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Frans Nollet - One of the best experts on this subject based on the ideXlab platform.
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Overcoming barriers to work participation for patients with Postpoliomyelitis Syndrome
Disability and rehabilitation, 2010Co-Authors: Kim Ten Katen, Anita Beelen, Frans Nollet, Monique H. W. Frings-dresen, Judith K. SluiterAbstract:Purpose: This study aimed to explore the perceived work ability of patients with Postpoliomyelitis Syndrome (PPS), to identify barriers and factors that are impeding or conducive, respectively, to work participation, and to identify possible interventions.Methods: Qualitative cross-sectional interview study with 17 subjects with PPS, 12 women and 5 men, mean age 49 years (SD: 11). Semi-structured interviews were held with the subjects in their homes, with the aid of a topic list. The COREQ criteria list for qualitative research was used as guideline in design and analysis.Results: Thirteen out of 17 subjects rated their work ability six or higher on a scale from 0 to 10. Most subjects worked in an administrative, educational or managerial function. Five subjects stopped working, four worked between 0 and 20 h/week and eight worked between 20 and 40 h/week. Factors conducive to working were physical adaptations in the workplace, accessibility of the workplace and high decision latitude. Barriers to full wo...
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Exercise therapy and cognitive behavioural therapy to improve fatigue, daily activity performance and quality of life in Postpoliomyelitis Syndrome: the protocol of the FACTS-2-PPS trial
BMC Neurology, 2010Co-Authors: Fieke S Koopman, Anita Beelen, Marianne De Visser, Karin H Gerrits, Gijs Bleijenberg, Tineke A Abma, Frans NolletAbstract:Background Postpoliomyelitis Syndrome (PPS) is a complex of late onset neuromuscular symptoms with new or increased muscle weakness and muscle fatigability as key symptoms. Main clinical complaints are severe fatigue, deterioration in functional abilities and health related quality of life. Rehabilitation management is the mainstay of treatment. Two different therapeutic interventions may be prescribed (1) exercise therapy or (2) cognitive behavioural therapy (CBT). However, the evidence on the effectiveness of both interventions is limited. The primary aim of the FACTS-2-PPS trial is to study the efficacy of exercise therapy and CBT for reducing fatigue and improving activities and quality of life in patients with PPS. Additionally, the working mechanisms, patients' and therapists' expectations of and experiences with both interventions and cost-effectiveness will be evaluated. Methods/Design A multi-centre, single-blinded, randomized controlled trial will be conducted. A sample of 81 severely fatigued patients with PPS will be recruited from 3 different university hospitals and their affiliate rehabilitation centres. Patients will be randomized to one of three groups i.e. (1) exercise therapy + usual care, (2) CBT + usual care, (3) usual care. At baseline, immediately post-intervention and at 3- and 6-months follow-up, fatigue, activities, quality of life and secondary outcomes will be assessed. Costs will be based on a cost questionnaire, and statistical analyses on GEE (generalized estimated equations). Analysis will also consider mechanisms of change during therapy. A responsive evaluation will be conducted to monitor the implementation process and to investigate the perspectives of patients and therapists on both interventions. Discussion A major strength of the FACTS-2-PPS study is the use of a mixed methods design in which a responsive and economic evaluation runs parallel to the trial. The results of this study will generate new evidence for the rehabilitation treatment of persons with PPS. Trial registration Dutch Trial Register NTR1371.
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Exercise therapy and cognitive behavioural therapy to improve fatigue, daily activity performance and quality of life in Postpoliomyelitis Syndrome: the protocol of the FACTS-2-PPS trial.
BMC neurology, 2010Co-Authors: Fieke S Koopman, Anita Beelen, Marianne De Visser, Karin H Gerrits, Gijs Bleijenberg, Tineke A Abma, Frans NolletAbstract:Background: Postpoliomyelitis Syndrome (PPS) is a complex of late onset neuromuscular symptoms with new or increased muscle weakness and muscle fatigability as key symptoms. Main clinical complaints are severe fatigue, deterioration in functional abilities and health related quality of life. Rehabilitation management is the mainstay of treatment. Two different therapeutic interventions may be prescribed (1) exercise therapy or (2) cognitive behavioural therapy (CBT). However, the evidence on the effectiveness of both interventions is limited. The primary aim of the FACTS-2-PPS trial is to study the efficacy of exercise therapy and CBT for reducing fatigue and improving activities and quality of life in patients with PPS. Additionally, the working mechanisms, patients’ and therapists’ expectations of and experiences with both interventions and costeffectiveness will be evaluated. Methods/Design: A multi-centre, single-blinded, randomized controlled trial will be conducted. A sample of 81 severely fatigued patients with PPS will be recruited from 3 different university hospitals and their affiliate rehabilitation centres. Patients will be randomized to one of three groups i.e. (1) exercise therapy + usual care, (2) CBT + usual care, (3) usual care. At baseline, immediately post-intervention and at 3- and 6months follow-up, fatigue, activities, quality of life and secondary outcomes will be assessed. Costs will be based on a cost questionnaire, and statistical analyses on GEE (generalized estimated equations). Analysis will also consider mechanisms of change during therapy. A responsive evaluation will be conducted to monitor the implementation process and to investigate the perspectives of patients and therapists on both interventions. Discussion: A major strength of the FACTS-2-PPS study is the use of a mixed methods design in which a responsive and economic evaluation runs parallel to the trial. The results of this study will generate new evidence for the rehabilitation treatment of persons with PPS.
