Browsing by Author "Swart, B.J.M. de"

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Process-oriented profiling of speech sound disorders
Diepeveen, S.J.H. ; Terband, H ; Haaften, L van ; Zande, A.M. ; Megens-Huigh, C. ; Swart, B.J.M. de ; Maassen, B
2022, Article / Letter to editor (CHILDREN-BASEL, vol. 9, iss. 1502, (2022), pp. 1-23)
Enhancing the role of the social network in activity (re)engagement post-stroke: a focus group study with rehabilitation professionals.
Veen, D.J. van der ; Jellema, S. ; Wees, P.J. van der ; Graff, M.J.L. ; Swart, B.J.M. de ; Steultjens, E.M.J.
2022, Article / Letter to editor (BMC Primary Care, vol. 23, iss. 1, (2022), pp. 285)
Healthcare needs, expectations, utilization, and experienced treatment effects in patients with hereditary spastic paraplegia: a web-based survey in the Netherlands
Kerstens, H.C.J.W. ; Lith, B.J.H. van ; Nijkrake, M.J. ; Swart, B.J.M. de ; Bemd, LAC van den ; Smeets, RJEM ; Klemens, F ; Warrenburg, BPC van de ; Wees, P.J. van der ; Geurts, A.C.H.
2021, Article / Letter to editor (Orphanet Journal of Rare Diseases, vol. 16, iss. 1, (2021))Background We aimed to identify healthcare needs, expectations, utilization, and the experienced treatment effects in a population of Dutch patients with hereditary spastic paraplegia (HSP). Methods We distributed an online questionnaire among 194 adult persons with HSP in the Netherlands, of which 166 returned a fully completed version. After applying predefined exclusion criteria, 109 questionnaires from persons with pure HSP were analysed. Results Healthcare needs and expectations were primarily focused on the relief of muscle stiffness and reduction of balance and gait impairments (65-80%), but many participants also expressed needs regarding relief of non-motor symptoms (e.g. pain, fatigue), emotional problems, impaired sleep and self-care capacity, and participation problems (> 60%). Remarkably, despite these frequent needs, relatively few participants (< 33%) expected to be able to improve in these additional domains. Rehabilitation physicians and physiotherapists were more frequently consulted than neurologists and occupational therapists, respectively. Physiotherapy was the most often proposed non-pharmacological intervention (85%), followed by orthopedic footwear (55%) and splints (28%). Approximately one third of the participants was never offered any pharmacological (spasmolytic) treatment. Spasmolytic oral drugs, injections, and intrathecal baclofen were given to 41%, 26%, and 5% of the participants, respectively. Independent of the type of pharmacological intervention, 35-46% of these participants experienced decreased spastiticy and improved general fitness. Other experienced effects differed per type of intervention. Conclusions Based on this web-based survey in the Netherlands, there seems to be ample room for improvement to meet and attune the healthcare needs and expectations of people with HSP concerning both their motor and non-motor symptoms and functional limitations. In addition, the provision of adequate information about non-pharmacological and pharmacological interventions seems to be insufficient for many patients to allow shared decision making. These conclusions warrant a more pro-active attitude of healthcare providers as well as an interdisciplinary approach for a substantial proportion of the HSP population, also involving professionals with a primary occupational and/or psychosocial orientation.
Maximum Repetition Rate in a large cross-sectional sample of typically developing Dutch-speaking children
Diepeveen, S.J.H. ; Haaften, L van ; Terband, H ; Swart, B.J.M. de ; Engel-Hoek, Lenie van den ; Maassen, B
2021, Article / Letter to editor (International Journal of Speech-Language Pathology, vol. 23, iss. 5, (2021), pp. 508-518)
Experienced consequences of spasticity and effects of botulinum toxin injections: a qualitative study amongst patients with disabling spasticity after stroke
Kerstens, H.C.J.W. ; Satink, T. ; Nijkrake, M.J. ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G. ; Wees, Philip van der ; Geurts, A.C.H.
2020, Article / Letter to editor (Disability and Rehabilitation, (2020))Purpose:Chronic spasticity poses a major burden on patients after stroke. Intramuscular botulinum toxin injections constitute an important part of the treatment for patients suffering from troublesome focal spasticity. This study explores the experienced consequences of chronic spasticity amongst patients after stroke regarding physical impairments and activities, the experienced effects of botulinum toxin treatment on these domains, and whether current spasticity management addresses patients' needs. Materials and methods:Fourteen participants with chronic spasticity after stroke who were treated with cyclical botulinum toxin injections in the upper and/or lower extremity muscles were interviewed. Inductive thematic analysis generated representative themes. Results:Analyses of the interviews revealed three themes: (1) spasticity-related impairments and activity limitations; (2) fluctuations in spasticity related to botulinum toxin; (3) need for professional support and feedback. Besides motor impairments, participants experienced activity limitations in many domains of everyday life, with considerable day-to-day fluctuations. Moreover, treatment with botulinum toxin led to cyclical fluctuations in spasticity-related symptoms, which differed across participants. The participants called for shared responsibility for treatment, particularly regarding optimising the timing of injections. Conclusion:Incorporating patient-relevant outcomes into the current assessment of spasticity and monitoring these outcomes may improve spasticity management, particularly regarding the timing of botulinum toxin injections.
