Er is een voortdurende en indrukwekkende toename van de beschikbare evidentie over werkzaamheid v... more Er is een voortdurende en indrukwekkende toename van de beschikbare evidentie over werkzaamheid van fysio-en kinesitherapeutisch handelen (zie kader). Verder zijn er de afgelopen jaren belangrijke inspanningen verricht om de toepassing van bevindingen uit gecontroleerd effectonderzoek in de klinische praktijk te stimuleren en een mentaliteitsverandering hieromtrent tot stand te brengen (Bekkering et al., 2003). Ondanks dit alles is het onduidelijk of deze inspanningen ook hebben geleid tot veranderingen in de kwaliteit van de zorgverstrekking. In deze bijdrage gaat de aandacht naar de manier waarop therapeuten kennis nemen van gegevens uit gecontroleerd klinisch onderzoek en systematische reviews, en die implementeren. Het begrijpen en vertalen van bevindingen uit onderzoeken in de praktijk is niet eenvoudig. Er bestaat ook vaak onenigheid tussen verschillende onderzoeken over welke therapie nu het meest werkzaam is. Zo duikt de vraag steeds weer op wat de therapeut concreet met dez...
Background: The RGB-D camera is an alternative to asses kinematics in order to obtain objective m... more Background: The RGB-D camera is an alternative to asses kinematics in order to obtain objective measurements of functional limitations. The aim of this study is to analyze the validity, reliability, and responsiveness of the motion capture depth camera in sub-acute and chronic low back pain patients. Methods: Thirty subjects (18–65 years) with non-specific lumbar pain were screened 6 weeks following an episode. RGB-D camera measurements were compared with an inertial measurement unit. Functional tests included climbing stairs, bending, reaching sock, lie-to-sit, sit-to-stand, and timed up-and-go. Subjects performed the maximum number of repetitions during 30 s. Validity was analyzed using Spearman’s correlation, reliability of repetitions was calculated by the intraclass correlation coefficient and the standard error of measurement, and receiver operating characteristic curves were calculated to assess the responsiveness. Results: The kinematic analysis obtained variable results acc...
Journal of pain and symptom management, Jan 14, 2017
Reliable identification of lower respiratory tract pathogens is crucial in the management of cyst... more Reliable identification of lower respiratory tract pathogens is crucial in the management of cystic fibrosis (CF). As part of another study (NCT02363764) investigating the bacterial yield of three sampling methods: nasal swabs (NS), cough swabs (CS) and (induced) sputum samples ((I)SS) in both expectorating (EPs) and non-expectorating (NEPs) patients with CF, the present study aimed to explore the prevalence of respiratory culture sampling-related pain as assessed by self-report within a cohort of children and adults. Literate patients with CF (>6y) completed a questionnaire on pain perception related to the three aforementioned sampling methods [No/Yes; visual analogue scale for pain "VAS-Pain" (0-10cm)]. Additionally, patients were asked to rank these methods by their own preference without taking into account the presumed bacterial yield. In total, 119 questionnaires were returned. In the EPs-group, CS was most frequently (n%;mean VAS-Pain if pain [range]) reported a...
Transcutaneous electric nerve stimulation (TENS) has proven to be effective for postsurgical pain... more Transcutaneous electric nerve stimulation (TENS) has proven to be effective for postsurgical pain relief. However, there is a lack of well-constructed clinical trials investigating the effect of TENS after total knee arthroplasty (TKA). In addition, previous investigations reported that low- and high-frequency TENSs produced analgesic tolerance after 4 or 5 days of treatment. The aim of this study is to explore the effect of burst TENS on pain during hospitalization after TKA and to investigate whether burst TENS produces analgesic tolerance after 4 or 5 days of treatment. This stratified, triple blind, randomized controlled trial was approved by the University Hospital Brussels. Sixty-eight subjects were screened for eligibility before surgery; 54 were found eligible and 53 were included in the analyses. Patients were allocated to either a burst TENS or sham burst TENS group. TENS was applied daily during continuous passive mobilization. Knee pain intensity, knee range of motion, a...
