Huisartsen ervaren vaak terughoudendheid om patiënten met chronischevermoeidheidsklachten te bege... more Huisartsen ervaren vaak terughoudendheid om patiënten met chronischevermoeidheidsklachten te begeleiden. Op dit moment ontbreekt een wetenschappelijk onderbouwde aanbeveling voor de aanpak van patiënten met chronische vermoeidheid in de eerste lijn. In dit artikel willen we enkele methoden aanreiken die de begeleiding van patiënten met langdurende vermoeidheid kunnen vormgeven. Er wordt ingegaan op het belang van interdisciplinaire samenwerking, bijvoorbeeld met een in deze materie ervaren kinesist. Bedoeling is om aan de hand van dit artikel beide beroepsgroepen, huisartsen en kinesisten, warm te maken voor de aanpak van deze bijzondere groep patiënten.
Cite this article: Eyskens Jb, De Nil L, Staring J. A tool to reorient physiotherapy: The use of ... more Cite this article: Eyskens Jb, De Nil L, Staring J. A tool to reorient physiotherapy: The use of the field model. Ann Anesth Pain Med 2020; 3(1): 1007.
Journal of Bodywork and Movement Therapies Available online 16 March 2019, 2019
The pathophysiology of chronic fatigue syndrome (CFS) remains unclear; no biomarkers have thus fa... more The pathophysiology of chronic fatigue syndrome (CFS) remains unclear; no biomarkers have thus far been identified or physical tests designed to underpin its diagnosis. Assessment mainly uses Fukuda's criteria and is based on the exclusion of symptoms related to other diseases/syndromes, subjective self-reporting, and outcomes of self-report questionnaires. In order to improve the baseline assessment and progress evaluation of individuals suspected of CFS and using an association-oriented research strategy and a cross-correlational design, this study investigates possible associations between the performance on two physical tests, i.e. ‘Timed Loaded Standing’ (TLS), assessing trunk-arm endurance, and the ‘Stops Walking with Eyes Closed while performing a secondary Cognitive Task’ (SWECCT), measuring impaired automaticity of gait, and the results of two self-report questionnaires, the Checklist Individual Strength (CIS, total score and fatigue subscale score) and the physical fun...
On earth so-called mechanical body overload, causing tissue strain, tissue damage and fatigue, is... more On earth so-called mechanical body overload, causing tissue strain, tissue damage and fatigue, is considered to be a major cause of physical complaints including neck and lower back pain. Mechanical strain related to body posture has been shown to play a significant role in ongoing, widespread pain and fatigue (patients prefer to lie down while limiting standing and sitting). Understandably, the link to gravity's vertical vector is quickly made. The authors felt it would be an interesting question to ask, "What would happen to pain and ongoing fatigue when in orbit, in a micro-gravity environment, lacking the earth's dominating vertical vector?" Surprisingly, results show that in micro-gravity both pain and fatigue are found occurring frequently. Data obtained from a literature review regarding both complaints in microgravity provides evidence for a change of perspective. This review's focus, confined to type-1 and type-2 muscle fiber type, highlighted a shift in muscle physiology specific to astronauts when in a microgravity environment. A similar shift in muscle fiber physiology among chronic low back patients and patients suffering from chronic fatigue syndrome exists on earth. It is proposed that biomechanics, as commonly implemented and interpreted based on levers, might be better informed by including a concept based on biotensegrity. This could be used to propose novel therapeutic approaches to address both local, regional and widespread pain as well as ongoing fatigue.
Eyskens Jb, De Nil L, Staring J. A tool to reorient physiotherapy: The use of the field model. Ann Anesth Pain Med 2020; 3(1): 1007., 2020
Patients presenting chronic musculoskeletal complaints, dysfunctions and syndromes are advised by... more Patients presenting chronic musculoskeletal complaints, dysfunctions and syndromes are advised by various care providers during their recovery process. Most patients present themselves with different comorbidities and underlying dysfunctions. No guideline is available for every dysfunction and every patient's specific context/comorbidities. Since motivation plays a central role in the change of behavior and therapy compliance, good communication between all partners involved enables the best possible (medical) approach. This paper aims to propose a field model as a means of communication whereby patients are advised the same policies, definitions and reference frames (ICD and ICF) by all professionals. This field model is in parallel with the one for physicians since both have the same horizontal timeline axis: risk factors , activating factors, and complications. Whereas the medical consists of three domains on its vertical axis (neu-ropsychiatric, internal-biological, and musculoskeletal), the physiotherapeutic field model uses local tissue damage, regional muscular defense, and central/widespread reactions. Each model therefore provides nine boxes. Since the physiotherapy model overlaps the physician's third domain, their parallel use will help implement a trans-disciplinary approach. After the patient and the physiotherapist, as equivalent partners, have filled in the nine boxes, the underlying problem of the patient's complaint will be focused on. From then on, patients can read just their view and the agreed-on policy can be taken closer to the scientific guidelines. It helps patients to enable (mostly secondary) prevention. The model helps to make a shift from a 'motor theory' towards an 'action theory' concept, a really 'embodied philosophy' to tackle a bad habit.