Self-management develops through doing of everyday activities-a longitudinal qualitative study of stroke survivors during two years post-stroke
Satink, T. ; Josephsson, S ; Zajec, J. ; Cup, Edith ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2020, Article / Letter to editor (BMC Neurology, vol. 16, (2020))Background: A description of the complexity of the process of self-management and the way stroke survivors give meaning to their process of self-management post-stroke is lacking. This study explores how stroke survivors managed their lives, gave meaning to their self-management post-stroke and how this evolved over time. Methods: Data was generated through participant observations and interviews of 10 stroke survivors at their homes at 3, 6, 9, 15 and 21 months post-discharge. A constant comparative method was chosen to analyse the data. Results: 'Situated doing' was central in stroke survivors' simultaneous development of self-management and their sense of being in charge of everyday life post-stroke. Doing everyday activities provided the stroke survivors with an arena to explore, experience, evaluate, develop and adapt self-management and being in charge of everyday activities and daily life. The influence of stroke survivors' partners on this development was sometimes experienced as empowering and at other times as constraining. Over time, the meaning of self-management and being in charge changed from the opinion that self-management was doing everything yourself towards self-managing and being in charge, if necessary, with the help of others. Moreover, the sense of self-management and being in charge differed among participants: it ranged from managing only at the level of everyday activities to full role management and experiencing a meaningful and valuable life post-stroke. Conclusions: The findings of this study indicate the doing of activities as an important arena in which to develop self-management and being in charge post-stroke. Stroke self-management programs could best be delivered in stroke survivors' own environment and focus on not only stroke survivors but also their relatives. Furthermore, the focus of such interventions should be on not only the level of activities but also the existential level of self-management post-stroke.
Educational programs for learning to observe movement quality in physical therapy: a designbased research approach
Dekkers, L.M.A. ; Satink, T. ; Nijhuis-van der Sanden, M.W.G. ; Swart, B.J.M. de ; Maas, M.J ; Janssen, A.J
2020, Article / Letter to editor (Physiotherapy Theory and Practice, (2020), pp. 1-13)
Clinical Reasoning for Speech Sound Disorders: Diagnosis and Intervention in Speech-Language Pathologists' Daily Practice
Diepeveen, S.J.H. ; Haaften, L van ; Terband, H ; Swart, B.J.M. de ; Maassen, B
2020, Article / Letter to editor (AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, vol. 29, (2020), pp. 1529-1549)
Stumbling, struggling, and shame due to spasticity: a qualitative study of adult persons with hereditary spastic paraplegia.
Kerstens, H.C.J.W. ; Satink, T. ; Nijkrake, M.J. ; Swart, B.J.M. de ; Lith, B.J.H. van ; Geurts, A.C.H. ; Nijhuis-van der Sanden, M.W.G.
2019, Article / Letter to editor (Disability and Rehabilitation, vol. 13, (2019), pp. 1-8)
"Everyone sees you sitting there struggling with your food": experiences of adolescents and young adults with cerebral palsy
Remijn, L. ; Engel-Hoek, Lenie van den ; Satink, T. ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2019, Article / Letter to editor (Disability and Rehabilitation, vol. 41, iss. 16, (2019), pp. 1898-1905)Objective: The impact of difficulties with eating and drinking in adolescents and young adults with cerebral palsy is unknown. The purpose of this study is to find out which difficulties adolescents and young adults with cerebral palsy experience with eating and drinking in daily life and how they deal with these difficulties. The study also explores how they think about themselves with respect to eating and what does or does not help regarding social participation. Method: We collected the data from ten participants with spastic cerebral palsy (aged 15-23 years) living in the Netherlands. We used a qualitative study design with a conventional content analysis. Semi-structured in-depth interviews were used to identify meaningful factors related to eating and drinking difficulties. We coded relevant phrases from each interview and clustered and synthesized them into categories. Result: We derived four categories from the transcripts: (I) perceived eating and drinking difficulties (e.g., not managing to eat all food textures and/or choking); (II) challenges in physical and social context (e.g., accessibility of restaurants, menu supply, and/or needing assistance or not); (III) dealing with eating and drinking difficulties (e.g., adaptation, food avoidance, and/or giving up); (IV) Negative feelings about their eating and drinking (e.g., shame, frustration, fear for choking, and/or concerns about the future). One striking finding was that most participants had not recently received either monitoring or intervention for their feeding skills. Conclusion: This study shows that adolescents and young adults with cerebral palsy experience many restrictions in eating and drinking situations leading to negative feelings and lower participation levels, while little attention is directed towards these difficulties. Regular multidisciplinary rehabilitation programs should include evaluation, advice, and intervention regarding eating and drinking ability in order to increase social participation and self-management.