Exercise is effective for reducing knee osteoarthritis (OA) pain but effect sizes vary widely. Mo... more Exercise is effective for reducing knee osteoarthritis (OA) pain but effect sizes vary widely. Moreover, not all knee OA patients perceive beneficial effects. Tailoring specific exercises to subgroups of knee OA patients may increase effectivity. Bone marrow lesions (BMLs) have been suggested as a criterion to define such subgroups. This study aimed to investigate whether BMLs' presence/absence is related to treatment outcomes in a group of knee OA patients who exercised for 18 weeks. Subjects with symptomatic knee OA started a strength or walking exercise program. BMLs' presence at baseline was assessed. Pain was assessed before and after the intervention with the intermittent and constant osteoarthritis pain (ICOAP) questionnaire. Also the global perceived effect (GPE) on the patient's complaints was rated. Thirty-five patients (strength (N = 17) and walking (N = 18)) were analyzed for BMLs. BMLs were present in 25 (71%) knees. Five (14%) patients dropped out and 19 (5...
Subjects with knee osteoarthritis walk differently compared to healthy subjects. Managing these g... more Subjects with knee osteoarthritis walk differently compared to healthy subjects. Managing these gait alterations has been proven effective for reducing pain and increasing function. The Stride Analyzer is a low cost gait analysis tool but its clinimetric properties have not been investigated yet in subjects with symptomatic knee osteoarthritis. The aim of this study was to investigate the reliability and validity of the SA compared with the Gold standard (Vicon) in persons with knee OA. Fifteen subjects with symptomatic knee osteoarthritis were instructed to walk at a self-selected speed in a gait laboratory. Temporospatial (TS) gait parameters were recorded simultaneously by the Stride Analyzer and by a 16-camera-infrared optoelectronic motion capturing system (Vicon). Validity and test-retest reliability of the Stride Analyzer were examined by Bland-Altman plots, intra-class correlation coefficients (ICC) and the standard error of measurement (SEM). Test-retest analyses showed good agreement for all TS parameters with ICC values ranging from 0.805 (single limb support right) to 0.949 (velocity) and SEM% values ranging from 0.78% (stance phase right (% of gait cycle)) to 4.52% (double limb support right (% of gait cycle)). Good agreement between Stride Analyzer and Vicon was found for the following TS parameters: velocity (z=1.01), cadence (z=-0.85), stride length (z=1.63) and gait cycle (z=0.86). All other gait parameters showed lower ICC values (<0.689). Our results suggest that the Stride Analyzer can be used in the clinical field to perform gait analysis in subjects with symptomatic knee osteoarthritis.
Exercise effectiveness is related to adherence, compliance and drop-out. The aim of this study is... more Exercise effectiveness is related to adherence, compliance and drop-out. The aim of this study is to investigate if exercise-induced pain and health status are related to these outcomes during two exercise programs in knee osteoarthritis patients. Symptomatic knee osteoarthritis patients were randomly allocated to a walking or strengthening program (N=19/group). At baseline, patients were categorized according to their health status. Exercise adherence and compliance were calculated and drop-out rate was registered. For exercise-induced pain, patients rated their pain on an 11-point numeric rating scale (NRS) before and after each training session. Before each session the maximal perceived pain of the last 24h (NRSmax24) was assessed. Patients rated their global self-perceived effect (GPE) on a 7-point ordinal scale after the intervention period. 53% of the participants felt they improved after the program, 6 patients dropped out. The mean adherence and compliance rates were higher ...