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Energy Demands of Walking in Persons With Postpoliomyelitis Syndrome: Relationship With Muscle Strength and Reproducibility
Archives of physical medicine and rehabilitation, 2006Co-Authors: Merel-anne Brehm, Frans Nollet, Jaap HarlaarAbstract:Abstract Brehm M-A, Nollet F, Harlaar J. Energy demands of walking in persons with Postpoliomyelitis Syndrome: relationship with muscle strength and reproducibility. Objectives To describe the energy demands of walking in subjects with Postpoliomyelitis Syndrome (PPS) in comparison with the demands in healthy subjects, and to assess the reproducibility of walking energy measurements. Design Four repeated measurements with a 1-week interval between each measurement. Setting Outpatient clinic of a university hospital. Participants Fourteen subjects with PPS and 14 age- and sex-matched healthy subjects. Interventions Not applicable. Main Outcome Measures Walking speed and energy cost of walking. The correlation parameter was lower-extremity muscle strength sum (MSS). The reproducibility parameters were standard error (SE) of measurement and smallest detectable difference (SDD). Results Walking speed in subjects with PPS (61.8m/min) was significantly lower (–28%) and energy cost (4.8J·kg –1 ·m –1 ) was significantly higher (40%) than in healthy subjects. MSS correlated strongly with energy cost ( r =–.84, P =.000), explaining 71% of the variance. The SE of measurement of energy cost measurements ranged between 1.7% and 3.4% for PPS subjects and between 1.2% and 2.4% for healthy subjects. The SDD ranged between 4.6% and 9.4% for PPS subjects and between 3.3% and 6.6% for healthy subjects, depending on the number of repeated measurements that were considered. Conclusions Energy cost of walking in subjects with PPS is strongly related to the extent of muscle weakness in the lower extremities. Although variability was greater for PPS subjects than for healthy subjects, reproducibility of energy cost measurements was high. Therefore, metabolic assessment of energy cost of walking is a sensitive tool that can reveal clinically relevant changes even in the condition of a person with PPS.
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Walking in Postpoliomyelitis Syndrome: the relationships between time-scored tests, walking in daily life and perceived mobility problems.
Journal of rehabilitation medicine, 2005Co-Authors: Herwin L D Horemans, Johannes B J Bussmann, Anita Beelen, Henk J. Stam, Frans NolletAbstract:Objective: To compare walking test results with walking in daily life, and to investigate the relationships between walking tests, walking activity in daily life, and perceived mobility problems in patients with post-poliomyelitis Syndrome. Subjects: Twenty-four ambulant patients with post-poliomyelitis Syndrome. Methods: Walking tests were performed at self-preferred and maximal speed. Walking activity was measured with an ambulatory activity monitor. Heart rate, step cadence and walking speed in the test and in daily life were compared. Walking speed in daily life was represented by the intensity of walking. Perceived mobility problems were assessed with the Nottingham Health Profile. Results: Heart rate during walking was lower in the test at self-preferred speed than in daily life (mean difference: 11.3 ± 10.4; p = 0.001). Self-preferred walking speed in the test and in daily life correlated significantly (r = 0.55; p= 0.04). In a sub-group with a test performance below the median value, test performance correlated significantly with walking activity. No significant correlation was found between perceived mobility problems and walking activity. Conclusion: Walking in daily life may be more demanding than walking under standardized conditions. Patients with post-poliomyelitis Syndrome with the lowest test performance walked less in daily life. Patients do not necessarily match their activity pattern to their perceived mobility problems.
Gustaaf J. Lankhorst - One of the best experts on this subject based on the ideXlab platform.
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Interventions: Not applicable.
2015Co-Authors: Gustaaf J. Lankhorst, Beelen A., Abstract Nollet F, De Visser MAbstract:maximal power output in polio subjects. Arch Phys Med Rehabil 2001;82:1678-85. Objectives: To compare the submaximal exercise capacity of polio subjects with Postpoliomyelitis Syndrome (PPS) and without (non-PPS) with that of healthy control subjects, to investigate the relationship of this capacity with maximal short-term power and quadriceps strength, and to evaluate movement economy. Desing: Cross-sectional survey. Setting: University hospital
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The course of functional status and muscle strength in patients with late-onset sequelae of poliomyelitis: a systematic review.