A Standardized Protocol for Maximum Repetition Rate Assessment in Children
Diepeveen, S.J.H. ; Haaften, L van ; Terband, H ; Swart, B.J.M. de ; Maassen, B
2019, Article / Letter to editor (Folia Phoniatrica et Logopaedica, vol. 71, iss. 5-6, (2019), pp. 238-250)
Profiling Speech Sound Disorders for Clinical Validation of the Computer Articulation Instrument
Haaften, L van ; Diepeveen, S.J.H. ; Terband, H ; Vermeij, B ; Engel-Hoek, Lenie van den ; Swart, B.J.M. de ; Maassen, B
2019, Article / Letter to editor (AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, vol. 28, iss. 2, (2019), pp. 844-856)
The Psychometric Evaluation of a Speech Production Test Battery for Children: The Reliability and Validity of the Computer Articulation Instrument
Haaften, L van ; Diepeveen, S.J.H. ; Engel-Hoek, Lenie van den ; Jonker, M. ; Swart, B.J.M. de ; Maassen, B
2019, Article / Letter to editor (Journal of Speech, Language, and Hearing Research, vol. 62, iss. 7, (2019), pp. 2141-2170)
Everyone sees you sitting there struggling with your food”: experiences of adolescents and young adults with cerebral palsy. Disability and Rehabilitation.
Remijn, L. ; Engel-Hoek, Lenie van den ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Disability and Rehabilitation, vol. 21, (2018), pp. 1-8)
Interrater Reliability of the Observable Movement Quality Scale for Children.
Dekkers, L.M.A. ; Nijhuis-van der Sanden, M.W.G. ; Jonker, M. ; Swart, B.J.M. de ; Janssen, Astrid
2018, Article / Letter to editor (Physiotherapy Canada, vol. 70, iss. 2, (2018), pp. 113-119)
The perspectives of spouses of stroke survivors on self-management – a focus group study.
Satink, T. ; Cup, Edith ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Disability and Rehabilitation, vol. 40, (2018), pp. 176-184)
Reader ‘Pitch Limiting Voice Treatment'
Swart, B.J.M. de
2018, Book (monograph)
Nursing home-acquired pneumonia, dysphagia and associated diseases in nursing home residents: A retrospective, cross-sectional study
Hollaar, V.R.Y. ; Putten, GJ van der ; Van der Maarel -Wierink, CD ; Bronkhorst, E.M. ; Swart, B.J.M. de ; Baat, C de ; Creugers, N.H.J.
2017, Article / Letter to editor (Geriatric Nursing, vol. 38, (2017), pp. 437-441)
Negotiating role management through everyday activities: narratives in action of two stroke survivors and their spouses
Satink, T. ; Josephsson, S ; Zajec, J. ; Cup, Edith ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2016, Article / Letter to editor (Disability and Rehabilitation, vol. 38, iss. 24-26, (2016), pp. 2354-2364)Purpose: To manage social roles is a challenging part of self-management post-stroke. This study explored how stroke survivors act as role managers with their spouses in the context of everyday activities. Method: Two stroke survivors with a first time stroke living at home with a spouse were included. Data were generated through participant observations at their own environment at 3, 6, 9, 15 and 21 months post-discharge. The narrative analysis focused on the actions of participants. Results: Daily activities can be understood as an arena where role management and a meaningful live is negotiated and co-constructed with others. Everyday activities gave stroke survivors and their spouses insight into stroke survivors' capacities in daily situations. This was sometimes empowering, and other times conflicting when a spouse had negative perceptions of the abilities of the stroke survivors. Conclusion: The findings add to the current understanding of self-management and role management with regard to how these are situated in everyday activities. Daily activities can help both spouses to reflect and understand about self-management, role management and comanagement in daily life. Moreover, observing stroke survivors in everyday situations provides professionals with concrete pictures of stroke survivors' performance and self-management in interaction with their spouses.
