Browsing by Author "Nijhuis-van der Sanden, M.W.G."

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Identifying the minimal important difference in patient-reported outcome measures in the field of people with severe mental illness: a pre-post-analysis of the Illness Management and Recovery Programme
Beentjes, T.A.A. ; Teerenstra, S. ; Vermeulen, H. ; Goossens, P. ; Nijhuis-van der Sanden, M.W.G. ; Gaal, B.G.I. van
2021, Article / Letter to editor (Quality of Life Research, (2021))Purpose Complementary interventions for persons with severe mental illness (SMI) focus on both personal recovery and illness self-management. This paper aimed to identify the patient-reported outcome measures (PROMs) associated with the most relevant and meaningful change in persons with SMI who attended the Illness Management and Recovery Programme (IMR). Methods The effect of the IMR was measured with PROMs concerning recovery, illness self-management, burden of symptoms and quality of life (QoL). From the QoL measures, an anchor was chosen based on the most statistically significant correlations with the PROMs. Then, we estimated the minimal important difference (MID) for all PROMs using an anchor-based method supported by distribution-based methods. The PROM with the highest outcome for effect score divided by MID (the effect/MID index) was considered to be a measure of the most relevant and meaningful change. Results All PROMs showed significant pre-post-effects. The QoL measure 'General Health Perception (Rand-GHP)' was identified as the anchor. Based on the anchor method, the Mental Health Recovery Measure (MHRM) showed the highest effect/MID index, which was supported by the distribution-based methods. Because of the modifying gender covariate, we stratified the MID calculations. In most MIDs, the MHRM showed the highest effect/MID indexes. Conclusion Taking into account the low sample size and the gender covariate, we conclude that the MHRM was capable of showing the most relevant and meaningful change as a result of the IMR in persons with SMI.
Multifaceted interventions are required to improve physical activity behaviour in hospital care: a meta-ethnographic synthesis of qualitative research
Koenders, N. ; Marcellis, L ; Nijhuis-van der Sanden, M.W.G. ; Satink, T. ; Hoogeboom, Th.
2021, Article / Letter to editor (Journal of Physiotherapy, vol. 67, iss. 2, (2021), pp. 115-123)Question: What are the views of patients, close relatives and healthcare professionals on physical activity behaviour in hospital care? Methods: A meta-ethnographic synthesis of qualitative studies was conducted with a lines-of-argument analysis. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme (CASP) checklist. The lines of argument were synthesised and mapped in an existing theoretical model. The confidence of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. Results: Eleven studies were included and provided data from 290 participants (145 patients, 0 close relatives and 145 healthcare professionals). We have synthesised six lines of argument that explained the (intention of) physical activity behaviour of patients during their hospital stay: patients and healthcare professionals perceive benefits and risks of physical activity for patients' health (high confidence); physical activity gives a sense of freedom, confidence in recovery and mental wellbeing (high confidence); all healthcare professionals should offer timely and tailored physical activity promotion (high confidence); patient motivation to be physically active may be contingent upon encouragement (moderate confidence); family members can influence physical activity behaviour favourably or unfavourably (low confidence); and hospital culture has a negative influence on physical activity behaviour of patients (high confidence). Conclusions: Physical activity behaviour of patients during their hospital stay is a complex phenomenon with multiple interactions at the level of patients, healthcare professionals and hospital culture. Considering the results of this synthesis, multifaceted implementation strategies are needed to improve physical activity intention and behaviour of patients during their hospital stay. (C) 2021 Australian Physiotherapy Association. Published by Elsevier B.V.
Mixed methods evaluation of a self-management group programme for patients with neuromuscular disease and chronic fatigue
Veenhuizen, Y ; Satink, T. ; Graff, Maud ; Geurts, A.C.H. ; Groothuis, JT ; Engelen, B.G.M. van ; Nijhuis-van der Sanden, M.W.G. ; Cup, E.H.C.
