Browse by Lectorate "Musculoskeletale Revalidatie"

Now showing items 51-100 of 125

Pain Exposure Physical Therapy versus conventional treatment in complex regional pain syndrome type 1-a cost-effectiveness analysis alongside a randomized controlled trial.
Barnhoorn, K. ; Staal, J.B. ; Dongen, R.T.M. van ; Frölke, J.P.M. ; Klomp, F.P. ; Meent, H. van de ; Adang, Eddy ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Clinical Rehabilitation, vol. 32, iss. 6, (2018), pp. 790-798)
Pain Exposure Physical Therapy in complex regional pain syndrome: promising enough to warrant further investigation.
Staal, J.B. ; Klomp, F.P. ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Canadian Journal of Anaesthesia, (2018))
Pain and disability after first-time spinal fusion for lumbar degenerative disorders: a systematic review and meta-analysis.
Koenders, N. ; Rushton, A. ; Verra, M.L. ; Willems, P.C. ; Hoogeboom, T.J. ; Staal, J.B.
2018, Article / Letter to editor (European Spine Journal, (2018))
Pain and disability after first-time spinal fusion for lumbar degenerative disorders: a systematic review and meta-analysis
Koenders, N. ; Rushton, A. ; Verra, M.L. ; Willems, P.C. ; Hoogeboom, T.J. ; Staal, J.B.
2019, Article / Letter to editor (European Spine Journal, vol. 28, iss. 4, (2019), pp. 696-709)
Opening the black box of non-pharmacological care in systemic sclerosis: a cross-sectional online survey of Dutch health professionals
Stöcker, J.K. ; Vonk, M.C. ; Hoogen, F.H.C. van den ; Nijhuis-van der Sanden, M.W.G. ; Spierings, J ; Staal, J.B. ; Satink, T. ; Ende, C.H.M.
2020, Article / Letter to editor (Rheumatology International, (2020))
NON-PHARMACOLOGICAL CARE IN SYSTEMIC SCLEROSIS: OPENING THE BLACK BOX
Stöcker, J.K. ; Cup, E.H.C. ; Vonk, M ; Hoogen, F van den ; Nijhuis-van der Sanden, M.W.G. ; Staal, J.B. ; Ende, C. van den
2018, Article / Letter to editor (Annals of the Rheumatic Diseases, vol. 78, (2018), pp. 112)
No evidence for stratified exercise therapy being cost-effective compared to usual exercise therapy in patients with knee osteoarthritis: Economic evaluation alongside cluster randomized controlled trial.
Knoop, J. ; Esser, J. ; Dekker, J ; Joode, J.W. de ; Ostelo, R.W.J.G. ; Dongen, J.M. van
2022, Article / Letter to editor (Braz J Phys Ther, vol. 27, iss. 1, (2022), pp. 100469)BACKGROUND: A stratified approach to exercise therapy may yield superior clinical and economic outcomes, given the large heterogeneity of individuals with knee osteoarthritis (OA). OBJECTIVE: To evaluate the cost-effectiveness during a 12-month follow-up of a model of stratified exercise therapy compared to usual exercise therapy in patients with knee OA, from a societal and healthcare perspective. METHODS: An economic evaluation was conducted alongside a cluster-randomized controlled trial in patients with knee OA (n = 335), comparing subgroup-specific exercise therapy for a 'high muscle strength subgroup', 'low muscle strength subgroup', and 'obesity subgroup' supplemented by a dietary intervention for the 'obesity subgroup' (experimental group), with usual ('non-stratified') exercise therapy (control group). Clinical outcomes included quality-adjusted life years - QALYs (EuroQol-5D-5 L), knee pain (Numerical Rating Scale) and physical functioning (Knee Injury and Osteoarthritis Outcome Score in daily living). Costs were measured by self-reported questionnaires at 3, 6, 9 and 12-month follow-up. Missing data were imputed using multiple imputation. Data were analyzed through linear regression. Bootstrapping techniques were applied to estimate statistical uncertainty. RESULTS: During 12-month follow-up, there were no significant between-group differences in clinical outcomes. The total societal costs of the experimental group were on average lower compared to the control group (mean [95% confidence interval]: € 405 [-1728, 918]), albeit with a high level of uncertainty. We found a negligible difference in QALYs between groups (mean [95% confidence interval]: 0.006 [-0.011, 0.023]). The probability of stratified exercise therapy being cost-effective compared to usual exercise therapy from the societal perspective was around 73%, regardless of the willingness-to-pay threshold. However, this probability decreased substantially to 50% (willingness-to-pay threshold of €20.000/QALY) when using the healthcare perspective. Similar results were found for knee pain and physical functioning. CONCLUSIONS: We found no clear evidence that stratified exercise therapy is likely to be cost-effective compared to usual exercise therapy in patients with knee OA. However, results should be interpreted with caution as the study power was lower than intended, due to the Coronavirus disease (COVID-19) pandemic.
A new method to normalize plantar pressure measurements for foot size and foot progression angle.
Keijsers, N.L.W. ; Stolwijk, N.M. ; Nienhuis, B. ; Duysens, J.
2009, Article / Letter to editor (Journal of Biomechanics, vol. 42, iss. 1, (2009), pp. 87-90)Plantar pressure measurement provides important information about the structure and function of the foot and is a helpful tool to evaluate patients with foot complaints. In general, average and maximum plantar pressure of 6-11 areas under the foot are used to compare groups of subjects. However, masking the foot means a loss of important information about the plantar pressure distribution pattern. Therefore, the purpose of this study was to develop and test a simple method that normalizes the plantar pressure pattern for foot size, foot progression angle, and total plantar pressure. Moreover, scaling the plantar pressure to a standard foot opens the door for more sophisticated analysis techniques such as pattern recognition and machine learning. Twelve subjects walked at preferred and half of the preferred walking speed over a pressure plate. To test the method, subjects walked in a straight line and in an approaching angle of approximately 40 degrees . To calculate the normalized foot, the plantar pressure pattern was rotated over the foot progression angle and normalized for foot size. After normalization, the mean shortest distance between the contour lines of straight walking and walking at an angle had a mean of 0.22 cm (SD: 0.06 cm) for the forefoot and 0.14 cm (SD: 0.06 cm) for the heel. In addition, the contour lines of normalized feet for the various subjects were almost identical. The proposed method appeared to be successful in aligning plantar pressure of various feet without losing information.
Negative language use of the physiotherapist in low back pain education impacts anxiety and illness beliefs: A randomised controlled trial in healthy respondents
Linskens, F.G. ; Scheer, E. van der ; Stortenbeker, I. ; Das, E. ; Staal, J.B. ; Lankveld, W.G.J.M. van
2023, Article / Letter to editor (Patient Education and Counseling, vol. 110, (2023))
Modulation of the startle response during human gait
Nieuwenhuijzen, P.H.J.A. ; Schillings, A.M. ; Van Galen, G. P.,, G.P. ; Duysens, J.