Self-management: challenges for allied healthcare professionals in stroke rehabilitation - a focus group study
Satink, T. ; Cup, Edith ; Swart, B.J.M. de ; Sanden, M.N. van
2015, Article / Letter to editor (Disability and Rehabilitation, vol. 37, iss. 18-19, (2015), pp. 1745-1752)Purpose: Self-management has become an important concept in stroke rehabilitation. This study explored allied healthcare professionals' (AHPs) perceptions and beliefs regarding the self-management of stroke survivors and their knowledge and skills regarding stroke self-management interventions. Method: Four focus group interviews were conducted with 27 professionals. Verbal questions and mind mapping were used to collect data. A constant comparative framework was used for analysis. Results: The AHPs discussed different levels of post-stroke self-management, depending on factors such as pre-stroke skills, recovery-phases post-stroke and cognitive abilities of the stroke patients. They hesitated about stroke clients' capacities to self-manage. AHPs questioned whether their own attitudes and skills were really supportive for stroke clients' self-management and criticised stroke services as being too medically oriented. They recommended that self-management programmes should focus both on clients and caregivers and be delivered at peoples' homes. Conclusion: Professional perceptions and beliefs are important factors to take into account when implementing stroke self-management programmes. Before professionals can enable stroke survivors to self-manage, they first need support in acquiring knowledge and skills regarding post-stroke self-management. Moreover, professionals could benefit from behavioural change models, and professionals recognised that stroke self-management interventions would be most beneficial when delivered post-discharge at people's homes.
How is self-management perceived by community living people after a stroke? A focus group study
Satink, T. ; Cup, Edith ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2015, Article / Letter to editor (Disability and Rehabilitation, vol. 37, iss. 3, (2015), pp. 223-230)Purpose: Self-management has become an important concept in stroke rehabilitation; however, the way that people post-stroke reflect on the concept of self-management has not yet been studied. This qualitative study explored the reflections of persons post-stroke on self-management, readiness and needs in self-management support. Methods: Focus group interviews were conducted with 16 community living stroke survivors (53-84 years of age). Both verbal questions and photo elicitations were used to collect data. A constant comparative framework was used for the analysis. Result: Participants described their self-management as a complex, long-term, personal learning process. Post-discharge, participants were not ready to self-manage. Aside from individual self-management, participants also mentioned co-management with relatives. Relatives could provide support, but they also limited the development of participants' self-management skills. Participants missed having professional support post-discharge and would have appreciated additional psychological and emotional support in their process of self-management. Conclusion: Self-management post-stroke is complex. Stroke self-management programmes may be optimised when integrating role and emotional management in addition to medical management. Although readiness to self-manage differs among individuals, support should start as soon as possible and continue post-discharge in people's personal environments. Self-management programmes should not only focus on self-management of stroke survivors but also on co-management with relatives.
Patients' Views on the Impact of Stroke on Their Roles and Self: A Thematic Synthesis of Qualitative Studies
Satink, T. ; Cup, Edith ; Ilott, I ; Prins, J ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2013, Article / Letter to editor (Archives of Physical Medicine and Rehabilitation, vol. 94, iss. 6, (2013), pp. 1171-1183)Objective: To synthesize patients' views on the impact of stroke on their roles and self. Data Sources: PubMed, CINAHL, Embase, PsycINFO, and Cochrane searched from inception to September 2010, using a combination of relevant Medical Subject Headings and free-text terms. This search was supplemented by reference tracking. Study Selection: Qualitative studies reporting the views of people poststroke. The search yielded 494 records. Opinion articles, quantitative studies, or those reporting somatic functioning were excluded. Thirty-three studies were included. Data Extraction: Data extraction involved identifying all text presented as "results" or "findings" in the included studies, and importing this into software for the analysis of qualitative data. Data Synthesis: The abstracted text was coded and then subject to a thematic analysis and synthesis, which was discussed and agreed by the research team. Three overarching themes were identified: (1) managing discontinuity is a struggle; (2) regaining roles: to continue or adapt? and (3) context influences management of roles and self. Regaining valued roles and self was an ongoing struggle, and discontinuity and uncertainty were central to the adjustment process after stroke. Conclusions: The thematic synthesis provides new insights into the poststroke experience. Regaining or developing a new self and roles was problematic. Interventions targeted at self-management should be focused on the recognition of this problem and included in rehabilitation, to facilitate adjustment and continuity as far as possible in life poststroke. (C) 2013 by the American Congress of Rehabilitation Medicine
Bevorderende en belemmerende factoren bij implementatie van het EDOMAH-programma
Olde-Rikkert, M. ; Vernooij-Dassen, M. ; Swart, B.J.M. de ; Graff, Maud ; Kaijen, M. ; Leven, 't N. van
2012, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 2012, iss. 5, (2012), pp. 5-14)Het doel van deze studie, die in 2007-2008 werd uitgevoerd, was het vaststellen van bevorderende en belemmerende factoren voor implementatie van dit EDOMAH-programma. Met een kwalitatieve onderzoeksmethode werden data verzameld: focusgroepen met 17 ergotherapeuten en telefonische interviews met 10 verwijzers en 4 managers. De analyses werden uitgevoerd op basis van de constante vergelijkingsmethode waarbij codes, categorieën en thema’s werden vastgesteld. De belangrijkste thema’s bij de belemmerende factoren waren het gebrek aan zelfvertrouwen bij ergotherapeuten om de doelgroep volgens het programma te behandelen, moeite met prioriteiten stellen binnen deze intensieve behandelwijze en het gebrek aan gerichte verwijzingen. Voor verwijzers en managers waren gebrek aan kennis over (deze vorm) van ergotherapie, over de vergoedingsmogelijkheden en gebrek aan beschikbare ergotherapeuten belemmerende factoren. Bevorderend waren de inhoud en doel van het programma, bewezen effectiviteit en externe ondersteuning. Op basis van deze resultaten kunnen gerichte implementatiestrategieën ontwikkeld worden.