2021, Article / Letter to editor (BMJ Open, vol. 11, iss. 8, (2021))Objective To obtain insight into experiences of patients with a neuromuscular disease and chronic fatigue and their healthcare professionals regarding content and delivery of a multidisciplinary outpatient self-management group programme to improve social participation. This will inform future implementation. Design A mixed method study alongside a randomised controlled trial. Setting University hospital, rehabilitation centre and community health centre. Participants 29 patients with a neuromuscular disease and chronic fatigue and 13 healthcare professionals participated in this mixed methods study. Intervention Multidisciplinary group programme, called Energetic, consisted of a 4 months intervention with weekly meetings and covered four modules: (1) individually tailored aerobic exercise training; (2) education about aerobic exercise; (3) self-management training in applying energy conservation strategies and (4) implementation and relapse prevention in daily life. Main measures Quantitative data were collected by a questionnaire measuring patients' (n=25, all completed the programme) satisfaction with the perceived results, content and delivery of the programme. Qualitative data were collected by individual and focus group interviews to gain insight in the experiences of patients (n=18), next of kin (n=2) and healthcare professionals (n=13) with facilitators and barriers to programme implementation. Results Patients were satisfied with the number and length of the sessions, the different modules and the therapists. Analysis of the interviews led to five themes: (1) the combination of modules makes a complete picture, (2) the programme is physically and mentally intensive, (3) the group setting is valuable, (4) small variations in delivery occur in different settings, (5) therapists are coaches. Suggestions for programme improvement include a combination of face to face and e-health, enhancement of therapists' skills in guiding group interventions and inclusion of more booster sessions to evaluate and maintain self-management competencies. Conclusions The Energetic programme could be implemented in different healthcare settings and group settings, and a combination of modules proved to be a facilitator for improving self-management.
A Blended Electronic Illness Management and Recovery Program for People With Severe Mental Illness: Qualitative Process Evaluation Alongside a Randomized Controlled Trial
Beentjes, T.A.A. ; Gaal, B.G.I. van ; Vermeulen, H. ; Nijhuis-van der Sanden, M.W.G. ; Goossens, P.
2021, Article / Letter to editor (JMIR Research Protocols, vol. 8(1), iss. e20860, (2021))
Recovery trajectories over six weeks in patients selected for a high-intensity physiotherapy program after Total knee Arthroplasty: a latent class analysis.
Harmelink, K.E.M. ; Dandis, R. ; Wees, P.J. van der ; Zeegers, A.V.C.M. ; Nijhuis-van der Sanden, M.W.G. ; Staal, J.B.
2021, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 22, iss. 1, (2021), pp. 179)BACKGROUND: Recovery trajectories differ between individual patients and it is hypothesizes that they can be used to predict if an individual patient is likely to recover earlier or later. Primary aim of this study was to determine if it is possible to identify recovery trajectories for physical functioning and pain during the first six weeks in patients after TKA. Secondary aim was to explore the association of these trajectories with one-year outcomes. METHODS: Prospective cohort study of 218 patients with the following measurement time points: preoperative, and at three days, two weeks, six weeks, and one year post-surgery (no missings). Outcome measures were performance-based physical functioning (Timed Up and Go [TUG]), self-reported physical functioning (Knee injury and Osteoarthritis Outcome Score-Activities of Daily Living [KOOS-ADL]), and pain (Visual Analogue Scale [VAS]). Latent Class Analysis was used to distinguish classes based on recovery trajectories over the first six weeks postoperatively. Multivariable regression analyses were used to identify associations between classes and one year outcomes. RESULTS: TUG showed three classes: "gain group" (n = 203), "moderate gain group" (n = 8) and "slow gain group" (n = 7), KOOS showed two classes: "gain group" (n = 86) and "moderate gain group" (n = 132), and VAS-pain three classes: "no/very little pain" (n = 151), "normal decrease of pain" (n = 48) and "sustained pain" (n = 19). The" low gain group" scored 3.31 [95% CI 1.52, 5.09] seconds less on the TUG than the "moderate gain group" and the KOOS "gain group" scored 11.97 [95% CI 8.62, 15.33] points better than the "moderate gain group" after one year. Patients who had an early trajectory of "sustained pain" had less chance to become free of pain at one year than those who reported "no or little pain" (odds ratio 0.11 [95% CI 0.03,0.42]. CONCLUSION: The findings of this study indicate that different recovery trajectories can be detected. These recovery trajectories can distinguish outcome after one year.
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.
How do community based dementia friendly initiatives work for people with dementia and their caregivers, and why? A rapid realist review
Thijssen, M.C.E. ; Daniels, R. ; Lexis, M. ; Jansens, R. ; Peeters, J. ; Chadborn, N. ; Nijhuis-van der Sanden, M.W.G. ; Graff, Maud
2021, Article / Letter to editor (International Journal of Geriatric Psychiatry, vol. 2021, (2021), pp. 1-14)
Family participation during physical activity in the intensive care unit: a longitudinal qualitative study
Felten-Barentsz, K. ; Wetering-van Dongen, V. van de ; Vloet, L.C.M. ; Koenders, N. ; Nijhuis-van der Sanden, M.W.G. ; Hoogeboom, Th.