2000, Article / Letter to editor (Journal of Neurophysiology, vol. 84, iss. 1, (2000), pp. 65-74)
Mechanically induced ankle inversion during human walking and jumping
Nieuwenhuijzen, P.H.J.A. ; Grüneberg, C. ; Duysens, J.
2002, Article / Letter to editor (Journal of Neuroscience Methods, vol. 117, iss. 2, (2002), pp. 133-140)A new method to study sudden ankle inversions during human walking and jumping is presented. Ankle inversions of 258wereelicited using a box containing a trap door. During the gait task, subjects walked at a speed of 4 km/h. At a pre-programmed delayafter left heel strike, an electromagnet released the box on the treadmill. This delay enabled the subject to step on the box withouthaving to change the walking cadence. During the jumping task, subjects jumped from a 30 cm high platform on the box in astandardised way. In both tasks 20 stimulus and 20 control trials were presented randomly. The average tiltingvelocity of the trapdoor during the stimulus trials was 4038/s during the walking task and 5958/s during the jumping task. For the control trials a tiltingof 08was used. With this method it is possible to evoke reproducible ankle inversions causing characteristic EMG responses in sixlower leg muscles.
Measurement of range-of-motion in infants with indications of upper cervical dysfunction using the Flexion-Rotation-Test and Lateral-Flexion-Test: a blinded inter-rater reliability study in a clinical practice setting.
Driehuis, F. ; Keijsers, N.L.W. ; Nijhuis-van der Sanden, M.W.G. ; Bie, R.A. de ; Staal, J.B. ; Hoogeboom, T.J.
2021, Article / Letter to editor (Journal of Manual & Manipulative Therapy, vol. 29, iss. 1, (2021), pp. 40-50)Background: In infants with indications of upper cervical dysfunction, the Flexion-Rotation-Test and Lateral-Flexion-Test are used to indicate reduced upper cervical range-of-motion (ROM). In infants, the inter-rater reliability of these tests is unknown. Objective: To assess the inter-rater reliability of subjectively and objectively measured ROM by using the Flexion-Rotation-Test and Lateral-Flexion-Test. Methods: 36 infants (<6 months) and three manual therapists participated in this cross-sectional observational study. Pairs of two manual therapists independently assessed infants' upper cervical ROM using the Flexion-Rotation-Test and Lateral-Flexion-Test, blinded for each other's outcomes. Two inertial motion sensors objectively measured cervical ROM. Inter-rater reliability was determined between each pair of manual therapists. For subjective outcomes, Cohen's kappa (ĸ) and the proportion of agreement (Pra) were calculated. For objectively measured ROM, Bland Altman plots were conducted and Limits of Agreement and Intraclass Correlation Coefficients (ICC) were calculated. Results: The inter-rater reliability of the Flexion-Rotation-Test and Lateral-Flexion-Test for subjective (ĸ: 0.077-0.727; Pra: 0.46-0.86) and objective outcomes (ICC: 0.019-0.496) varied between pairs of manual therapists. Conclusion: Assessed ROM largely depends on the performance of the assessment and its interpretation by manual therapists, leading to high variation in outcomes. Therefore, the Flexion-Rotation-Test and Lateral-Flexion-Test cannot be used solely as a reliable outcome measure in clinical practice and research context.
Magnetic-resonance-imaging-based three-dimensional muscle reconstruction of hip abductor muscle volume in a person with a transfemoral bone-anchored prosthesis: A feasibility study.
Leijendekkers, R.A. ; Marra, M.A. ; Ploegmakers, M.J.M. ; Hinte, G. van ; Frolke, J.P. ; Meent, H. van de ; Staal, J.B. ; Hoogeboom, T.J. ; Verdonschot, N.
2018, Article / Letter to editor (Physiotherapy Theory and Practice, vol. 28, (2018), pp. 1-10)
Magnetic-resonance-imaging-based three-dimensional muscle reconstruction of hip abductor muscle volume in a person with a transfemoral bone-anchored prosthesis: A feasibility study.
Leijendekkers, R.A. ; Marra, M.A. ; Ploegmakers, M.J.M. ; Hinte, G. van ; Frölke, J.P.M. ; Meent, H. van de ; Staal, J.B. ; Hoogeboom, T.J. ; Verdonschot, N.
2019, Article / Letter to editor (Physiotherapy Theory and Practice, vol. 35, iss. 5, (2019), pp. 495-504)
Linear dependence of peak, mean, and pressure-time integral values in plantar pressure images.
Keijsers, N.L.W. ; Stolwijk, N.M. ; Pataky, T.C.
2010, Article / Letter to editor (Gait & Posture, vol. 31, iss. 1, (2010), pp. 140-142)Dynamic plantar pressure images are routinely used in clinical gait assessment, and peak pressure, mean pressure, and pressure-time integral are the most frequently used parameters to summarize these images. Many studies report only one parameter, but other studies report all three. The interdependency of these variables has not been explicitly studied previously. The purpose of this study was to describe the linear relation between these three pressure parameters. 327 subjects walked normally over a pressure plate. Peak pressure, mean pressure and pressure-time integral were calculated for 10 different anatomical areas and, after applying a previously described spatial normalization procedure, these variables were also calculated for each pixel. Mean pressure was highly correlated with peak pressure (r=0.90+/-0.09) and pressure-time integral (r=0.81+/-0.13) for pixels. Peak pressure and pressure-time integral showed a linear correlation coefficient of r=0.78+/-0.21. The pressure parameters of the forefoot pixels were more highly correlated than the heel pixels. The current results have two major implications: (1) plantar pressure parameters (peak, mean, and impulse) can be reasonably compared across studies, even across parameters, and (2) the variables most commonly used to characterize plantar pressures are highly inter-correlated, implying that a smaller set of parameters may more efficiently capture the biomechanical behavior of interest.
Limited health literacy in primary care physiotherapy: Does a physiotherapist use techniques to improve communication?
Scheer, E. van der ; Rutten, G. ; Stortenbeker, I. ; Borkent, J.W. ; Klein Swormink, W. ; Das, E. ; Staal, J.B. ; Lankveld, W.G.J.M. van
2023, Article / Letter to editor (Patient Education and Counseling, vol. 109, (2023))
Leg-amplitude differentiation guided by haptic and visual feedback to detect alterations in motor flexibility due to Total Knee Replacement.
Roelofsen, E.G.J. ; Cingel, R. van ; Pronk, Y. ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G. ; Meulenbroek, R.G.J.