Community-dwelling people with chronic stroke need disproportionate attention while walking and negotiating obstacles
Smulders, Katrijn ; Geurts, Alexander ; Swart, B.J.M. de ; Weerdesteyn, V. ; Swigchem, R. van
2012, Article / Letter to editor (Gait & Posture, vol. 36, iss. 1, (2012), pp. 127-132)The objective of the present study was to examine the attentional demands of gait adaptations required to walk over irregular terrain in community-dwelling people with chronic stroke. Eight community ambulators (>6 months post-stroke, aged 57 ± 15 years) and eight age-matched healthy controls participated in the study. As the primary motor task, participants walked on a treadmill while they quickly reacted to a sudden obstacle in front of the affected (in the stroke group) or left (in healthy controls) leg. The secondary, cognitive task was an auditory Stroop task. Outcomes were avoidance success rate and muscle reaction times of the biceps and rectus femoris (motor task), and a composite score of accuracy and verbal reaction time (cognitive task). Success rates did not differ between single- and dual-task conditions in either group, while muscle reaction times deteriorated equally during the dual task in both groups. However, compared with the Stroop scores just before and after obstacle crossing, the scores while crossing the obstacle deteriorated more in the stroke group than in the controls (p=0.012). The higher dual-task costs on the Stroop task reflect greater attentional demands during walking and crossing obstacles. The absence of dual-task effects on obstacle avoidance performance suggests that the people with stroke used a "posture-first strategy". The results imply that common daily life tasks such as obstacle crossing while walking require disproportionate attention even in well-recovered people with stroke.
Oral muscles are progressively affected in Duchenne muscular dystrophy : Implications for dysphagia treatment
Swart, B.J.M. de ; Klein, W. ; Engel-Hoek, Lenie van den ; Pillen, S. ; Hendriks, J.C.M. ; Geurts, Alexander ; Groot, M. de ; Sie, L. ; Erasmus, C.
2012, Article / Letter to editor (Journal of Neurology, vol. 260, iss. 5, (2012), pp. 1295-1303)Dysphagia is reported in advanced stages of Duchenne muscular dystrophy (DMD). The population of DMD is changing due to an increasing survival. We aimed to describe the dysphagia in consecutive stages and to assess the underlying mechanisms of dysphagia in DMD, in order to develop mechanism based recommendations for safe swallowing. In this cross-sectional study, participants were divided into: early and late ambulatory stage (AS, n = 6), early non-ambulatory stage (ENAS, n = 7), and late non-ambulatory stage (LNAS, n = 11). Quantitative oral muscle ultrasound was performed to quantify echo intensity. Swallowing was assessed with a video fluoroscopic swallow study, surface electromyography (sEMG) of the submental muscle group and tongue pressure. Differences in outcome parameters among the three DMD stages were tested with analysis of variance. Oral muscles related to swallowing were progressively affected, starting in the AS with the geniohyoid muscle. Tongue (pseudo) hypertrophy was found in 70 % of patients in the ENAS and LNAS. Oral phase problems and post-swallow residue were observed, mostly in the LNAS with solid food. sEMG and tongue pressure data of swallowing solid food revealed the lowest sEMG amplitude, the longest duration and lowest tongue pressure in the LNAS. In case of swallowing problems in DMD, based on the disturbed mechanisms of swallowing, it is suggested to (1) adjust meals in terms of less solid food, and (2) drink water after meals to clear the oropharyngeal area.
Prevalence of oropharyngeal dysphagia in Parkinson’s disease : A meta-analysis
Bloem, Bastiaan ; Kalf, Johanna ; Munneke, Marten ; Swart, B.J.M. de
2012, Article / Letter to editor (Parkinsonism & Related Disorders, vol. 18, iss. 4, (2012), pp. 311-315)Dysphagia is a potentially harmful feature, also in Parkinsons disease (PD). As published prevalence rates vary widely, we aimed to estimate the prevalence of oropharyngeal dysphagia in PD in a meta-analysis. We conducted a systematic literature search in February 2011 and two independent reviewers selected the papers. We computed the estimates of the pooled prevalence weighted by sample size. Twelve studies were suitable for calculating prevalence rates. Ten studies provided an estimate based on subjective outcomes, which proved statistically heterogeneous (p < 0.001), with a pooled prevalence estimate with random effect analysis of 35% (95% CI 28-41). Four studies provided an estimate based on objective measurements, which were statistically homogeneous (p = 0.23), with a pooled prevalence estimate of 82% (95% CI 77-87). In controls the pooled subjective prevalence was 9% (95% CI 2-17), while the pooled objective prevalence was 23% (95% CI 13-32). The pooled relative risk was 3.2 for both subjective outcomes (95% CI 2.32-4.41) and objective outcomes (95% CI 2.08-4.98). Clinical heterogeneity between studies was chiefly explained by differences in disease severity. Subjective dysphagia occurs in one third of community-dwelling PD patients. Objectively measured dysphagia rates were much higher, with 4 out of 5 patients being affected. This suggests that dysphagia is common in PD, but patients do not always report swallowing difficulties unless asked. This underreporting calls for a proactive clinical approach to dysphagia, particularly in light of the serious clinical consequences.