Archives of physical medicine and rehabilitation, 2005Co-Authors: Janneke M. Stolwijk-swüste, Anita Beelen, Gustaaf J. Lankhorst, Frans NolletAbstract:Abstract Stolwijk-Swuste JM, Beelen A, Lankhorst GJ, Nollet F, for the CARPA Study Group. The course of functional status and muscle strength in patients with late-onset sequelae of poliomyelitis: a systematic review. Objectives To review systematically studies of late-onset polio sequelae on the course of functional status and muscle strength over time and to identify prognostic factors of change. Data Sources We conducted a computerized literature search up to July 2004 in MEDLINE, EMBASE, CINAHL, Web of Science, PsychInfo, and the Cochrane controlled trial register using the key words: postpolio , Postpoliomyelitis , Postpoliomyelitis Syndrome , post poliomyelitis muscular atrophy , and poliomyelitis . Study Selection Reports were selected by 1 reviewer if the study involved subjects with a history of poliomyelitis, the outcome measures described functional status or muscle strength, and follow-up was for at least 6 months. Data Extraction Studies were summarized with regard to population, design, sample size, outcome measures, results, and methodologic scores. Overlap in populations between studies was checked. Data Synthesis Of 71 potentially relevant studies, 19 were included (2 on functional status, 15 on muscle strength, 2 on both muscle strength and functional status). Two studies on the course of functional status had sufficient quality and reported inconsistent results. Four studies on the course of muscle strength had sufficient quality. Two studies reported a decline in strength and 2 reported no change. Decline in strength was only reported in studies with a follow-up period longer than 2 years. One study reported extent of paresis as a prognostic factor for change in perceived physical mobility. Conclusions Conclusions cannot be drawn from the literature with regard to the functional course or prognostic factors in late-onset polio sequelae. The rate of decline in muscle strength is slow, and prognostic factors have not yet been identified. Long-term follow-up studies with unselected study populations and age-matched controls are needed, with specific focus on prognostic factors.
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A comparison of 4 questionnaires to measure fatigue in Postpoliomyelitis Syndrome.
Archives of physical medicine and rehabilitation, 2004Co-Authors: Herwin L D Horemans, Anita Beelen, Frans Nollet, Gustaaf J. LankhorstAbstract:Abstract Horemans HL, Nollet F, Beelen A, Lankhorst GJ. A comparison of 4 questionnaires to measure fatigue in Postpoliomyelitis Syndrome. Arch Phys Med Rehabil 2004;85:392–8. Objective To assess the comparability and reproducibility of 4 questionnaires used to measure fatigue in Postpoliomyelitis Syndrome (PPS). Design Repeated-measures at a 3-week interval. Setting University hospital. Participants Convenience sample of 65 patients with PPS. Interventions Not applicable. Main outcome measures The Fatigue Severity Scale (FSS), the Nottingham Health Profile (NHP) energy category, the Polio Problem List (PPL) fatigue item, and the Dutch Short Fatigue Questionnaire (SFQ). Results Correlations of scores between questionnaires were all significant ( P P Conclusions Although the questionnaires measure the same fatigue construct in PPS, the results are not interchangeable because the ranges of measurement differ. The NHP energy category, in particular, appeared to have a high detection threshold. The moderate reproducibility of the questionnaires indicates a lack of precision, especially when applied at the individual patient level.
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Reproducibility of walking at self-preferred and maximal speed in patients with Postpoliomyelitis Syndrome
Archives of physical medicine and rehabilitation, 2004Co-Authors: Herwin L D Horemans, Anita Beelen, Frans Nollet, Gustaaf J. LankhorstAbstract:Abstract Horemans HL, Beelen A, Nollet F, Lankhorst GJ. Reproducibility of walking at self-preferred and maximal speed in patients with Postpoliomyelitis Syndrome. Objective To assess the reproducibility of walking performance, heart rate, and perceived exertion at self-preferred speed and maximal walking speed in patients with the Postpoliomyelitis Syndrome (PPS). Design Repeated measurement at a 3-week interval. Setting University hospital. Participants Convenience sample of 65 patients with PPS. Interventions Not applicable. Main outcome measures Walking performance: the distance walked in 2 minutes at a self-preferred speed and the time needed to walk 75m at maximal speed, heart rate, and rating of perceived exertion (RPE) on an 11-point scale. Results Test-retest reliability of walking performance was excellent for both tests (intraclass correlation coefficient [ICC] range, .94–.97). No systematic differences existed between test and retest. The smallest detectable change for an individual was 15% for both tests. Test-retest reliability for heart rate was good (ICC=.86) but moderate for RPE (Spearman ρ range, .67–.70). The smallest detectable change for RPE was between 4 and 6 scale points. The variability in walking performance was significantly correlated with the variability in heart rate at self-preferred speed ( r =.36, P r =.20, P =.11). Conclusions Both walking tests showed good reproducibility and may be appropriate to monitor (individual) changes in walking capacity in patients with PPS. Because of its moderate reproducibility, RPE does not seem to be suitable to monitor physical exertion. The usefulness of an objective measure such as heart rate for this purpose needs further investigation.
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Reproducibility of maximal quadriceps strength and its relationship to maximal voluntary activation in Postpoliomyelitis Syndrome
Archives of physical medicine and rehabilitation, 2004Co-Authors: Herwin L D Horemans, Anita Beelen, Frans Nollet, David Jones, Gustaaf J. LankhorstAbstract:Abstract Horemans HL, Beelen A, Nollet F, Jones DA, Lankhorst GJ. Reproducibility of maximal quadriceps strength and its relationship to maximal voluntary activation in Postpoliomyelitis Syndrome. Arch Phys Med Rehabil 2004;85:1273–8. Objectives To determine what changes in maximal isometric strength can be detected in a symptomatic quadriceps muscle in patients with Postpoliomyelitis Syndrome (PPS) and to investigate the association between the variability in maximal strength and maximal voluntary activation (MVA). Design Repeated-measures over a 3-week interval. Setting University hospital. Patients Convenience sample of 65 patients with PPS. Intervention Dynamometer testing. Main outcome measures Maximal voluntary contraction (MVC) torque of the quadriceps was measured with a Kin-Com dynamometer and MVA was determined by twitch interpolation. Results The mean difference between the 2 consecutive measurements was −0.7±12.8Nm (95% confidence interval [CI], −3.9 to 2.5). The test-retest reliability was excellent for MVC torque (intraclass correlation coefficient [ICC]=.96; 95% CI, .93–.98) and moderate for MVA (ICC=.73; 95% CI, .56–.85). The smallest detectable change in MVC torque was 25% for an individual. The variability in MVA explained 18% of the variability in maximal strength. Conclusions Variability in maximal quadriceps strength, measured with a fixed dynamometer, was large and partly related to variability in MVA. This implies that even with optimally standardized strength testing, a follow-up of many years is required to objectify progression of quadriceps weakness in an individual patient with PPS. To demonstrate changes in strength in groups of patients in follow-up or intervention studies, feasible sample sizes are required.