2020, Article / Letter to editor (Human Movement Science, vol. 71, (2020), pp. 102623)Following total knee replacement (TKR), patients often persist in maladaptive motor behavior which they developed before surgery to cope with symptoms of osteoarthritis. An important challenge in physical therapy is to detect, recognize and change such undesired movement behavior. The goal of this study was to measure the differences in clinical status of patients pre-TKR and post-TKR and to investigate if differences in clinical status were accompanied by differences in the patients'' motor flexibility. Eleven TKR participants were measured twice: pre-TKR and post-TKR (twenty weeks after TKR). In order to infer maladaptation, the pre-TKR and post-TKR measurements of the patient group were separately compared to one measurement in a control group of fourteen healthy individuals. Clinical status was measured with the Visual Analogue Scale (VAS) for pain and knee stiffness and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Furthermore, Lower-limb motor flexibility was assessed by means of a treadmill walking task and a leg-amplitude differentiation task (LAD-task) supported by haptic or visual feedback. Motor flexibility was measured by coordination variability (standard deviation (SD) of relative phase between the legs) and temporal variability (sample entropy) of both leg movements. In the TKR-group, the VAS-pain and VAS- stiffness and the subscales of the KOOS significantly decreased after TKR. In treadmill walking, lower-limb motor flexibility did not significantly change after TKR. Between-leg coordination variability was significantly lower post-TKR compared to controls. In the LAD-task, a significant decrease of between-leg coordination variability between pre-TKR and post-TKR was accompanied by a significant increase in temporal variability. Post-TKR-values of lower-limb flexibility approached the values of the control group. The results demonstrate that a clinically relevant change in clinical status, twenty weeks after TKR, is not accompanied by alterations in lower-limb motor flexibility during treadmill walking but is accompanied by changes in motor flexibility towards the level of healthy controls during a LAD-task with visual and haptic feedback. Challenging patients with non-preferred movements such as amplitude differentiation may be a promising tool in clinical assessment of motor flexibility following TKR.
Lack of consensus across clinical guidelines regarding the role of psychosocial factors within low back pain care: a systematic review.
Knoop, J. ; Rutten, G. ; Lever, C. ; Leemeijer, J. ; Jong, L.J. de ; Verhagen, A.P. ; Lankveld, W.G.J.M. van ; Staal, J.B.
2021, Article / Letter to editor (Journal of Pain, (2021))It is widely accepted that psychosocial prognostic factors should be addressed by clinicians in their assessment and management of patient suffering from low back pain (LBP). On the other hand, an overview is missing how these factors are addressed in clinical LBP guidelines. Therefore, our objective was to summarize and compare recommendations regarding the assessment and management of psychosocial prognostic factors for LBP chronicity, as reported in clinical LBP guidelines. We performed a systematic search of clinical LBP guidelines (PROSPERO registration number 154730). This search consisted of a combination of previously published systematic review articles and a new systematic search in medical or guideline-related databases. From the included guidelines, we extracted recommendations regarding the assessment and management of LBP which addressed psychosocial prognostic factors (i.e., psychological factors ('yellow flags'), perceptions about the relationship between work and health, ('blue flags'), system or contextual obstacles ('black flags') and psychiatric symptoms ('orange flags')). In addition, we evaluated the level or quality of evidence of these recommendations. In total, we included 15 guidelines. Psychosocial prognostic factors were addressed in 13/15 guidelines regarding their assessment and in 14/15 guidelines regarding their management. Recommendations addressing psychosocial factors almost exclusively concerned 'yellow' or 'black flags', and varied widely across guidelines. The supporting evidence was generally of very low quality. We conclude that in general, clinical LBP guidelines do not provide clinicians with clear instructions about how to incorporate psychosocial factors in LBP care and should be optimized in this respect. More specifically, clinical guidelines vary widely in whether and how they address psychosocial factors, and recommendations regarding these factors generally require better evidence support. This emphasizes a need for a stronger evidence-base underlying the role of psychosocial risk factors within LBP care, and a need for uniformity in methodology and terminology across guidelines. Perspective This systematic review summarized clinical guidelines on low back pain (LBP) on how they addressed the identification and management of psychosocial factors. This review revealed a large amount of variety across guidelines in whether and how psychosocial factors were addressed. Moreover, recommendations generally lacked details and were based on low quality evidence.
De koppelstructuur als rijke leeromgeving. Gezamenlijk leren in de praktijk.
Seeger, J. ; Koenders, N. ; Staal, J.B. ; Hoogeboom, T.J.
2018, Article / Letter to editor (Fysiopraxis, (2018), pp. 10-13)
Kinesiophobia is not required to predict chronic low back pain in workers: a decision curve analysis.
Panken, A.M. ; Staal, J.B. ; Heymans, M.W.
2020, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 21, iss. 1, (2020), pp. 163)BACKGROUND: Currently used performance measures for discrimination were not informative to determine the clinical benefit of predictor variables. The purpose was to evaluate if a former relevant predictor, kinesiophobia, remained clinically relevant to predict chronic occupational low back pain (LBP) in the light of a novel discriminative performance measure, Decision Curve Analysis (DCA), using the Net Benefit (NB). METHODS: Prospective cohort data (nn=n170) of two merged randomized trials with workers with LBP on sickleave, treated with Usual Care (UC) were used for the analyses. An existing prediction model for chronic LBP with the variables 'a clinically relevant change in pain intensity and disability status in the first 3 months', 'baseline measured pain intensity' and 'kinesiophobia' was compared with the same model without the variable 'kinesiophobia' using the NB and DCA. RESULTS: Both prediction models showed an equal performance according to the DCA and NB. Between 10 and 95% probability thresholds of chronic LBP risk, both models were of clinically benefit. There were virtually no differences between both models in the improved classification of true positive (TP) patients. CONCLUSIONS: This study showed that the variable kinesiophobia, which was originally included in a prediction model for chronic LBP, was not informative to predict chronic LBP by using DCA. DCA and NB have to be used more often to develop clinically beneficial prediction models in workers because they are more sensitive to evaluate the discriminate ability of prediction models.
Jouw client in beweging
Hanemaaijer-Slottje, R. ; Nieuwenhuijzen, P.H.J.A.
2020, Book (monograph) Dit basisboek voor oefentherapie geeft beginnende fysiotherapeuten praktische richtlijnen om cliënten in beweging te brengen en te houden. Het boek is overzichtelijk en helpt om je de vaardigheden rond beweegagogiek eigen te maken en te onderbouwen met theoretische kaders en literatuur. Jouw cliënt in beweging is gebaseerd op evidence-based inzichten vanuit het motorisch leren, de gedragswetenschappen en de didactiek. Deze theoretische achtergronden worden kort en bondig uitgelegd mét verwijzing naar de bronnen die deze theorie uitgebreider beschrijven. Er worden steeds verschillende handvaten gegeven voor eenzelfde situatie. Die zijn uitgewerkt in herkenbare casussen om de toepassing in de praktijk te laten zien. Zo kan je zelf kiezen waar je meer van wilt weten, rekening houdend met jouw klinische expertise en de patient values van jouw cliënt. Jouw cliënt in beweging geeft bovendien vragen en opdrachten waarmee je wordt uitgedaagd om zelf kritisch en op professionele wijze na te blijven denken. De bij het boek behorende online omgeving bevat alle tekst inclusief links, video’s en extra achtergrondmateriaal in pdf-bestanden. Auteurs van Jouw cliënt in beweging zijn Roos Hanemaaijer en dr. Henk Nieuwenhuijzen. Hanemaaijer is bekkenfysiotherapeut (MSPT), Hoofddocent (Avans+) en sporttrainer. Nieuwenhuijzen is bewegingswetenschapper, fysiotherapeut en hogeschooldocent (Hogeschool van Arnhem en Nijmegen).