Prognostic value of a decreased tongue strength for survival time in patients with amyotrophic lateral sclerosis
Swart, B.J.M. de ; Schelhaas, J. ; Weikamp, J. ; Hendriks, J.C.M. ; Geurts, Alexander
2012, Article / Letter to editor (Journal of Neurology, vol. 259, iss. 11, (2012), pp. 2360-2366)Decreased tongue strength (TS) might herald bulbar involvement in patients with amyotrophic lateral sclerosis (ALS) well before dysarthria or dysphagia occur, and as such might be prognostic of short survival. The purpose of this study was to investigate the prognostic value of a decreased TS, in addition to other prognostic factors, such as site of onset, bulbar symptoms, bulbar signs, age, sex, maximum phonation time, time from symptoms to diagnosis, and gastrostomy, for survival time in patients with ALS. TS was measured in four directions in 111 patients who attended the diagnostic outpatient motor neuron clinic of our university hospital. Of these patients, 54 were diagnosed with ALS. TS was considered abnormal if the strength in minimally one direction was at least two standard deviations below the reference values obtained from comparable age category and sex-groups of healthy controls (n = 119). Twenty of the patients with ALS had a decreased TS. Multivariable analysis showed that, in addition to age, TS was an independent prognostic factor for survival time in patients with ALS.
Reproducibility and validity of patient-rated assessment of speech, swallowing, and saliva control in Parkinson’s Disease
Zwarts, Machiel ; Kalf, Johanna ; Bloem, Bastiaan ; Borm, George ; Munneke, Marten ; Swart, B.J.M. de
2012, Article / Letter to editor (Archives of Physical Medicine and Rehabilitation, vol. 2011, iss. 92, (2012), pp. 1152-1158)To report on the development and psychometric evaluation of the Radboud Oral Motor Inventory for Parkinsons Disease (ROMP), a newly developed patient-rated assessment of speech, swallowing, and saliva control in patients with Parkinsons disease (PD). To evaluate reproducibility, 60 patients completed the ROMP twice within a mean of 24±12 days. To study validity, another cohort of 118 patients who had completed the ROMP was assessed by both a neurologist (HY stage, Unified Parkinsons Disease Rating Scale III) and speech-language pathologist (severity of dysarthria, dysphagia, drooling) who were blinded to ROMP scores. Confirmatory factor analysis identified the 3 a priori-designed ROMP domains of speech, swallowing, and saliva control. Internal consistency was .95 for the total ROMP and .87 to .94 for the 3 domains or subscales. Intraclass correlation coefficients for reproducibility were .94 and .83 to .92 for the subscales. Construct validity was substantial to good with correlations ranging from .36 to .82. The ROMP differentiated significantly (P<.001) between patients indicated for speech therapy (based on independent assessment) and those who were not and between mild, moderate, and severe PD according to HY stage. The ROMP provides a reliable and valid instrument to evaluate patient-perceived problems with speech, swallowing, and saliva control in patients with PD or AP.
Literatuurstudie van de constraint-induced movement therapy en implicaties voor de praktijk
Bosmans, Juliette ; Minis, Marie-Antoinett van ; Steultjens, E.M.J. ; Swart, B.J.M. de
2012, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 2012, iss. 2, (2012), pp. 33-46)De Constraint-Induced Movement Therapy (CIMT) is een behandelmethode in de neurorevalidatie die erop gericht is om het gHet primaire doel van deze literatuurstudie is te achterhalen of de CIMT en de modified-CIMT (mCIMT) valide en effectieve behandelmethoden zijn om de armen handfunctie van de paretische zijde in de subacute en chronische fase na een CVA te verbeteren. De secundaire doelen zijn het onderzoeken van de effecten van de CIMT en mCIMT op het verbeteren van de uitvoer van dagelijkse activiteiten en participatie.ebruik van de paretische arm en hand na een Cerebro Vasculair Accident (CVA) te verbeteren.