Journal of Rehabilitation Research and Development, 2015
Patients with chronic fatigue syndrome (CFS), like patients with osteoporosis, have similar diffi... more Patients with chronic fatigue syndrome (CFS), like patients with osteoporosis, have similar difficulties in standing and sitting. The aim of the study was to compare combined trunk and arm endurance between women with CFS (n = 72), women with osteoporosis (n = 30), nondisabled women (n = 55), and women from non-industrialized countries (n = 58) using the timed loaded standing (TLS) test. TLS measures how long a person can hold a 1 kg dumbbell in each hand in front of him/her with straight arms. TLS was higher in the industrialized nondisabled population than in the non-industrialized study population (p < 0.001) and in patients with osteoporosis (p = 0.002). TLS was lower in patients with CFS than in nondisabled controls (p < 0.001). After adjustment for age, body height, and weight, combined trunk and arm endurance was even lower in CFS than in osteoporotic patients more than 25 yr old (p < 0.001). In CFS, TLS was lower compared in the non-industrialized group (p = 0.02). Since only women were studied, external validity of the results is limited to adult female patients with CFS. TLS revealed a specific biomechanical weakness in CFS patients that can be taken into account from the onset of a rehabilitation program. We propose that influencing the quality, rather than the quantity, of movement could be used in the rehabilitation.
—Patients with chronic fatigue syndrome (CFS) report difficulties walking for a prolonged period ... more —Patients with chronic fatigue syndrome (CFS) report difficulties walking for a prolonged period of time. This study compares gait automaticity between women with CFS and nondisabled controls. The " stops walking with eyes closed with secondary cognitive task " test is based on the classic " stops walking while talking " test but compares walking with eyes closed while performing a secondary cognitive task in a female CFS population (n = 34) and in female nondisabled controls (n = 38). When initiating gate, 23.5% of patients with CFS looked toward the ground compared with only 2.6% of nondisabled controls. After 7 m, subjects were asked to close their eyes, and after another 7 m, they were asked, " How much is 100 minus 7? " Of the patients with CFS, 55.9% stopped walking compared with 5.3% of nondisabled controls. Less automated walking was observed in patients with CFS than in nondisabled controls (p < 0.001). The test-retest reliability is moderate for global stopping. This simple test observed reduced gait automaticity in patients with CFS for the first time. Dual tasking could be helpful to address the functional limitations found in this particular study.
Patients presenting chronic musculoskeletal complaints, dysfunctions and syndromes are advised by... more Patients presenting chronic musculoskeletal complaints, dysfunctions and syndromes are advised by various care providers during their recovery process. Most patients present themselves with different comorbidities and underlying dysfunctions. No guideline is available for every dysfunction and every patient's specific context/comorbidities. Since motivation plays a central role in the change of behavior and therapy compliance, good communication between all partners involved enables the best possible (medical) approach. This paper aims to propose a field model as a means of communication whereby patients are advised the same policies, definitions and reference frames (ICD and ICF) by all professionals. This field model is in parallel with the one for physicians since both have the same horizontal timeline axis: risk factors , activating factors, and complications. Whereas the medical consists of three domains on its vertical axis (neu-ropsychiatric, internal-biological, and musculoskeletal), the physiotherapeutic field model uses local tissue damage, regional muscular defense, and central/widespread reactions. Each model therefore provides nine boxes. Since the physiotherapy model overlaps the physician's third domain, their parallel use will help implement a trans-disciplinary approach. After the patient and the physiotherapist, as equivalent partners, have filled in the nine boxes, the underlying problem of the patient's complaint will be focused on. From then on, patients can read just their view and the agreed-on policy can be taken closer to the scientific guidelines. It helps patients to enable (mostly secondary) prevention. The model helps to make a shift from a 'motor theory' towards an 'action theory' concept, a really 'embodied philosophy' to tackle a bad habit.