Anita Beelen - One of the best experts on this subject based on the ideXlab platform.
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Overcoming barriers to work participation for patients with Postpoliomyelitis Syndrome
Disability and rehabilitation, 2010Co-Authors: Kim Ten Katen, Anita Beelen, Frans Nollet, Monique H. W. Frings-dresen, Judith K. SluiterAbstract:Purpose: This study aimed to explore the perceived work ability of patients with Postpoliomyelitis Syndrome (PPS), to identify barriers and factors that are impeding or conducive, respectively, to work participation, and to identify possible interventions.Methods: Qualitative cross-sectional interview study with 17 subjects with PPS, 12 women and 5 men, mean age 49 years (SD: 11). Semi-structured interviews were held with the subjects in their homes, with the aid of a topic list. The COREQ criteria list for qualitative research was used as guideline in design and analysis.Results: Thirteen out of 17 subjects rated their work ability six or higher on a scale from 0 to 10. Most subjects worked in an administrative, educational or managerial function. Five subjects stopped working, four worked between 0 and 20 h/week and eight worked between 20 and 40 h/week. Factors conducive to working were physical adaptations in the workplace, accessibility of the workplace and high decision latitude. Barriers to full wo...
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Exercise therapy and cognitive behavioural therapy to improve fatigue, daily activity performance and quality of life in Postpoliomyelitis Syndrome: the protocol of the FACTS-2-PPS trial
BMC Neurology, 2010Co-Authors: Fieke S Koopman, Anita Beelen, Marianne De Visser, Karin H Gerrits, Gijs Bleijenberg, Tineke A Abma, Frans NolletAbstract:Background Postpoliomyelitis Syndrome (PPS) is a complex of late onset neuromuscular symptoms with new or increased muscle weakness and muscle fatigability as key symptoms. Main clinical complaints are severe fatigue, deterioration in functional abilities and health related quality of life. Rehabilitation management is the mainstay of treatment. Two different therapeutic interventions may be prescribed (1) exercise therapy or (2) cognitive behavioural therapy (CBT). However, the evidence on the effectiveness of both interventions is limited. The primary aim of the FACTS-2-PPS trial is to study the efficacy of exercise therapy and CBT for reducing fatigue and improving activities and quality of life in patients with PPS. Additionally, the working mechanisms, patients' and therapists' expectations of and experiences with both interventions and cost-effectiveness will be evaluated. Methods/Design A multi-centre, single-blinded, randomized controlled trial will be conducted. A sample of 81 severely fatigued patients with PPS will be recruited from 3 different university hospitals and their affiliate rehabilitation centres. Patients will be randomized to one of three groups i.e. (1) exercise therapy + usual care, (2) CBT + usual care, (3) usual care. At baseline, immediately post-intervention and at 3- and 6-months follow-up, fatigue, activities, quality of life and secondary outcomes will be assessed. Costs will be based on a cost questionnaire, and statistical analyses on GEE (generalized estimated equations). Analysis will also consider mechanisms of change during therapy. A responsive evaluation will be conducted to monitor the implementation process and to investigate the perspectives of patients and therapists on both interventions. Discussion A major strength of the FACTS-2-PPS study is the use of a mixed methods design in which a responsive and economic evaluation runs parallel to the trial. The results of this study will generate new evidence for the rehabilitation treatment of persons with PPS. Trial registration Dutch Trial Register NTR1371.
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Exercise therapy and cognitive behavioural therapy to improve fatigue, daily activity performance and quality of life in Postpoliomyelitis Syndrome: the protocol of the FACTS-2-PPS trial.
BMC neurology, 2010Co-Authors: Fieke S Koopman, Anita Beelen, Marianne De Visser, Karin H Gerrits, Gijs Bleijenberg, Tineke A Abma, Frans NolletAbstract:Background: Postpoliomyelitis Syndrome (PPS) is a complex of late onset neuromuscular symptoms with new or increased muscle weakness and muscle fatigability as key symptoms. Main clinical complaints are severe fatigue, deterioration in functional abilities and health related quality of life. Rehabilitation management is the mainstay of treatment. Two different therapeutic interventions may be prescribed (1) exercise therapy or (2) cognitive behavioural therapy (CBT). However, the evidence on the effectiveness of both interventions is limited. The primary aim of the FACTS-2-PPS trial is to study the efficacy of exercise therapy and CBT for reducing fatigue and improving activities and quality of life in patients with PPS. Additionally, the working mechanisms, patients’ and therapists’ expectations of and experiences with both interventions and costeffectiveness will be evaluated. Methods/Design: A multi-centre, single-blinded, randomized controlled trial will be conducted. A sample of 81 severely fatigued patients with PPS will be recruited from 3 different university hospitals and their affiliate rehabilitation centres. Patients will be randomized to one of three groups i.e. (1) exercise therapy + usual care, (2) CBT + usual care, (3) usual care. At baseline, immediately post-intervention and at 3- and 6months follow-up, fatigue, activities, quality of life and secondary outcomes will be assessed. Costs will be based on a cost questionnaire, and statistical analyses on GEE (generalized estimated equations). Analysis will also consider mechanisms of change during therapy. A responsive evaluation will be conducted to monitor the implementation process and to investigate the perspectives of patients and therapists on both interventions. Discussion: A major strength of the FACTS-2-PPS study is the use of a mixed methods design in which a responsive and economic evaluation runs parallel to the trial. The results of this study will generate new evidence for the rehabilitation treatment of persons with PPS.