2021, Article / Letter to editor (Journal of Critical Care, (2021))
The effects of integrating work-related factors and improving cooperation in musculoskeletal physical therapy practice: protocol for the 'WORK TO BE DONE' cluster randomised controlled trial.
Hutting, N. ; Oswald, W. ; Nijhuis-van der Sanden, M.W.G. ; Filart, M. ; Raaijmakers, T. ; Bieleman, H.J. ; Staal, J.B. ; Heerkens, Y.F.
2020, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 21, iss. 1, (2020), pp. 360)BACKGROUND: Musculoskeletal disorders (MSDs) are the primary cause of disability worldwide and a major societal burden. Recent qualitative research found that although a patient's work is considered important, physical therapists take work participation insufficiently into account as a determining factor in the treatment of patients with MSDs. Therefore, the aim of this study is to improve the effectiveness of physical therapy (in primary healthcare) with respect to the work participation of employees with MSDs by increasing the knowledge and skills of generalist physical therapists and by improving the collaboration between generalist physical therapists and physical therapists specialised in occupational health. METHODS/DESIGN: This trial is a two-arm non-blinded cluster randomised controlled trial. Working patients with MSDs visiting a physical therapy practice are the target group. The control group will receive normal physical therapy treatment. The intervention group will receive treatment from a physical therapist with more knowledge about work-related factors and skills in terms of integrating work participation into the patients' care. Data are gathered at baseline (T0), at four months (T1) and eight months (T2) follow-up. Most outcomes will be assessed with validated patient-reported questionnaires. Primary outcomes are the limitations in specific work-related activities and pain during work. Secondary outcomes include limitations in general work-related activities, general pain, quality of life, presenteeism, sick leave (absenteeism), estimated risk for future work disability, work-related psychosocial risk factors, job performance, and work ability. Based on a sample size calculation we need to include 221 patients in each arm (442 in total). During data analysis, each outcome variable will be analysed independently at T1 and at T2 as a dependent variable using the study group as an independent variable. In addition to the quantitative evaluation, a process evaluation will be performed by interviewing physical therapists as well as patients. DISCUSSION: The trial is expected to result in a more effective physical therapy process for working patients with MSDs. This will lead to a substantial reduction of costs: lower costs thanks to a more effective physical therapy process and lower costs due to less or shorter sick leave and decreased presenteeism. TRIAL REGISTRATION: Netherlands Trial Register, registration number: NL8518, date of registration 9 April 2020, URL registration: https://www.trialregister.nl/trial/8518.
Assessment instruments of movement quality in patients with non-specific low back pain: A systematic review and selection of instruments
Dijk, M.J.H. ; Smorenburg, N.T.A. ; Heerkens, Y.F. ; Mollema, J. ; Kiers, H. ; Nijhuis-van der Sanden, M.W.G. ; Visser, B.
2020, Article / Letter to editor (Gait & Posture, vol. 2020 Feb, iss. 76, (2020), pp. 346-357)
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.
Experienced complaints, activity limitations and loss of motor capacities in patients with pure hereditary spastic paraplegia: a web-based survey in the Netherlands
Lith, B.J.H. van ; Kerstens, H.C.J.W. ; Bemd, LAC van den ; Nijhuis-van der Sanden, M.W.G. ; Weerdesteyn, V. ; Smeets, R.J.E.M. ; Fheodoroff, K ; Warrenburg, BPC van de ; Geurts, A.C.H.