Is Fear of Harm (FoH) in Sports-Related Activities a Latent Trait? The Item Response Model Applied to the Photographic Series of Sports Activities for Anterior Cruciate Ligament Rupture (PHOSA-ACLR)
Lankveld, W.G.J.M. van ; Pat El, R ; Melick, N. van ; Cingel, R. van ; Staal, J.B.
2020, Article / Letter to editor (International Journal of Environmental Research and Public Health, (2020))
Is a model of stratified exercise therapy by physical therapists in primary care feasible in patients with knee osteoarthritis? : a mixed methods study.
Knoop, J. ; Leeden, M van der ; Esch, M. van der ; Rooij, M. de ; Peter, W.F. ; Bennell, K.L. ; Steultjens, M.P.M. ; Hakkinen, A. ; Roorda, L.D. ; Lems, W.F. ; Dekker, J et al. sine al.
2020, Article / Letter to editor (Physiotherapy, vol. 106, (2020), pp. 101-110)OBJECTIVES: To explore the feasibility of a newly developed model of stratified exercise therapy in primary care for patients with knee osteoarthritis (OA). DESIGN: Mixed method design (process, outcome and qualitative evaluation). SETTING: Six physical therapy practices in primary care around Amsterdam. PARTICIPANTS: Fifty eligible patients with knee OA, visiting one of the participating physical therapists (PTs). INTERVENTION: Patients were allocated to a subgroup based on a simple stratification tool and received subgroup-specific, protocolized, 4-month, exercise therapy. MAIN OUTCOME MEASURES: Feasibility of this model of stratified exercise therapy was explored by multiple process parameters, outcome measures (physical functioning and knee pain; at baseline and 4-months follow-up) and experiences from patients and PTs. RESULTS: From 97 potentially eligible patients, fifty patients were included and allocated to the 'high muscle strength subgroup' (n=17), 'depression subgroup' (n=4), 'obesity subgroup' (n=6) or 'low muscle strength subgroup' (n=23). Three patients dropped out during the study period. PTs provided relatively low numbers of sessions (on average 10 sessions), although exceedance of the recommended maximum number of sessions did occur frequently. We found clinically relevant improvements on physical functioning and knee pain (P<0.001 for both) for the total group. In general, the model of stratified exercise therapy was considered to be easily applicable and of added value for daily practice. CONCLUSIONS: Our model of stratified exercise therapy seems to be feasible in primary care, although a number of limitations were reported. Future research should determine the (cost-)effectiveness of an adapted model, compared to usual, non-stratified exercise therapy.
Intrarater reliability of the Humac NORM isokinetic dynamometer for strength measurements of the knee and shoulder muscles.
Habets, B. ; Staal, J.B. ; Tijssen, M. ; Cingel, Robert van
2018, Article / Letter to editor (BMC Research Notes, vol. 11, iss. 1, (2018), pp. 15)
In response.
Mooren - van der Meer, S ; Trippolini, M. ; Palen, J. van der ; Verhoeven, J. ; Reneman, M.
2014, Article / Letter to editor (Spine, vol. 39, iss. 6, (2014), pp. 529)
Implementing a Personalized Physical Therapy Approach (Coach2Move) Is Effective in Increasing Physical Activity and Improving Functional Mobility in Older Adults: A Cluster-Randomized, Stepped Wedge Trial.
Heij, W. ; Sweerts, L. ; Staal, J.B. ; Teerenstra, S. ; Adang, E. ; Wees, P.J. van der ; -van der Sanden, M.W.G. Nijhuis ; Hoogeboom, T.J.
2022, Article / Letter to editor (Physical Therapy, (2022))OBJECTIVE: The purpose of this study was to assess whether the superior cost-effectiveness of a personalized physical therapy approach (Coach2Move)-which was demonstrated in a previous trial when compared to usual care physical therapy (UCP)-can be replicated in daily clinical practice. METHODS: A multicenter cluster-randomized stepped wedge trial with 4 clusters consisting of 4 physical therapist practices in the Netherlands was used to compare a personalized physical therapy approach to elicit physical activity (Coach2Move) versus care as usual. Multilevel analyses for effectiveness were conducted for the amount of physical activity (Longitudinal Aging Study Amsterdam Physical Activity Questionnaire) and functional mobility (Timed "Up & Go" Test) at 3, 6 (primary outcome), and 12 months' follow-up. Secondary outcomes were: level of frailty (Evaluative Frailty Index for Physical Activity), perceived effect (Global Perceived Effect and Patient-Specific Complaints questionnaires), quality of life (Euro Quality of Life-5 Dimensions-5 Levels [EQ-5D-5L]), and health care expenditures. RESULTS: The 292 community-dwelling older adults with mobility problems visiting physical therapists were included in either the Coach2Move (nn=n112; mean [SD] agen=n82 [5] y; 60% female) or UCP (nn=n180; mean [SD] agen=n81 (6) y; 62% female) section of the trial. At baseline, Coach2Move participants were less physically active as compared with UCP participants (mean differencen=n-198; 95% CIn=n-90 to -306) active minutes. At 6 months, between-group mean differences (95% CI) favored Coach2Move participants on physical activity levels (297 [83 to 512] active minutes), functional mobility (-14.2 [-21 to -8]) seconds] and frailty levels (-5 [-8 to -1] points). At 12 months, the physical activity levels of Coach2Move participants further increased and frailty levels and secondary outcomes remained stable, whereas outcomes of UCP participants decreased. After the Coach2Move implementation strategy, physical therapists utilized significantly fewer treatment sessions compared with before the implementation (15 vs 22). Anticipated cost savings were not observed. CONCLUSIONS: This study replicated the results of an earlier trial and shows that Coach2Move leads to better mid- and long-term outcomes (physical activity, functional mobility, level of frailty) in fewer therapeutic sessions compared with UCP. Based on these and earlier findings, the implementation of Coach2Move in physical therapist practice is recommended. IMPACT: This article describes the implementation of the Coach2Move approach, a treatment strategy that has proven to be cost-effective in a previously conducted randomized controlled trial. Implementation of Coach2Move in a real-life setting allowed an evaluation of the effects in a clinically relevant population. Coach2Move has been shown to increase physical activity, improve functional mobility, and reduce frailty more effectively in comparison with usual care physical therapy and, therefore, has application for physical therapists working with older adults in daily clinical practice. LAY SUMMARY: Coach2Move is a new physical therapeutic approach for older adults. This manuscript describes how implementation of Coach2Move in daily clinical practice achieves better outcomes over a longer period of time against similar costs in comparison with regular physical therapy.