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Walking in Postpoliomyelitis Syndrome: the relationships between time-scored tests, walking in daily life and perceived mobility problems.
Journal of rehabilitation medicine, 2005Co-Authors: Herwin L D Horemans, Johannes B J Bussmann, Anita Beelen, Henk J. Stam, Frans NolletAbstract:Objective: To compare walking test results with walking in daily life, and to investigate the relationships between walking tests, walking activity in daily life, and perceived mobility problems in patients with post-poliomyelitis Syndrome. Subjects: Twenty-four ambulant patients with post-poliomyelitis Syndrome. Methods: Walking tests were performed at self-preferred and maximal speed. Walking activity was measured with an ambulatory activity monitor. Heart rate, step cadence and walking speed in the test and in daily life were compared. Walking speed in daily life was represented by the intensity of walking. Perceived mobility problems were assessed with the Nottingham Health Profile. Results: Heart rate during walking was lower in the test at self-preferred speed than in daily life (mean difference: 11.3 ± 10.4; p = 0.001). Self-preferred walking speed in the test and in daily life correlated significantly (r = 0.55; p= 0.04). In a sub-group with a test performance below the median value, test performance correlated significantly with walking activity. No significant correlation was found between perceived mobility problems and walking activity. Conclusion: Walking in daily life may be more demanding than walking under standardized conditions. Patients with post-poliomyelitis Syndrome with the lowest test performance walked less in daily life. Patients do not necessarily match their activity pattern to their perceived mobility problems.
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The course of functional status and muscle strength in patients with late-onset sequelae of poliomyelitis: a systematic review.
Archives of physical medicine and rehabilitation, 2005Co-Authors: Janneke M. Stolwijk-swüste, Anita Beelen, Gustaaf J. Lankhorst, Frans NolletAbstract:Abstract Stolwijk-Swuste JM, Beelen A, Lankhorst GJ, Nollet F, for the CARPA Study Group. The course of functional status and muscle strength in patients with late-onset sequelae of poliomyelitis: a systematic review. Objectives To review systematically studies of late-onset polio sequelae on the course of functional status and muscle strength over time and to identify prognostic factors of change. Data Sources We conducted a computerized literature search up to July 2004 in MEDLINE, EMBASE, CINAHL, Web of Science, PsychInfo, and the Cochrane controlled trial register using the key words: postpolio , Postpoliomyelitis , Postpoliomyelitis Syndrome , post poliomyelitis muscular atrophy , and poliomyelitis . Study Selection Reports were selected by 1 reviewer if the study involved subjects with a history of poliomyelitis, the outcome measures described functional status or muscle strength, and follow-up was for at least 6 months. Data Extraction Studies were summarized with regard to population, design, sample size, outcome measures, results, and methodologic scores. Overlap in populations between studies was checked. Data Synthesis Of 71 potentially relevant studies, 19 were included (2 on functional status, 15 on muscle strength, 2 on both muscle strength and functional status). Two studies on the course of functional status had sufficient quality and reported inconsistent results. Four studies on the course of muscle strength had sufficient quality. Two studies reported a decline in strength and 2 reported no change. Decline in strength was only reported in studies with a follow-up period longer than 2 years. One study reported extent of paresis as a prognostic factor for change in perceived physical mobility. Conclusions Conclusions cannot be drawn from the literature with regard to the functional course or prognostic factors in late-onset polio sequelae. The rate of decline in muscle strength is slow, and prognostic factors have not yet been identified. Long-term follow-up studies with unselected study populations and age-matched controls are needed, with specific focus on prognostic factors.
Herwin L D Horemans - One of the best experts on this subject based on the ideXlab platform.
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Walking in Postpoliomyelitis Syndrome: the relationships between time-scored tests, walking in daily life and perceived mobility problems.