2020, Article / Letter to editor (Orphanet Journal of Rare Diseases, vol. 15, iss. 1, (2020))Background Hereditary spastic paraplegia (HSP) is a group of inherited disorders characterized by progressive spastic paresis of the lower limbs. Treatment is often focused on reducing spasticity and its physical consequences. To better address individual patients' needs, we investigated a broad range of experienced complaints, activity limitations, and loss of motor capacities in pure HSP. In addition, we aimed to identify patient characteristics that are associated with increased fall risk and/or reduced walking capacity. Methods We developed and distributed an HSP-specific online questionnaire in the Netherlands. A total of 109 out of 166 questionnaires returned by participants with pure HSP were analyzed. Results Participants experienced the greatest burden from muscle stiffness and limited standing and walking activities, while 72% reported leg and/or back pain. Thirty-five and 46% reported to use walking aids (e.g. crutches) indoors and outdoors, respectively; 57% reported a fall incidence of at least twice a year ('fallers'); in 51% a fall had led to an injury at least once; and 73% reported fear of falling. Duration of spasticity and incapacity to rise from the floor were positively associated with being a 'faller', whereas non-neurological comorbidity and wheelchair use were negatively associated. Higher age, experienced gait problems, not being able to stand for 10 min, and incapacity to open a heavy door showed a negative association with being a 'walker without aids' (> 500 m). Conclusions Our results emphasize the large impact of spastic paraparesis on the lives of people with pure HSP and contribute to a better understanding of possible targets for rehabilitation.
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))
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)
Changes in motor-flexibility following anterior cruciate ligament reconstruction as measured by means of a leg-amplitude differentiation task with haptic and visual feedback.
Roelofsen, E.G.J. ; Cingel, R. van ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G. ; Meulenbroek, R.G.J.
2020, Article / Letter to editor (Clinical Biomechanics, vol. 80, (2020), pp. 105186)BACKGROUND: In the current study changes in lower-limb motor flexibility of patients undergoing Anterior Cruciate Ligament Reconstruction were evaluated in relation to fear of harm. METHODS: Fourteen patients were measured pre- and post-surgery, and data were compared to those of a single measurement in fifteen controls. Lower-limb motor-flexibility was assessed in treadmill-walking and a cyclic leg-amplitude differentiation task augmented with haptic or visual feedback. Flexibility was captured by determining the between-leg coordination-variability (SD of relative phase) and each leg's temporal variability (sample entropy). Patients were post hoc divided into a higher-fear-group (pre-surgery: n = 6, post-surgery: n = 7) and a lower-fear-group (pre-surgery: n = 6, post-surgery: n = 7) by means of a median split of their scores on a self-reported fear of harm scale. Differences in flexibility-measures between the higher-fear-group and the lower-fear-group were also assessed. FINDINGS: No pre- and post-surgery differences, nor differences with the control group, were found in motor-flexibility during treadmill-walking but the post-surgery higher-fear-group did show lower values of SD relative phase. In the leg-amplitude differentiation task the SD of the relative phase decreased but sample entropy increased post-surgery towards levels of the control-group. The pre-surgery higher-fear-group showed lower values of sample entropy in visual conditions. INTERPRETATION: While gait kinematics may not show motor-flexibility changes following anterior cruciate ligament reconstruction, a leg-amplitude differentiation task does show such changes. Differentiating patients on a fear-of-harm scale revealed subtle differences in motor-flexibility. Challenging patients with non-preferred movements such as amplitude differentiation may be a promising tool to evaluate motor-flexibility following ACLR.
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.
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.
Room for improvement in non-pharmacological systemic sclerosis care?—a cross-sectional online survey of 650 patients
Stöcker, J.K. ; Vonk, M.C. ; Hoogen, F.H.C. van den ; Nijhuis-van der Sanden, M.W.G. ; Staal, J.B. ; Satink, T. ; Ende, C.H.M.
2020, Article / Letter to editor (Rheumatology, vol. 4, iss. 1, (2020), pp. 1-9)
Spinal manual therapy in infants, children and adolescents: A systematic review and meta-analysis on treatment indication, technique and outcomes.
Driehuis, F. ; Hoogeboom, T.J. ; Nijhuis-van der Sanden, M.W.G. ; Bie, R.A. de ; Staal, J.B.
2019, Article / Letter to editor (PLoS One, vol. 14, iss. 6, (2019))
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)
Activity resumption after acquired brain injury: the influence of the social network as described by social workers.
Jellema, S. ; Erp, S.H.A. van ; Nijhuis-van der Sanden, M.W.G. ; Sande, W.M.M. van der ; Steultjens, E.M.J.
2019, Article / Letter to editor (Disability and Rehabilitation, vol. 20, (2019), pp. 1-8)
The decline in physical activity in aging people is not modified by gender or the presence of cardiovascular disease.
Achttien, R. ; Lieshout, J.V. ; Wensing, M. ; Nijhuis-van der Sanden, M.W.G. ; Staal, J.B.
2019, Article / Letter to editor (European Journal of Public Health, (2019))
Valued activities and informal caregiving in stroke: a scoping review.
