-plot uitgelegd
Nieuwenhuijzen, P.H.J.A. ; Seeger, J.
2019, Article / Letter to editor (Physiopraxis, vol. 28, iss. 4, (2019), pp. 22-25)
Beperkte gezondheidsvaardigheden en fysiotherapie. Begrijpelijk communiceren
Scheer, E. van der ; Lankveld, W.G.J.M. van ; Staal, J.B.
2021, Article / Letter to editor (Fysiopraxis, (2021), pp. 17-19)
Bepalen prognose bij lage rugpijn aan de hand van zelf verzamelde gegevens.
Staal, J.B. ; Verbeek, A.L.M.
2020, Article / Letter to editor (Physios, vol. 2020, iss. 4, (2020), pp. 40-47)
Author Response.
Bier, J.D. ; Scholten-Peeters, W.G.M. ; Staal, J.B. ; Pool, J. ; Tulder, M.W. van ; Beekman, E. ; Knoop, J. ; Meerhoff, G. ; Verhagen, A.P.
2019, Article / Letter to editor (Physical Therapy, vol. 99, iss. 1, (2019), pp. 120)
Association between language use of physiotherapists during first musculoskeletal physiotherapy consultations with anxiety, illness perception and working alliance.
Staal, J.B.
2020, Article in monograph or in proceedings (European Region - World Congress of Physiotherapy)

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