Journal of rehabilitation medicine, 2005Co-Authors: Herwin L D Horemans, Johannes B J Bussmann, Anita Beelen, Henk J. Stam, Frans NolletAbstract:Objective: To compare walking test results with walking in daily life, and to investigate the relationships between walking tests, walking activity in daily life, and perceived mobility problems in patients with post-poliomyelitis Syndrome. Subjects: Twenty-four ambulant patients with post-poliomyelitis Syndrome. Methods: Walking tests were performed at self-preferred and maximal speed. Walking activity was measured with an ambulatory activity monitor. Heart rate, step cadence and walking speed in the test and in daily life were compared. Walking speed in daily life was represented by the intensity of walking. Perceived mobility problems were assessed with the Nottingham Health Profile. Results: Heart rate during walking was lower in the test at self-preferred speed than in daily life (mean difference: 11.3 ± 10.4; p = 0.001). Self-preferred walking speed in the test and in daily life correlated significantly (r = 0.55; p= 0.04). In a sub-group with a test performance below the median value, test performance correlated significantly with walking activity. No significant correlation was found between perceived mobility problems and walking activity. Conclusion: Walking in daily life may be more demanding than walking under standardized conditions. Patients with post-poliomyelitis Syndrome with the lowest test performance walked less in daily life. Patients do not necessarily match their activity pattern to their perceived mobility problems.
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A comparison of 4 questionnaires to measure fatigue in Postpoliomyelitis Syndrome.
Archives of physical medicine and rehabilitation, 2004Co-Authors: Herwin L D Horemans, Anita Beelen, Frans Nollet, Gustaaf J. LankhorstAbstract:Abstract Horemans HL, Nollet F, Beelen A, Lankhorst GJ. A comparison of 4 questionnaires to measure fatigue in Postpoliomyelitis Syndrome. Arch Phys Med Rehabil 2004;85:392–8. Objective To assess the comparability and reproducibility of 4 questionnaires used to measure fatigue in Postpoliomyelitis Syndrome (PPS). Design Repeated-measures at a 3-week interval. Setting University hospital. Participants Convenience sample of 65 patients with PPS. Interventions Not applicable. Main outcome measures The Fatigue Severity Scale (FSS), the Nottingham Health Profile (NHP) energy category, the Polio Problem List (PPL) fatigue item, and the Dutch Short Fatigue Questionnaire (SFQ). Results Correlations of scores between questionnaires were all significant ( P P Conclusions Although the questionnaires measure the same fatigue construct in PPS, the results are not interchangeable because the ranges of measurement differ. The NHP energy category, in particular, appeared to have a high detection threshold. The moderate reproducibility of the questionnaires indicates a lack of precision, especially when applied at the individual patient level.
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Reproducibility of walking at self-preferred and maximal speed in patients with Postpoliomyelitis Syndrome
Archives of physical medicine and rehabilitation, 2004Co-Authors: Herwin L D Horemans, Anita Beelen, Frans Nollet, Gustaaf J. LankhorstAbstract:Abstract Horemans HL, Beelen A, Nollet F, Lankhorst GJ. Reproducibility of walking at self-preferred and maximal speed in patients with Postpoliomyelitis Syndrome. Objective To assess the reproducibility of walking performance, heart rate, and perceived exertion at self-preferred speed and maximal walking speed in patients with the Postpoliomyelitis Syndrome (PPS). Design Repeated measurement at a 3-week interval. Setting University hospital. Participants Convenience sample of 65 patients with PPS. Interventions Not applicable. Main outcome measures Walking performance: the distance walked in 2 minutes at a self-preferred speed and the time needed to walk 75m at maximal speed, heart rate, and rating of perceived exertion (RPE) on an 11-point scale. Results Test-retest reliability of walking performance was excellent for both tests (intraclass correlation coefficient [ICC] range, .94–.97). No systematic differences existed between test and retest. The smallest detectable change for an individual was 15% for both tests. Test-retest reliability for heart rate was good (ICC=.86) but moderate for RPE (Spearman ρ range, .67–.70). The smallest detectable change for RPE was between 4 and 6 scale points. The variability in walking performance was significantly correlated with the variability in heart rate at self-preferred speed ( r =.36, P r =.20, P =.11). Conclusions Both walking tests showed good reproducibility and may be appropriate to monitor (individual) changes in walking capacity in patients with PPS. Because of its moderate reproducibility, RPE does not seem to be suitable to monitor physical exertion. The usefulness of an objective measure such as heart rate for this purpose needs further investigation.
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Reproducibility of maximal quadriceps strength and its relationship to maximal voluntary activation in Postpoliomyelitis Syndrome
Archives of physical medicine and rehabilitation, 2004Co-Authors: Herwin L D Horemans, Anita Beelen, Frans Nollet, David Jones, Gustaaf J. LankhorstAbstract:Abstract Horemans HL, Beelen A, Nollet F, Jones DA, Lankhorst GJ. Reproducibility of maximal quadriceps strength and its relationship to maximal voluntary activation in Postpoliomyelitis Syndrome. Arch Phys Med Rehabil 2004;85:1273–8. Objectives To determine what changes in maximal isometric strength can be detected in a symptomatic quadriceps muscle in patients with Postpoliomyelitis Syndrome (PPS) and to investigate the association between the variability in maximal strength and maximal voluntary activation (MVA). Design Repeated-measures over a 3-week interval. Setting University hospital. Patients Convenience sample of 65 patients with PPS. Intervention Dynamometer testing. Main outcome measures Maximal voluntary contraction (MVC) torque of the quadriceps was measured with a Kin-Com dynamometer and MVA was determined by twitch interpolation. Results The mean difference between the 2 consecutive measurements was −0.7±12.8Nm (95% confidence interval [CI], −3.9 to 2.5). The test-retest reliability was excellent for MVC torque (intraclass correlation coefficient [ICC]=.96; 95% CI, .93–.98) and moderate for MVA (ICC=.73; 95% CI, .56–.85). The smallest detectable change in MVC torque was 25% for an individual. The variability in MVA explained 18% of the variability in maximal strength. Conclusions Variability in maximal quadriceps strength, measured with a fixed dynamometer, was large and partly related to variability in MVA. This implies that even with optimally standardized strength testing, a follow-up of many years is required to objectify progression of quadriceps weakness in an individual patient with PPS. To demonstrate changes in strength in groups of patients in follow-up or intervention studies, feasible sample sizes are required.