Implementation of a Cost-Effective Physical Therapy Approach (Coach2Move) to Improve Physical Activity in Community-Dwelling Older Adults With Mobility Problems: Protocol for a Cluster-Randomized, Stepped Wedge Trial.
Heij, W. ; Teerenstra, S. ; Sweerts, L. ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G. ; Hoogeboom, T.J.
2020, Article / Letter to editor (Physical Therapy, vol. 100, iss. 4, (2020), pp. 653-661)BACKGROUND: Coach2Move is a personalized treatment strategy by physical therapists to elicit physical activity in community-dwelling older adults with mobility problems. OBJECTIVE: The primary objective of this study is to assess the effectiveness and cost-effectiveness of the implementation of Coach2Move compared with regular care physical therapy in daily clinical practice. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION: A multicenter cluster-randomized stepped wedge trial is being implemented in 16 physical therapist practices (4 clusters of 4 practices in 4 steps) in the Netherlands. The study aims to include 400 older adults (≥70 years) living independently with mobility problems and/or physically inactive lifestyles. The intervention group receives physical therapy conforming to the Coach2Move strategy; the usual care group receives typical physical therapist care. MEASUREMENTS: Measurements are taken at baseline and 3, 6, and 12 months after the start of treatment. The primary outcomes for effectiveness are the amount of physical activity (LASA Physical Activity Questionnaire) and functional mobility (Timed Up and Go test). Trial success can be declared if at least 1 parameter improves while another does not deteriorate. Secondary outcomes are level of frailty (Evaluative Frailty Index for Physical Activity), perceived effect (Global Perceived Effect and Patient Specific Complaints questionnaire), quality of life (EQ-5D-5 L), and health care expenditures. Multilevel linear regression analyses are used to compare the outcomes between treatment groups according to an intention-to-treat approach. Alongside the trial, a mixed-methods process evaluation is performed to understand the outcomes, evaluate therapist fidelity to the strategy, and detect barriers and facilitators in implementation. LIMITATIONS: An important limitation of the study design is the inability to blind treating therapists to study allocation. DISCUSSION: The trial provides insight into the effectiveness and cost-effectiveness of the Coach2Move strategy compared with usual care. The process evaluation provides insight into influencing factors related to outcomes and implementation.
Immediate patient perceptions following lumbar spinal fusion surgery: semi-structured multi-centre interviews exploring the patient journey and experiences of lumbar fusion surgery (FuJourn).
Rushton, A. ; Elena, B. ; Jadhakhan, F. ; Masson, A. ; Staal, J.B. ; Verra, M.L. ; Emms, A. ; Reddington, M. ; Cole, A. ; Willems, P.C. ; Benneker, L. ; Heneghan, N.R. ; Soundy, A. et al. sine al.
2022, Article / Letter to editor (European Spine Journal, vol. 31, iss. 12, (2022), pp. 3590-3602)PURPOSE: To understand the patient journey to Lumbar Spinal Fusion Surgery (LSFS) and patients' experiences of surgery. METHODS: Qualitative study using interpretive phenomenological analysis. Adult participants following LSFS were recruited from 4 UK clinical sites using purposive sampling to ensure representation of key features (e.g. age). Semi-structured interviews informed by a piloted topic guide developed from the literature were audio-recorded and transcribed verbatim. Framework analysis for individual interviews and then across participants (deductive and inductive) identified emerging themes. Trustworthiness of data analyses was enhanced using multiple strategies (e.g. attention to negative cases). RESULTS: Four emerging themes from nn=n31 patients' narratives were identified: decision for surgery, coping strategies, barriers to recovery and recovery after surgery. Decision for surgery and recovery after surgery themes are distinguished by the point of surgery. However, barriers to recovery and coping strategies are key to the whole patient journey encompassing long journeys to surgery and their initial journey after surgery. The themes of coping strategies and barriers to recovery were inter-related and perceived by participants as parallel concepts. The 4 multifactorial themes interacted with each other and shaped the process of an individual patient's recovery. Factors such as sporadic interventions prior to surgery, time-consuming wait for diagnosis and surgery and lack of information regarding recovery strongly influenced perceptions of outcome. CONCLUSION: Patient driven data enables insights to inform research regarding surgery/rehabilitation through depth of understanding of the patient journey. Awareness of factors important to patients is important; ensuring that patient-driven data informs research and patient care.
Imaging versus no imaging for low back pain: a systematic review, measuring costs, healthcare utilization and absence from work.
Lemmers, G.P.G. ; Lankveld, W.G.J.M. van ; Westert, G.P. ; Wees, Philip van der ; Staal, J.B.
2019, Article / Letter to editor (European Spine Journal, vol. 28, iss. 5, (2019), pp. 937-950)
How should clinicians rehabilitate patients after ACL reconstruction? A systematic review of clinical practice guidelines (CPGs) with a focus on quality appraisal (AGREE II).
Andrade, D. ; Pereira, R. ; Cingel, Robert van ; Staal, J.B. ; Espregueira-Mendes, J.
2019, Article / Letter to editor (British Journal of Sports Medicine, (2019))
How does injury compensation affect health and disability in patients with complaints of whiplash? A qualitative study among rehabilitation experts-professionals.
Mooren - van der Meer, S ; Pieterse, M. ; Reneman, M. ; Verhoeven, J. ; Palen, J. van der
2016, Article / Letter to editor (Disability and Rehabilitation, vol. 38, iss. 3, (2016), pp. 211-217)PURPOSE: To explore rehabilitation professionals' opinions about the influence and the pathways of injury compensation (IC) on health and disability in patients with whiplash associated disorder (WAD). METHODS: Semi-structured interviews were performed among a purposeful selected sample of Dutch expert-professionals in the field of rehabilitation of patients with WAD. Inclusion continued until saturation was reached. Inductive and deductive thematic analyses were performed. RESULTS: Ten rehabilitation expert-professionals (five females), working as physician, psychologist or physiotherapist, were interviewed. All expert-professionals acknowledged that IC can influence rehabilitation, health and disability. The expert-professionals provided three causal pathways; a pathway through prolonged distress, a behavioral pathway, and patient characteristics that may either attenuate or worsen their response. They assess the influence of IC mainly with interview techniques. Most professionals discuss the potential influence of IC with their patients, because they want to give clear information to the patient. Some emphasize that their role is neutral in relation with the IC. Others mention that financial consequences can accompany functional improvement. CONCLUSIONS: Rehabilitation expert-professionals believe that IC may affect rehabilitation, health and disability in patients with WAD. Three pathways are mentioned by the experts-professionals. IMPLICATIONS FOR REHABILITATION: According to rehabilitation expert-professionals, an injury compensation (IC) can lead to distress, by creating a (conscious or unconscious) conflict of interests within a patient between striving for compensation on one hand, and recovery on the other hand. Patient characteristics can either attenuate or worsen IC-related distress. Reliable and valid tools need to be developed to assess the influence of IC on health, disability and rehabilitation, and to limit the negative effects. Rehabilitation professionals can discuss the possible unintended effects of IC with their patients to clarify their current situation.