Quantitative ultrasound of the tongue and submental muscles in children and young adults
Engel-Hoek, Lenie van den ; Pillen, S. ; Groot, M. de ; Swart, B.J.M. de ; Alfen, N. van
2012, Article / Letter to editor (Muscle and Nerve, vol. 46, iss. 1, (2012), pp. 31-37)The purpose of this study was to assess the feasibility of quantitative muscle ultrasound (QMUS) to visualize oral muscles and to establish normative data for muscle thickness and echo intensity of submental and tongue muscles in healthy children and young adults. The data were compared with those of 5 patients with Duchenne muscular dystrophy (DMD). Ultrasound images from the suprahyoid region and from the surface of the tongue were made in 53 healthy subjects aged 5 to 30 years. All measurements were feasible in all subjects and patients with good reproducibility except for the mylohyoid muscle. Muscle thickness depended on height, and echo intensity depended on weight. Our findings suggest gradual involvement of oral muscles in DMD. QMUS in oral muscles is feasible in healthy children, adults and patients with DMD. These data show that it is possible to differentiate between healthy persons and patients with DMD.
Aanvulling en Revisie Hoofdstuk 9 ‘Eten en drinken’ en hoofdstuk 20 ‘Logopedie’
Swart, B.J.M. de ; Kalf, Johanna
2011, Part of book or chapter of book ()Het zorgboek Ziekte van Parkinson is ontwikkeld voor mensen met parkinson en hun naasten. Op basis van goede medische informatie biedt de map praktische aanknopingspunten om problemen die door de aandoening kunnen ontstaan, aan te pakken. In dit boek wordt de volledige breedte van deze problematiek bestreken, zodat de gehele medische, verpleegkundige, psychosociale en maatschappelijke zorg rondom deze patiëntengroep aan bod komt.
Barriers to and facilitators for the use of an evidence-based occupational therapy guideline for older people with dementia and their carers
Swart, B.J.M. de ; Kaijen, M. ; Leven, 't N. van ; Vernooij-Dassen, M. ; Graff, Maud ; Olde-Rikkert, M.
2011, Article / Letter to editor (International Journal of Geriatric Psychiatry, vol. 27, iss. 7, (2011), pp. 742-748)Implementing evidence-based guidelines is not a simple task. This study aimed to define barriers to and facilitators for implementing the proven and effective Community Occupational Therapy in Dementia (COTiD) guideline for older people with dementia and their carers. The qualitative method we used was the grounded theory. We collected data from focus group interviews with 17 occupational therapists (OTs) and telephone interviews with 10 physicians and 4 managers. We analysed the data with the constant comparative method by identifying codes, categories, and main themes. The main themes in barriers that OTs encountered were that they did not feel competent in treating older people with dementia at home according to the guideline; they had difficulties prioritising in this complex treatment, both for the client and themselves; and they were unsure about the minimal criteria for guideline adherence. The intensity of this programme was the main barrier. The barriers that confronted physicians and managers were lack of knowledge about occupational therapy and its reimbursement and lack of available trained OTs. For the OTs, the guidelines content and focus, evidence, and external support facilitated the use of the guideline. For physicians and managers, the guidelines evidence base and its benefits for clients and carers were the main facilitators. This study generates knowledge for applying innovations in health care settings. Improvement of the OTs knowledge and self-confidence is needed for using the guideline. We expect that more competent OTs will motivate their physicians and managers to use this successful COTiD intervention
De Geriatric Depression Scale-15 (GDS-15) als screeningsinstrument voor depressieve stoornissen door paramedici en Verpleegkundigen bij cliënten na een beroerte in een verpleeghuis?
Swart, B.J.M. de ; Mortel, Erik van de
2011, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 2012, iss. 4, (2011), pp. 38-48)Depressie komt vaak voor na een beroerte en algemeen wordt aangenomen dat dit van grote invloed is op de behandelmogelijkheden en -resultaten. Het is een onafhankelijke determinant voor de prognose van herstel van ADL-vaardigheid. Aangezien paramedici en verpleegkundigen, door het intensieve contact, vaak als eersten stemmingsveranderingen signaleren is de beschikbaarheid van een adequaat screeningsinstrument van waarde voor het revalidatieproces. De Geriatric Depression Scale-15 (GDS-15) is, als meest bekend instrument in de verpleeghuissetting, een van de mogelijke instrumenten om de signalen van depressie te kunnen objectiveren.
Ontwikkeling van criteria voor indicatiestelling fysiotherapie binnen verpleeghuizen
Hobbelen, H. ; Leemrijse, C. ; Ravensberg, Dorine van ; Koopmans, R.T. ; Swart, B.J.M. de ; Haastert, C. van ; Veenhof, C.