Jellema, S. ; Wijnen, M.A.M. ; Steultjens, E.M.J. ; Nijhuis-van der Sanden, M.W.G. ; Sande, W.M.M. van der
2019, Article / Letter to editor (Disability and Rehabilitation, vol. 41, iss. 18, (2019), pp. 2223-2234)
Factors influencing the implementation of Home-Based Stroke Rehabilitation: Professionals' perspective.
Veen, D.J. van der ; Döpp, C.M.E. ; Siemonsma, P.C. ; Nijhuis-van der Sanden, M.W.G. ; Sande, W.M.M. van der
2019, Article / Letter to editor (PLoS One, (2019))
Self-management support in cardiovascular consultations by advanced practice nurses trained in motivational interviewing: An observational study
Engelen, M.M. ; Dulmen, S. van ; Nijhuis-van der Sanden, M.W.G. ; Adriaansen, M.J.M. ; Vermeulen, H. ; Bredie, S.J.H. ; Gaal, B.G.I. van
2019, Article / Letter to editor (Patient Education and Counseling, vol. 103, iss. 1, (2019), pp. 159-164)
'Lessons learned from patients with access to an online self-management enhancing program for RA patients: Qualitative analysis of interviews alongside a randomized clinical trial'
Zuidema, S.U. ; Dulmen, S. van ; Nijhuis-van der Sanden, M.W.G. ; Fransen, G.A.J. ; Gaal, B.G.I. van
2019, Article / Letter to editor (Patient Education and Counseling, vol. 2019, iss. 102(6), (2019), pp. 1-16)
Efficacy of a Web-Based Self-Management Enhancing Program for Patients with Rheumatoid Arthritis: Explorative Randomized Controlled Trial
Zuidema, R ; Dulmen, S. van ; Nijhuis-van der Sanden, M.W.G. ; Meek, I ; Ende, C. van den ; Fransen, J ; Gaal, B.G.I. van
2019, Article / Letter to editor (Journal of Medical Internet Research, vol. 21, iss. 4, (2019))Background: Web-based self-management enhancing programs have the potential to support patients with rheumatoid arthritis (RA) in their self-management; for example, improve their health status by increasing their self-efficacy or taking their prescribed medication. We developed a Web-based self-management enhancing program in collaboration with RA patients and professionals as co-designers on the basis of the intervention mapping framework. Although self-management programs are complex interventions, it is informative to perform an explorative randomized controlled trial (RCT) before embarking on a larger trial. Objective: This study aimed to evaluate the efficacy of a Web based self-management enhancing program for patients with RA and identify outcome measures most likely to capture potential benefits. Methods: A multicenter exploratory RCT was performed with an intervention group and a control group. Both groups received care as usual. In addition, the intervention group received 12 months of access to a Web-based self-management program. Assessment occurred at baseline, 6 months, and 12 months. Outcome measures included self-management behavior (Patient Activation Measurement, Self-Management Ability Scale), self-efficacy (Rheumatoid Arthritis task-specific Self-Efficacy, Perceived Efficacy in Patient-Physician Interaction), general health status (RAND-36), focus on fatigue (Modified Pain Coping Inventory for Fatigue), and perceived pain and fatigue (Numeric Rating Scales). A linear mixed model for repeated measures, using the intention-to-treat principle, was applied to study differences between the patients in the intervention (n=78) and control (n=79) groups. A sensitivity analysis was performed in the intervention group to study the influence of patients with high (N=30) and low (N=40) use of the intervention. Results: No positive effects were found regarding the outcome measurements. Effect sizes were low. Conclusions: Based on these results, it is not possible to conclude on the positive effects of the intervention or to select outcome measures to be regarded as the primary/main or secondary outcomes for a future trial. A process evaluation should be performed to provide more insight into the low compliance with and effectiveness of the intervention. This can determine for whom this sort of program will work and help to fine-tune the inclusion criteria.
"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.
Is the level of eye-hand coordination and executive functioning related to performance in para table tennis players? –An explorative study
Faber, I.R. ; Pion, J.A.J. ; Willemse, Bas ; Nijhuis-van der Sanden, M.W.G.
2019, Article / Letter to editor (International Journal of Racket Sports Science, vol. 1, iss. 1, (2019), pp. 45-60)
The benefits of the 5-week Table Stars @school program as part of physical education in primary schools –A pilot intervention study
Faber, I.R. ; Pion, J.A.J. ; Nijhuis-van der Sanden, M.W.G.