How does hip osteoarthritis differ from knee osteoarthritis?
Hall, M. ; Esch, M. van der ; Hinman, R.S. ; Peat, G. ; Zwart, A. de ; Quicke, J.G. ; Runhaar, J. ; Knoop, J. ; Leeden, M van der ; Rooij, M. de ; Meulenbelt, I. ; Vliet Vlieland, T. ; Lems, W.F. ; Holden, M.A. ; Foster, N.E. ; Bennell, K.L. et al. sine al.
2022, Article / Letter to editor (Osteoarthritis and Cartilage, vol. 30, iss. 1, (2022), pp. 32-41)Hip and knee osteoarthritis (OA) are leading causes of global disability. Most research to date has focused on the knee, with results often extrapolated to the hip, and this extends to treatment recommendations in clinical guidelines. Extrapolating results from research on knee OA may limit our understanding of disease characteristics specific to hip OA, thereby constraining development and implementation of effective treatments. This review highlights differences between hip and knee OA with respect to prevalence, prognosis, epigenetics, pathophysiology, anatomical and biomechanical factors, clinical presentation, pain and non-surgical treatment recommendations and management.
Hoe effectief is Blue®m?
Hollaar, V.R.Y. ; Swaaij, BMW van ; Aardenhout, H ; Hoekstra, JWM
2020, Article / Letter to editor (Ned Tijdschr Tandheelkd., vol. 127, iss. 2, (2020), pp. 79-82)
Guideline adherence of physiotherapists in the treatment of patients with low back pain: A qualitative study.
Lemmers, G.P.G. ; Bier, J.D. ; Lankveld, W. van ; Westert, G.P. ; Staal, J.B. ; Wees, P.J. van der
2022, Article / Letter to editor (Journal of Evaluation in Clinical Practice, vol. 28, iss. 6, (2022), pp. 1147-1156)RATIONALE: Adherence rates to guidelines show room for improvement, and increase in adherence to guidelines may potentially lead to better outcomes and reduced costs of treatment. To improve adherence, it is essential to understand the considerations of physiotherapists regarding the assessment and management of low back pain (LBP). The purpose of this study is to gain insight in the considerations of Dutch physiotherapists on adherence to the national physiotherapy guideline in the treatment of patients with LBP. METHODS: This is a qualitative study, using an interpretive approach of semi-structured interviews with 14 physiotherapists who regularly treat patients with LBP. Thematic analysis was conducted with open coding using an existing framework. This framework distinguishes five components to adherence based on patient factors, provider factors, guideline characteristics, institutional factors and the implementation process. RESULTS: Participating physiotherapists mentioned that the guideline should provide more information about psychosocial prognostic factors and psychosocial treatment options. The participants experienced difficulties in addressing patient expectations that conflict with guideline recommendations. The implementation process of the guideline was considered insufficient. Physiotherapists might rely too much on their experience, and knowledge of evidence-based treatment might be improved. In general, the interviewed physiotherapists thought they were mainly non-adherent to the guidelines. However, when comparing their considerations with the actual guideline recommendations they were mainly adherent. CONCLUSION: To improve adherence, the guideline should provide more information about addressing psychosocial prognostic factors, and Dutch physiotherapists might be trained in communication skills to better address patient expectations. A more extensive implementation process is warranted for the next guideline to increase the physiotherapists' knowledge of evidence-based treatment.
De fysiotherapeutische diagnose gediagnosticeerd.
Enck, H. van ; Nieuwenhuijzen, P.H.J.A.
2013, Article / Letter to editor (Physiopraxis, iss. 8, (2013), pp. 28-31)
A framework exploring the therapeutic alliance between elite athletes and physiotherapists: a qualitative study.
Charmant, W.M. ; Wees, P.J. van der ; Staal, J.B. ; Cingel, R. van ; Sieben, J.M. ; Bie, R.A. de
2021, Article / Letter to editor (BMC Sports Science, Medicine and Rehabilitation, vol. 13, iss. 1, (2021), pp. 122)BACKGROUND: The therapeutic alliance (TA) is the bond between a patient and a physiotherapist during collaboration on recovery or training. Previous studies focused on the TA between physiotherapists and patients of the general population. Little information exists on whether this is similar in the demanding environment of elite athletes. The aim of this study was to investigate the components of TA between elite athletes and physiotherapists. METHODS: Ten elite athletes and ten physiotherapists were interviewed using one-on-one semi-structured interviews between June 2020 and October 2020. Athletes were included if they competed at national or international championships. Physiotherapists had to treat elite athletes on a regular basis. Interview questions were based on TA components of the general physiotherapy population. The interviews were transcribed and coded using inductive thematic analysis. RESULTS: The analysis resulted in an elite athlete TA framework which consists of nine themes and ten subthemes that could influence the TA. The nine themes are trust, communication, professional bond, social bond, elite athlete, physiotherapist, time, pressure and adversity, and external factors. This showed that the TA consists of bonds on different social levels, depends on the traits of both elite athletes and physiotherapists, and can be positively and negatively influenced by the external environment. The influences from the external environment seem to be more present in the elite athlete TA compared to the TA in the general physiotherapy setting. Multiple relations between themes were discovered. Trust is regarded as the main connecting theme. CONCLUSION: This study provides a framework to better understand the complex reality of the TA between elite athletes and physiotherapists. Compared to the general physiotherapy setting, new themes emerged. The created framework can help elite athletes and physiotherapists to reflect and improve their TA and subsequently improve treatment outcomes.
Foot lengthening and shortening during gait: a parameter to investigate foot function?
Stolwijk, N.M. ; Koenraadt, K.L. ; Louwerens, J.W. ; Grim, D. ; Duysens, J. ; Keijsers, N.L.W.
2014, Article / Letter to editor (Gait & Posture, vol. 39, iss. 2, (2014), pp. 773-777)INTRODUCTION: Based on the windlass mechanism theory of Hicks, the medial longitudinal arch (MLA) flattens during weight bearing. Simultaneously, foot lengthening is expected. However, changes in foot length during gait and the influence of walking speed has not been investigated yet. METHODS: The foot length and MLA angle of 34 healthy subjects (18 males, 16 females) at 3 velocities (preferred, low (preferred -0.4 m/s) and fast (preferred +0.4 m/s) speed were investigated with a 3D motion analysis system (VICON(®)). The MLA angle was calculated as the angle between the second metatarsal head, the navicular tuberculum and the heel in the local sagittal plane. Foot length was calculated as the distance between the marker at the heel and the 2nd metatarsal head. A General Linear Model for repeated measures was used to indicate significant differences in MLA angle and foot length between different walking speeds. RESULTS: The foot lengthened during the weight acceptance phase of gait and shortened during propulsion. With increased walking speed, the foot elongated less after heel strike and shortened more during push off. The MLA angle and foot length curve were similar, except between 50% and 80% of the stance phase in which the MLA increases whereas the foot length showed a slight decrease. CONCLUSION: Foot length seems to represent the Hicks mechanism in the foot and the ability of the foot to bear weight. At higher speeds, the foot becomes relatively stiffer, presumably to act as a lever arm to provide extra propulsion.