2011, Article / Letter to editor (Fysiotherapie en Ouderenzorg, vol. 25, iss. 3, (2011), pp. 5-16)Er bestaat een grote variatie in het percentage bewoners per verpleeghuis dat wel of geen fysiotherapeutische zorg ontvangt. Hierdoor is het onduidelijk of de juiste groep wel fysiotherapie ontvangt. Er is dan ook behoefte aan meer transparantie en standaardisatie van de indicatiestelling fysiotherapie in verpleeghuizen. Het doel van deze studie is om criteria te ontwikkelen voor de indicatiestelling fysiotherapie in verpleeghuizen en deze te toetsen in de praktijk.
Pathophysiology of diurnal drooling in Parkinson’s disease
Engel-Hoek, Lenie van den ; Kalf, Johanna ; Bloem, Bastiaan ; Borm, George ; Zwarts, Machiel ; Swart, B.J.M. de ; Munneke, Marten
2011, Article / Letter to editor (Movement Disorders, vol. 26, iss. 9, (2011), pp. 1670-1676)Drooling is an incapacitating feature of Parkinsons disease. Better pathophysiological insights are needed to improve treatment. In this study, we tested the hypothesis that the cause of drooling is multifactorial. We examined 15 patients with Parkinsons disease with distinct diurnal saliva loss ("droolers") and 15 patients with Parkinsons disease without drooling complaints ("nondroolers"). We evaluated all factors that could potentially contribute to drooling: swallowing capacity (maximum volume), functional swallowing (assessed with the dysphagia subscale of the Therapy Outcome Measures for rehabilitation specialists), unintentional mouth opening due to hypomimia (Unified Parkinsons Disease Rating Scale item), posture (quantified from sagittal photographs), and nose-breathing ability. We also quantified the frequency of spontaneous swallowing during 45 minutes of quiet sitting, using polygraphy. Droolers had more advanced Parkinsons disease than nondroolers (Unified Parkinsons Disease Rating Scale motor score 31 vs 22; P=.014). Droolers also scored significantly worse on all recorded variables except for nose breathing. Swallowing frequency tended to be higher, possibly to compensate for less efficient swallowing. Logistic regression with adjustment for age and disease severity showed that hypomimia correlated best with drooling. Linear regression with hypomimia as the dependent variable identified disease severity, dysphagia, and male sex as significant explanatory factors. Drooling in Parkinsons disease results from multiple risk factors, with hypomimia being the most prominent. When monitored, patients appear to compensate by increasing their swallowing frequency, much like the increased cadence that is used to compensate for stepping akinesia. These findings can provide a rationale for behavioral approaches to treat drooling.
Dysphagia is present but mild in myotonic dystrophy type 2
Ensink, R. ; Swart, B.J.M. de ; Vliet, J. van ; Tieleman, A. ; Engelen, M.M. ; Knuijt, S.
2009, Article / Letter to editor (Neuromuscular Disorders, vol. 19, iss. 3, (2009), pp. 196-198)The phenotype of myotonic dystrophy type 2 (DM2) shows similarities as well as differences to that of myotonic dystrophy type 1 (DM1). Dysphagia, a predominant feature in DM1, has not yet been examined in DM2. In a recent nationwide questionnaire survey of gastrointestinal symptoms in DM2, 12 out of 29 DM2 patients reported to have difficulty in swallowing for solid food. The aim of the study was to investigate the presence of dysphagia in patients with genetically proven DM2 who reported difficulty in swallowing for solid food at the questionnaire survey. Swallowing function and fiberoptic endoscopic evaluation of swallowing (FEES) were examined by a speech therapist and otorhinolaryngologist, respectively. In DM2 patients who reported difficulty in swallowing the presence of dysphagia could be confirmed (clinically in 100%, by FEES in 88%). A correlation exists between Dysphagia Outcome and Severity Score (DOSS) and age (p = 0.05). None of the patients was underweight, and none of the patients had suffered aspiration pneumonia in the past. Dysphagia is present among DM2 patients and is more severe in older patients. However, dysphagia is generally mild, and do not lead to weight loss, or aspiration pneumonia.
Effectiviteit en kosteneffectiviteit ergotherapie aan huis bij ouderen met dementie en hun mantelzorgers. Een gerandomiseerd gecontroleerd onderzoek
Schreurs, Victor ; Swart, B.J.M. de ; Engels, J.A. ; Schaafsma, Gertjan ; Steultjens, E.M.J. ; Hullegie, Wim ; Heerkens, Y.F. ; Cingel, Robert van
2009, Article / Letter to editor (Fysiotherapie en Ouderenzorg, vol. 23, iss. 3, (2009), pp. 19-30)Ergotherapie wordt in de eerstelijn steeds vaker geïndiceerd. Daarbij is erg belangrijk dat ook de hoeveelheid beschikbare evidence groeit. Dit artikel laat zien dat het dagelijks functioneren van patiënten met dementie verbetert en de draaglast van mantelzorgers neemt af ten gevolge van een gestructureerde aanpak. Bovendien blijkt dat deze verbeteringen behouden blijven na follow-up.

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