Huisartsen ervaren vaak terughoudendheid om patiënten met chronischevermoeidheidsklachten te bege... more Huisartsen ervaren vaak terughoudendheid om patiënten met chronischevermoeidheidsklachten te begeleiden. Op dit moment ontbreekt een wetenschappelijk onderbouwde aanbeveling voor de aanpak van patiënten met chronische vermoeidheid in de eerste lijn. In dit artikel willen we enkele methoden aanreiken die de begeleiding van patiënten met langdurende vermoeidheid kunnen vormgeven. Er wordt ingegaan op het belang van interdisciplinaire samenwerking, bijvoorbeeld met een in deze materie ervaren kinesist. Bedoeling is om aan de hand van dit artikel beide beroepsgroepen, huisartsen en kinesisten, warm te maken voor de aanpak van deze bijzondere groep patiënten.
Cite this article: Eyskens Jb, De Nil L, Staring J. A tool to reorient physiotherapy: The use of ... more Cite this article: Eyskens Jb, De Nil L, Staring J. A tool to reorient physiotherapy: The use of the field model. Ann Anesth Pain Med 2020; 3(1): 1007.
Journal of Bodywork and Movement Therapies Available online 16 March 2019, 2019
The pathophysiology of chronic fatigue syndrome (CFS) remains unclear; no biomarkers have thus fa... more The pathophysiology of chronic fatigue syndrome (CFS) remains unclear; no biomarkers have thus far been identified or physical tests designed to underpin its diagnosis. Assessment mainly uses Fukuda's criteria and is based on the exclusion of symptoms related to other diseases/syndromes, subjective self-reporting, and outcomes of self-report questionnaires. In order to improve the baseline assessment and progress evaluation of individuals suspected of CFS and using an association-oriented research strategy and a cross-correlational design, this study investigates possible associations between the performance on two physical tests, i.e. ‘Timed Loaded Standing’ (TLS), assessing trunk-arm endurance, and the ‘Stops Walking with Eyes Closed while performing a secondary Cognitive Task’ (SWECCT), measuring impaired automaticity of gait, and the results of two self-report questionnaires, the Checklist Individual Strength (CIS, total score and fatigue subscale score) and the physical fun...
On earth so-called mechanical body overload, causing tissue strain, tissue damage and fatigue, is... more On earth so-called mechanical body overload, causing tissue strain, tissue damage and fatigue, is considered to be a major cause of physical complaints including neck and lower back pain. Mechanical strain related to body posture has been shown to play a significant role in ongoing, widespread pain and fatigue (patients prefer to lie down while limiting standing and sitting). Understandably, the link to gravity's vertical vector is quickly made. The authors felt it would be an interesting question to ask, "What would happen to pain and ongoing fatigue when in orbit, in a micro-gravity environment, lacking the earth's dominating vertical vector?" Surprisingly, results show that in micro-gravity both pain and fatigue are found occurring frequently. Data obtained from a literature review regarding both complaints in microgravity provides evidence for a change of perspective. This review's focus, confined to type-1 and type-2 muscle fiber type, highlighted a shift in muscle physiology specific to astronauts when in a microgravity environment. A similar shift in muscle fiber physiology among chronic low back patients and patients suffering from chronic fatigue syndrome exists on earth. It is proposed that biomechanics, as commonly implemented and interpreted based on levers, might be better informed by including a concept based on biotensegrity. This could be used to propose novel therapeutic approaches to address both local, regional and widespread pain as well as ongoing fatigue.
Eyskens Jb, De Nil L, Staring J. A tool to reorient physiotherapy: The use of the field model. Ann Anesth Pain Med 2020; 3(1): 1007., 2020
Patients presenting chronic musculoskeletal complaints, dysfunctions and syndromes are advised by... more Patients presenting chronic musculoskeletal complaints, dysfunctions and syndromes are advised by various care providers during their recovery process. Most patients present themselves with different comorbidities and underlying dysfunctions. No guideline is available for every dysfunction and every patient's specific context/comorbidities. Since motivation plays a central role in the change of behavior and therapy compliance, good communication between all partners involved enables the best possible (medical) approach. This paper aims to propose a field model as a means of communication whereby patients are advised the same policies, definitions and reference frames (ICD and ICF) by all professionals. This field model is in parallel with the one for physicians since both have the same horizontal timeline axis: risk factors , activating factors, and complications. Whereas the medical consists of three domains on its vertical axis (neu-ropsychiatric, internal-biological, and musculoskeletal), the physiotherapeutic field model uses local tissue damage, regional muscular defense, and central/widespread reactions. Each model therefore provides nine boxes. Since the physiotherapy model overlaps the physician's third domain, their parallel use will help implement a trans-disciplinary approach. After the patient and the physiotherapist, as equivalent partners, have filled in the nine boxes, the underlying problem of the patient's complaint will be focused on. From then on, patients can read just their view and the agreed-on policy can be taken closer to the scientific guidelines. It helps patients to enable (mostly secondary) prevention. The model helps to make a shift from a 'motor theory' towards an 'action theory' concept, a really 'embodied philosophy' to tackle a bad habit.