Flat feet, happy feet? Comparison of the dynamic plantar pressure distribution and static medial foot geometry between Malawian and Dutch adults.
Stolwijk, N.M. ; Duysens, J. ; Louwerens, J.W. ; Ven, Y.H. van de ; Keijsers, N.L.W.
2013, Article / Letter to editor (PLoS One, vol. 8, iss. 2, (2013), pp. e57209)In contrast to western countries, foot complaints are rare in Africa. This is remarkable, as many African adults walk many hours each day, often barefoot or with worn-out shoes. The reason why Africans can withstand such loading without developing foot complaints might be related to the way the foot is loaded. Therefore, static foot geometry and dynamic plantar pressure distribution of 77 adults from Malawi were compared to 77 adults from the Netherlands. None of the subjects had a history of foot complaints. The plantar pressure pattern as well as the Arch Index (AI) and the trajectory of the center of pressure during the stance phase were calculated and compared between both groups. Standardized pictures were taken from the feet to assess the height of the Medial Longitudinal Arch (MLA). We found that Malawian adults: (1) loaded the midfoot for a longer and the forefoot for a shorter period during roll off, (2) had significantly lower plantar pressures under the heel and a part of the forefoot, and (3) had a larger AI and a lower MLA compared to the Dutch. These findings demonstrate that differences in static foot geometry, foot loading, and roll off technique exist between the two groups. The advantage of the foot loading pattern as shown by the Malawian group is that the plantar pressure is distributed more equally over the foot. This might prevent foot complaints.
Feasibility of a stratified blended physiotherapy intervention for patients with non-specific low back pain: a mixed methods study.
TIlburg, M.L. van ; Kloek, C.J.J. ; Staal, J.B. ; Bossen, D. ; Veenhof, C.
2020, Article / Letter to editor (Physiotherapy Theory and Practice, (2020), pp. 1-13)INTRODUCTION: Integrating web-based or mobile components and face-to-face components within a treatment process is called blended care. As part of the participatory development of a blended physiotherapeutic intervention for patients with low back pain (e-Exercise LBP), a proof of concept study was carried out and showed promising results. OBJECTIVE: To investigate the feasibility of the e-Exercise LBP prototype for patients and physiotherapists to improve the intervention. METHODS: A mixed methods study was executed, embedded in the development phase of e-Exercise LBP. 21 physiotherapists treated 41 patients with e-Exercise LBP. Quantitative data consisted of: patients' satisfaction on a five-point Likert Scale; patients' and physiotherapists' experienced usability of the web-based application (System Usability Scale) and; patients' experiences with e-Exercise LBP (closed-ended questions and statements related to the elements and goals of e-Exercise LBP). Semi-structured interviews about experiences with e-Exercise LBP were conducted with seven patients and seven physiotherapists. Qualitative data were analyzed by a phenomenological approach. Quantitative data were analyzed with descriptive statistics. RESULTS: Patients were satisfied with e-Exercise LBP (mean: 4.0; SD:0.8; range: extreme dissatisfaction (1)-extreme satisfaction (5)). Usability of the web-based application was acceptable (patients: mean: 73.2 (SD:16.3); physiotherapists: mean: 63.3 (SD:12.0); range: 0-100). Interviews revealed that physiotherapists' training is essential to successfully integrate the web-based application and face-to-face sessions within physiotherapy treatment. Also, patients addressed the need of reminder messages to support long-term (exercise) adherence. CONCLUSION: e-Exercise LBP appeared to be feasible. However, various prerequisites and points of improvement were mentioned to improve physiotherapists' training and the prototype.
Experiences of Participants in a Self-Management Program for Employees with Complaints of the Arm, Neck or Shoulder (CANS): A Mixed Methods Study
Hutting, N. ; Detaille, S.I. ; Heerkens, Y.F. ; Engels, J.A. ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G.
2017, Article / Letter to editor (Journal of Occupational Rehabilitation, vol. 27, (2017), pp. 35-48)
Experiences of employees with arm, neck or shoulder complaints: a focus group study.
Hutting, N. ; Heerkens, Y.F. ; Engels, J.A. ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G.
2014, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 15, (2014), pp. 141)BACKGROUND: Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. METHODS: A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. RESULTS: Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). CONCLUSIONS: Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be addressed in the adaptation of an existing self-management program to the characteristics of employees suffering from CANS.
Experiences and needs of physiotherapists and exercise therapists regarding the management of working people with complaints of the arm, neck and shoulder (CANS): A focus group study.
Brunnekreef, J.J. ; Feleus, A. ; Miedema, H.S. ; Staal, J.B. ; Hutting, N.
2022, Article / Letter to editor (Musculoskeletal Science and Practice, vol. 62, (2022), pp. 102644)BACKGROUND: Non-traumatic complaints of the arm, neck and/or shoulder (CANS) are difficult-to-treat musculoskeletal conditions. CANS treatment has varying degrees of success, particularly in the working population. OBJECTIVES: To evaluate the experiences and needs of physiotherapists (PTs) and exercise therapists (ETs) regarding the treatment of working patients with CANS. DESIGN: An exploratory qualitative focus group study was conducted. METHOD: Qualitative data were collected from 27 therapists who were purposefully recruited for their broad range of experience and qualifications. The data was analysed using thematic analysis. RESULTS: Both PTs and ETs assess CANS extensively by exploring their patients' psychosocial factors, work-related factors, illness beliefs, and working conditions. Therapists apply hands-off treatment interventions, such as coaching the patient to make behavioural changes and providing self-management support. However, therapists experience many difficulties in these areas, resulting in a need to learn more about coaching techniques for behavioural change, engaging in meaningful conversations about the patient's perspective, supporting patients in building a strong social network in the workplace, and creating a professional network for collaboration. CONCLUSIONS: The treatment of working people with CANS is difficult for PTs and ETs. Therapists express a need to learn more about supporting self-management, applying coaching techniques and engaging in meaningful conversations. Moreover, therapists indicate a need to establish a professional multidisciplinary network to support collaborations with other disciplines to treat working patients with CANS.
Exercise treatment effect modifiers in persistent low back pain: an individual participant data meta-analysis of 3514 participants from 27 randomised controlled trials.
Hayden, J.A. ; Wilson, M.N. ; Stewart, S. ; Cartwright, J.L. ; Smith, A.O. ; Riley, R.D. ; Tulder, M. van ; Bendix, T. ; Cecchi, F. ; Costa, L.O.P. ; Dufour, N. ; Ferreira, M.L. ; Foster, N.E. ; Gudavalli, M.R. ; Hartvigsen, J. ; Helmhout, P. ; Kool, J. ; Koumantakis, G.A. ; Kovacs, F.M. ; Kuukkanen, T. ; Long, A. ; Macedo, L.G. ; Machado, L.A.C. ; Maher, C.G. ; Mehling, W. ; Morone, G. ; Peterson, T. ; Rasmussen-Barr, E. ; Ryan, C.G. ; Sjögren, T. ; Smeets, R. ; Staal, J.B. ; Unsgaard-Tøndel, M. ; Wajswelner, H. ; Yeung, E.W. et al. sine al.