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Motor unit characteristics in healthy subjects and those with Postpoliomyelitis Syndrome: a high-density surface EMG study.
Muscle & nerve, 2004Co-Authors: Gea Drost, Herwin L D Horemans, Frans Nollet, Dick F Stegeman, M.l. Schillings, Henny M.h.a. Janssen, Mark Massa, Machiel J ZwartsAbstract:The purpose of this study was to identify optimal ways to detect neurogenic changes with high-density surface electromyography (HD-sEMG). For this purpose, we searched for the variables that most clearly discriminated between Postpoliomyelitis and healthy subjects. We obtained HD-sEMG from the quadriceps muscle at different force levels in nine subjects with Postpoliomyelitis Syndrome and in matched healthy controls. Single motor unit action potentials (MUAPs), extracted from the HD-sEMG signal and the raw signal itself, were analyzed. Areas under the curve of the extracted MUAP waveform, indicating motor unit size, perfectly separated both groups. Raw signal analysis showed significant differences between groups for the monopolarly recorded amplitude up to 60% of maximal force and for the level of interference at higher force levels (40-100% force). We conclude that with HD-sEMG it is possible to detect neurogenic motor unit changes noninvasively, both by analysis of the raw signal itself and by analysis of extracted single MUAPs. The diagnostic yield of the single MUAP analysis is clearly higher. These findings point toward applications for clinical practice and invite further studies exploring the diagnostic value of HD-sEMG.
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Longitudinal associations between physical activity, anxiety, and depression in adults with long-term physical disabilities.
Health psychology : official journal of the Division of Health Psychology American Psychological Association, 2020Co-Authors: Samuel L Battalio, Sarah E Huffman, Mark P. JensenAbstract:OBJECTIVE To evaluate the longitudinal associations between self-reported physical activity and anxiety and depression symptom severity in adults with long-term physical disabilities. METHOD A secondary analysis of data from a United States-based longitudinal survey study of community-dwelling adults with 1 of 4 potential long-term physical disabilities (multiple sclerosis, muscular dystrophy, spinal cord injury, Postpoliomyelitis Syndrome). The first time point (T1) for the current study was completed by 1,594 participants. The second survey (T2) was sent 1 year later, and the third (T3) was sent 3 years later; each were completed by 1,380 and 1,218 participants, respectively. At each time point, participants completed a measure of physical activity (Godin Leisure Time Exercise Questionnaire) and Patient-Reported Outcomes Measurement System short forms evaluating depression and anxiety severity. RESULTS Mixed growth curve models showed greater quantities of physical activity were associated with decreases in both depression (χ2(2) = 84.01, p < .001) and anxiety (χ2(2) = 21.66, p < .001) symptom severity over the 4-year period. However, while greater quantities of moderate (anxiety z = -2.24, p < .05; depression z = -5.48, p < .001) and strenuous (anxiety z = -2.59, p < .05; depression z = -3.90, p < .001) physical activity were significantly associated with decreases in negative affect, mild physical activity was not. CONCLUSION The current study provides evidence that physical activity is longitudinally associated with anxious and depressive symptoms in adults with long-term physical disabilities. Future research should examine the quantities and intensities of physical activity necessary to impart psychological benefits. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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secondary health conditions and social role satisfaction in adults with long term physical disability
Health Psychology, 2019Co-Authors: Samuel L Battalio, Mark P. Jensen, Ivan R. MoltonAbstract:Objective Individuals living with physical disability due to early acquired or traumatic conditions often experience a range of psychological and physical health problems that are associated with their condition but are not directly caused by it. Known as "secondary health conditions," these problems can interact with existing functional limitations and other medical comorbidities to limit social participation. The current study assessed the concurrent and longitudinal associations between secondary health conditions, chronic medical comorbidities, and functional limitations, with a PROMIS® measure of social role participation. Methods A longitudinal survey study of community-dwelling adults with one of four chronic physical conditions (multiple sclerosis, muscular dystrophy, spinal cord injury, Postpoliomyelitis Syndrome). The baseline survey (T1) was mailed to 2041 individuals, and1862 baseline surveys were completed and returned (91% response rate). The follow-up survey (T2) was mailed roughly three years later; 1594 completed and returned the T2 survey (86% of T1 survey completers). Results Multiple linear regression analyses revealed that secondary health conditions, functional impairments, and chronic medical comorbidities accounted for 52% of the variance in satisfaction with social roles concurrently at T1. The amount of variance of change in satisfaction with social roles over the ∼3-year period accounted for by these variables was 3%. Functional limitations and more psychologically oriented secondary conditions were the strongest predictors of satisfaction with social roles. Conclusions Findings suggest that, for people with disabilities, addressing psychologically oriented secondary health conditions may be as important as functional impairment in predicting long-term social health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Anxiety, depression, and function in individuals with chronic physical conditions: A longitudinal analysis.