2019, Article / Letter to editor (International Journal of Racket Sports Science, vol. 1, iss. 1, (2019), pp. 3-15)
Does a perceptuomotor skills assessment have added value to detect talent for table tennis in primary school children?
Faber, I.R. ; Pion, J.A.J. ; Munivrana, G. ; Faber, N.R. ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Journal of Sports Sciences, vol. 36, iss. 23, (2018), pp. 2716-2723)
Does motor expertise facilitate amplitude differentiation of lower limb-movements in an asymmetrical bipedal coordination task?
Roelofsen, E.G.J. ; Brown, D.D. ; Nijhuis-van der Sanden, M.W.G. ; Staal, J.B. ; Meulenbroek, R.G.J.
2018, Article / Letter to editor (Human Movement Science, vol. 59, (2018), pp. 201-211)
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))
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 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)
Patient views regarding the impact of hydrotherapy on critically ill ventilated patients: A qualitative exploration study.
Felten-Barentsz, K. ; Oorsouw, R. van ; Haans, A.J.C. ; Staal, J.B. ; Hoeven, J.G. van der ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Journal of Critical Care, vol. 48, (2018), pp. 321-327)
Physical exercise prior to hematopoietic stem cell transplantation: A feasibility study.
Haren, I.E.P.M. van ; Staal, J.B. ; Potting, C.M. ; Atsma, F. ; Hoogeboom, T.J. ; Blijlevens, N.M.A. ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Physiotherapy Theory and Practice, vol. 16, (2018), pp. 1-10)
Everyday Activities for Children with Mitochondrial Disorder: A Retrospective Chart Review.
Lindenschot, M. ; Groot, I. de ; Koene, S. ; Satink, T. ; Steultjens, E.M.J. ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Occupational Therapy International, (2018))
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 and values of children with a mitochondrial disorder with regard to everyday activities.
Lindenschot, M. ; Steultjens, E.M.J. ; Zajec, J. ; Nijhuis-van der Sanden, M.W.G. ; Koene, S. ; Groot, I. de
2018, Article / Letter to editor (Journal of Developmental and Physical Disabilities, (2018), pp. 1-26)
The 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)
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)
What moves the rheumatologist? Unravelling decision making in the referral of systemic sclerosis patients to health professionals: a qualitative study
Stöcker, J.K. ; Cup, E.H.C. ; Vonk, M.C. ; Hoogen, F.H.C. van den ; Nijhuis-van der Sanden, M.W.G. ; Staal, J.B. ; Ende, C.H.M.
2018, Article / Letter to editor (Rheumatology, vol. 2, iss. 2, (2018))
E-IMR: e-health added to face-to-face delivery of Illness Management & Recovery programme for people with severe mental illness, an exploratory clustered randomized controlled trial.
Beentjes, T.A.A. ; Goossens, P. ; Vermeulen, H. ; Teerenstra, S. ; Gaal, B.G.I. van ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (BMC Health Services Research, vol. 18, iss. 1, (2018))
Effect and Process Evaluation of e-Powered Parents, a Web-Based Support Program for Parents of Children With a Chronic Kidney Disease: Feasibility Randomized Controlled Trial.
Geense, W.W. ; Gaal, B.G.I. van ; Knoll, J.L. ; Maas, N.M. ; Kok, G. ; Cornelissen, E.A. ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Journal of Medical Internet Research, vol. 20, iss. 8, (2018), pp. e245)
A responder analysis of the table stars @school intervention in primary school children (6-12 years) – preliminary results
Faber, I.R. ; Pion, J.A.J. ; Nijhuis-van der Sanden, M.W.G.
2018, Article in monograph or in proceedings ()
Evaluating the Social Fitness Programme for older people with cognitive problems and their caregivers: lessons learned from a failed trial
Donkers, H.W. ; Veen, D.J. van der ; Teerenstra, S. ; Vernooij-Dassen, M. ; Nijhuis-van der Sanden, M.W.G. ; Graff, Maud
2018, Article / Letter to editor (BMC Geriatrics, vol. 18, iss. 1, (2018))
Social participation perspectives from persons with cognitive problems and their caregivers: a descriptive qualitative study
Donkers, H.W. ; Veen, D.J. van der ; Vernooij-Dassen, M. ; Nijhuis-van der Sanden, M.W.G. ; Graff, Maud
2018, Article / Letter to editor (Ageing and Society, vol. 39, iss. 7, (2018), pp. 1-27)

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