2020, Article / Letter to editor (British Journal of Sports Medicine, vol. 54, iss. 21, (2020), pp. 1277-1278)BACKGROUND: Low back pain is one of the leading causes of disability worldwide. Exercise therapy is widely recommended to treat persistent non-specific low back pain. While evidence suggests exercise is, on average, moderately effective, there remains uncertainty about which individuals might benefit the most from exercise. METHODS: In parallel with a Cochrane review update, we requested individual participant data (IPD) from high-quality randomised clinical trials of adults with our two primary outcomes of interest, pain and functional limitations, and calculated global recovery. We compiled a master data set including baseline participant characteristics, exercise and comparison characteristics, and outcomes at short-term, moderate-term and long-term follow-up. We conducted descriptive analyses and one-stage IPD meta-analysis using multilevel mixed-effects regression of the overall treatment effect and prespecified potential treatment effect modifiers. RESULTS: We received IPD for 27 trials (3514 participants). For studies included in this analysis, compared with no treatment/usual care, exercise therapy on average reduced pain (mean effect/100 (95% CI) -10.7 (-14.1 to -7.4)), a result compatible with a clinically important 20% smallest worthwhile effect. Exercise therapy reduced functional limitations with a clinically important 23% improvement (mean effect/100 (95% CI) -10.2 (-13.2 to -7.3)) at short-term follow-up. Not having heavy physical demands at work and medication use for low back pain were potential treatment effect modifiers-these were associated with superior exercise outcomes relative to non-exercise comparisons. Lower body mass index was also associated with better outcomes in exercise compared with no treatment/usual care. This study was limited by inconsistent availability and measurement of participant characteristics. CONCLUSIONS: This study provides potentially useful information to help treat patients and design future studies of exercise interventions that are better matched to specific subgroups. PROTOCOL PUBLICATION: https://doi.org/10.1186/2046-4053-1-64.
Evidence and consensus-based recommendations for non-pharmacological treatment of fatigue, hand function loss, Raynaud’s phenomenon and digital ulcers in patients with systemic sclerosis
Stöcker, J.K. ; Schouffoer, A.A. ; Spierings, J ; Schriemer, M.R. ; Potjewijd, J. ; de Pundert, L. ; van den Hoogen, F.H.J. ; Nijhuis- van der Sanden, M.W.G. ; Staal, J.B. ; Satink, T. ; Vonk, M.C. ; van den Ende, C.H.M. et al. sine al.
2022, Article / Letter to editor (Rheumatology, vol. 61, (2022), pp. 1476-1486)
Evidence and consensus-based recommendations for non-pharmacological treatment of fatigue, hand function loss, Raynaud's phenomenon and digital ulcers in patients with systemic sclerosis.
Stöcker, J.K. ; Schouffoer, A.A. ; Spierings, J ; Schriemer, M.R. ; Potjewijd, J. ; Pundert, L. de ; Hoogen, F.H.C. van den ; -van der Sanden, M.W.G. Nijhuis ; Staal, J.B. ; Satink, T. ; Vonk, M.C. ; Ende, C.H.M. et al. sine al.
2022, Article / Letter to editor (Rheumatology, vol. 61, iss. 4, (2022), pp. 1476-1486)OBJECTIVE: SSc is a complex CTD affecting mental and physical health. Fatigue, hand function loss, and RP are the most prevalent disease-specific symptoms of systemic sclerosis. This study aimed to develop consensus and evidence-based recommendations for non-pharmacological treatment of these symptoms. METHODS: A multidisciplinary task force was installed comprising 20 Dutch experts. After agreeing on the method for formulating the recommendations, clinically relevant questions about patient education and treatments were inventoried. During a face-to-face task force meeting, draft recommendations were generated through a systematically structured discussion, following the nominal group technique. To support the recommendations, an extensive literature search was conducted in MEDLINE and six other databases until September 2020, and 20nkey systematic reviews, randomized controlled trials, and published recommendations were selected. Moreover, 13 Dutch medical specialists were consulted on non-pharmacological advice regarding RP and digital ulcers. For each recommendation, the level of evidence and the level of agreement was determined. RESULTS: Forty-one evidence and consensus-based recommendations were developed, and 34, concerning treatments and patient education of fatigue, hand function loss, and RP/digital ulcers-related problems, were approved by the task force. CONCLUSIONS: These 34 recommendations provide guidance on non-pharmacological treatment of three of the most frequently described symptoms in patients with systemic sclerosis. The proposed recommendations can guide referrals to health professionals, inform the content of non-pharmacological interventions, and can be used in the development of national and international postgraduate educational offerings.
De enkel is zelden ‘enkel’
Nieuwenhuijzen, P.H.J.A. ; Wijchen, J. van
2021, Article / Letter to editor (Physios, iss. 1, (2021), pp. 32-41)
Effects of General Physical Activity Promoting Interventions on Functional Outcomes in Patients Hospitalized over 48 Hours: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Seeger, J.P.H. ; Koenders, N. ; Staal, J.B. ; Hoogeboom, T.J.
2021, Article / Letter to editor (Int J Environ Res Public Health, vol. 18, iss. 3, (2021))Low physical activity of patients is a global problem and associated with loss of strength and independent mobility. This study analyzes the effect of general physical activity promoting interventions on functional and hospital outcomes in patients hospitalized over 48 h. Five electronic databases were searched for randomized controlled trials. For outcomes reported in two studies or more, a meta-analysis was performed to test between-group differences (intervention versus control) using a random-effects model. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence for each outcome. Out of 23,302 identified studies, we included four studies (in total n = 368 participants). We found with moderate certainty of evidence 0 reported falls in the intervention (n = 126) versus five reported falls in the control (n = 122), a non-statistically significant difference between intervention and control groups (p = 0.06). In addition, we found with (very) low certainty of evidence no statistically significant differences between groups on activities of daily living (ADL-activity) and time spent standing and walking. Overall, we found no conclusive evidence on the effect of general physical activity promoting interventions on functional outcomes. More research is needed to understand and improve the effect of general physical activity promoting interventions for patients during the hospital stay.
Effectiveness of supervised home-based exercise therapy compared to a control intervention on functions, activities and participation in older patients after hip fracture: a systematic review and meta-analysis.
Kuijlaars, I.A.R. ; Sweerts, L. ; Nijhuis-van der Sanden, M.W.G. ; Balen, R. van ; Staal, J.B. ; Meeteren, N. van ; Hoogeboom, T.J.
2018, Article / Letter to editor (Archives of Physical Medicine and Rehabilitation, (2018))
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.

Now showing items 51-100 of 125

Browse by Lectorate "Musculoskeletale Revalidatie"

Browse

All of HAN Publications