Rehabilitation psychology, 2018Co-Authors: Samuel L Battalio, Kevin N. Alschuler, Mari Glette, Mark P. JensenAbstract:OBJECTIVE This longitudinal study examined the unique relationship between anxiety, symptoms (pain intensity, sleep disturbance, fatigue severity), and function domains (self-reported cognitive function, physical function, satisfaction with social roles) in individuals with chronic physical conditions, independent of depressive symptoms. METHOD Three surveys were mailed on an approximately yearly basis to community-dwelling adults with one of four chronic physical conditions (spinal cord injury, multiple sclerosis, muscular dystrophy, Postpoliomyelitis Syndrome). The first survey was completed by 1594 individuals (T1). Of these, 1380 completed the second survey (T2), and 1272 completed the third survey (T3). RESULTS Mixed growth curve models evidenced significant concurrent and longitudinal associations between anxiety and each symptom and function domain, independent of depression severity. The largest unique association found was between anxiety and self-reported cognitive function; inclusion of the measure of anxiety in the model improved model fit substantially over depression alone, χ²[2] = 104.40, p < .001. Both anxiety and depression exhibited similar effect sizes in their unique relationships with each symptom and function domain measure. However, depression was more strongly associated with satisfaction with social roles and physical function than was anxiety. CONCLUSIONS The findings showed that anxiety assessed at one point in time demonstrated significant and unique associations with concurrent and subsequent symptom and function domains. Given that anxiety has been inadequately studied (and perhaps evaluated and treated) in rehabilitation populations, the current findings suggest that researchers and clinicians should broaden their scope when assessing and treating psychological distress to incorporate anxiety and related disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Resilience and Function in Adults With Physical Disabilities: An Observational Study
Archives of physical medicine and rehabilitation, 2016Co-Authors: Samuel L Battalio, Arielle M. Silverman, Dawn M. Ehde, Dagmar Amtmann, Karlyn A. Edwards, Mark P. JensenAbstract:Abstract Objectives To determine if resilience is uniquely associated with functional outcomes (satisfaction with social roles, physical functioning, and quality of life) in individuals with physical disabilities, after controlling for measures of psychological health (depression and anxiety) and symptom severity (pain, fatigue, and sleep disturbance); and to examine the potential moderating effect of sex, age, and diagnosis on the hypothesized associations between resilience and function. Design Cross-sectional survey study. Setting Surveys were mailed (81% response rate) to a community sample of 1949 individuals with multiple sclerosis, muscular dystrophy, Postpoliomyelitis Syndrome, or spinal cord injury. Participants were recruited through the Internet or print advertisement (28%), a registry of previous research participants who indicated interest in future studies (21%), a departmental registry of individuals interested in research (19%), disability-specific registries (18%), word of mouth (10%), or other sources (3%). Participants Convenience sample of community-dwelling adults aging with physical disabilities (N=1574), with a mean Connor-Davidson Resilience Scale (10 items) score of 29. Interventions Not applicable. Main Outcome Measures Patient-Reported Outcomes Measurement Information System measures of Satisfaction with Social Roles and Activities and Physical Functioning, the World Health Organization's brief Older People's Quality of Life Questionnaire, and the Connor-Davidson Resilience Scale (10 items). Results After controlling for age, age squared, sex, diagnosis, psychological health, and symptom severity, resilience was significantly and positively associated with satisfaction with social roles (β=.17, P P P >.05). For every 1-point increase in scores of resilience, there was an increase of .50 in the quality of life score and .20 in the satisfaction with social roles score. Sex also moderated the association between resilience and satisfaction with social roles (F 1,1453 =4.09, P =.043). Conclusions The findings extend past research, providing further evidence indicating that resilience plays a unique role in nonphysical functional outcomes among individuals with physical disabilities.
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Resilience Predicts Functional Outcomes in People Aging With Disability: A Longitudinal Investigation
Archives of physical medicine and rehabilitation, 2015Co-Authors: Arielle M. Silverman, Ivan R. Molton, Kevin N. Alschuler, Dawn M. Ehde, Mark P. JensenAbstract:Abstract Objectives To investigate the links between resilience and depressive symptoms, social functioning, and physical functioning in people aging with disability and to investigate the effects of resilience on change in functional outcomes over time. Design Longitudinal postal survey. Setting Surveys were mailed to a community sample of individuals with 1 of 4 diagnoses: multiple sclerosis, muscular dystrophy, Postpoliomyelitis Syndrome, or spinal cord injury. The survey response rate was 91% at baseline and 86% at follow-up. Participants A convenience sample of community-dwelling individuals (N=1594; age range, 20–94y) with multiple sclerosis, muscular dystrophy, Postpoliomyelitis Syndrome, or spinal cord injury. Interventions Not applicable. Main Outcome Measures Patient Health Questionnaire-9 (to assess depressive symptoms) and Patient Reported Outcomes Measurement Information System (to assess social role satisfaction and physical functioning). Results At baseline, resilience was negatively correlated with depressive symptoms ( r =−.55) and positively correlated with social and physical functioning ( r =.49 and r =.17, respectively). Controlling for baseline outcomes, greater baseline resilience predicted a decrease in depressive symptoms (partial r =−.12) and an increase in social functioning (partial r =.12) 3 years later. Conclusions The findings are consistent with a view of resilience as a protective factor that supports optimal functioning in people aging with disability.