Journal of Rehabilitation Research and Development, 2015
Patients with chronic fatigue syndrome (CFS), like patients with osteoporosis, have similar diffi... more Patients with chronic fatigue syndrome (CFS), like patients with osteoporosis, have similar difficulties in standing and sitting. The aim of the study was to compare combined trunk and arm endurance between women with CFS (n = 72), women with osteoporosis (n = 30), nondisabled women (n = 55), and women from non-industrialized countries (n = 58) using the timed loaded standing (TLS) test. TLS measures how long a person can hold a 1 kg dumbbell in each hand in front of him/her with straight arms. TLS was higher in the industrialized nondisabled population than in the non-industrialized study population (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and in patients with osteoporosis (p = 0.002). TLS was lower in patients with CFS than in nondisabled controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). After adjustment for age, body height, and weight, combined trunk and arm endurance was even lower in CFS than in osteoporotic patients more than 25 yr old (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). In CFS, TLS was lower compared in the non-industrialized group (p = 0.02). Since only women were studied, external validity of the results is limited to adult female patients with CFS. TLS revealed a specific biomechanical weakness in CFS patients that can be taken into account from the onset of a rehabilitation program. We propose that influencing the quality, rather than the quantity, of movement could be used in the rehabilitation.
—Patients with chronic fatigue syndrome (CFS) report difficulties walking for a prolonged period ... more —Patients with chronic fatigue syndrome (CFS) report difficulties walking for a prolonged period of time. This study compares gait automaticity between women with CFS and nondisabled controls. The " stops walking with eyes closed with secondary cognitive task " test is based on the classic " stops walking while talking " test but compares walking with eyes closed while performing a secondary cognitive task in a female CFS population (n = 34) and in female nondisabled controls (n = 38). When initiating gate, 23.5% of patients with CFS looked toward the ground compared with only 2.6% of nondisabled controls. After 7 m, subjects were asked to close their eyes, and after another 7 m, they were asked, " How much is 100 minus 7? " Of the patients with CFS, 55.9% stopped walking compared with 5.3% of nondisabled controls. Less automated walking was observed in patients with CFS than in nondisabled controls (p < 0.001). The test-retest reliability is moderate for global stopping. This simple test observed reduced gait automaticity in patients with CFS for the first time. Dual tasking could be helpful to address the functional limitations found in this particular study.
Patients presenting chronic musculoskeletal complaints, dysfunctions and syndromes are advised by... more Patients presenting chronic musculoskeletal complaints, dysfunctions and syndromes are advised by various care providers during their recovery process. Most patients present themselves with different comorbidities and underlying dysfunctions. No guideline is available for every dysfunction and every patient's specific context/comorbidities. Since motivation plays a central role in the change of behavior and therapy compliance, good communication between all partners involved enables the best possible (medical) approach. This paper aims to propose a field model as a means of communication whereby patients are advised the same policies, definitions and reference frames (ICD and ICF) by all professionals. This field model is in parallel with the one for physicians since both have the same horizontal timeline axis: risk factors , activating factors, and complications. Whereas the medical consists of three domains on its vertical axis (neu-ropsychiatric, internal-biological, and musculoskeletal), the physiotherapeutic field model uses local tissue damage, regional muscular defense, and central/widespread reactions. Each model therefore provides nine boxes. Since the physiotherapy model overlaps the physician's third domain, their parallel use will help implement a trans-disciplinary approach. After the patient and the physiotherapist, as equivalent partners, have filled in the nine boxes, the underlying problem of the patient's complaint will be focused on. From then on, patients can read just their view and the agreed-on policy can be taken closer to the scientific guidelines. It helps patients to enable (mostly secondary) prevention. The model helps to make a shift from a 'motor theory' towards an 'action theory' concept, a really 'embodied philosophy' to tackle a bad habit.
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