Exercise effectiveness is related to adherence, compliance and drop-out. The aim of this study is... more Exercise effectiveness is related to adherence, compliance and drop-out. The aim of this study is to investigate if exercise-induced pain and health status are related to these outcomes during two exercise programs in knee osteoarthritis patients. Symptomatic knee osteoarthritis patients were randomly allocated to a walking or strengthening program (N=19/group). At baseline, patients were categorized according to their health status. Exercise adherence and compliance were calculated and drop-out rate was registered. For exercise-induced pain, patients rated their pain on an 11-point numeric rating scale (NRS) before and after each training session. Before each session the maximal perceived pain of the last 24h (NRSmax24) was assessed. Patients rated their global self-perceived effect (GPE) on a 7-point ordinal scale after the intervention period. 53% of the participants felt they improved after the program, 6 patients dropped out. The mean adherence and compliance rates were higher than .83 in both groups. Worse health and higher exercise-induced pain were seen in drop-outs. NRSmax24 during the first 3weeks did not significantly increase compared to baseline, but correlated negatively with adherence during the home sessions (-.56, p<.05). Lower adherence during supervised sessions was significantly related with higher pre-exercise pain scores (ρ=-.35, p<.05). Patients who drop-out show a worse health condition and higher exercise-induced pain levels compared to patients that retained the program.
Er is een voortdurende en indrukwekkende toename van de beschikbare evidentie over werkzaamheid v... more Er is een voortdurende en indrukwekkende toename van de beschikbare evidentie over werkzaamheid van fysio-en kinesitherapeutisch handelen (zie kader). Verder zijn er de afgelopen jaren belangrijke inspanningen verricht om de toepassing van bevindingen uit gecontroleerd effectonderzoek in de klinische praktijk te stimuleren en een mentaliteitsverandering hieromtrent tot stand te brengen (Bekkering et al., 2003). Ondanks dit alles is het onduidelijk of deze inspanningen ook hebben geleid tot veranderingen in de kwaliteit van de zorgverstrekking. In deze bijdrage gaat de aandacht naar de manier waarop therapeuten kennis nemen van gegevens uit gecontroleerd klinisch onderzoek en systematische reviews, en die implementeren. Het begrijpen en vertalen van bevindingen uit onderzoeken in de praktijk is niet eenvoudig. Er bestaat ook vaak onenigheid tussen verschillende onderzoeken over welke therapie nu het meest werkzaam is. Zo duikt de vraag steeds weer op wat de therapeut concreet met dez...
Background: The RGB-D camera is an alternative to asses kinematics in order to obtain objective m... more Background: The RGB-D camera is an alternative to asses kinematics in order to obtain objective measurements of functional limitations. The aim of this study is to analyze the validity, reliability, and responsiveness of the motion capture depth camera in sub-acute and chronic low back pain patients. Methods: Thirty subjects (18–65 years) with non-specific lumbar pain were screened 6 weeks following an episode. RGB-D camera measurements were compared with an inertial measurement unit. Functional tests included climbing stairs, bending, reaching sock, lie-to-sit, sit-to-stand, and timed up-and-go. Subjects performed the maximum number of repetitions during 30 s. Validity was analyzed using Spearman’s correlation, reliability of repetitions was calculated by the intraclass correlation coefficient and the standard error of measurement, and receiver operating characteristic curves were calculated to assess the responsiveness. Results: The kinematic analysis obtained variable results acc...
Journal of pain and symptom management, Jan 14, 2017
Reliable identification of lower respiratory tract pathogens is crucial in the management of cyst... more Reliable identification of lower respiratory tract pathogens is crucial in the management of cystic fibrosis (CF). As part of another study (NCT02363764) investigating the bacterial yield of three sampling methods: nasal swabs (NS), cough swabs (CS) and (induced) sputum samples ((I)SS) in both expectorating (EPs) and non-expectorating (NEPs) patients with CF, the present study aimed to explore the prevalence of respiratory culture sampling-related pain as assessed by self-report within a cohort of children and adults. Literate patients with CF (>6y) completed a questionnaire on pain perception related to the three aforementioned sampling methods [No/Yes; visual analogue scale for pain "VAS-Pain" (0-10cm)]. Additionally, patients were asked to rank these methods by their own preference without taking into account the presumed bacterial yield. In total, 119 questionnaires were returned. In the EPs-group, CS was most frequently (n%;mean VAS-Pain if pain [range]) reported a...
Transcutaneous electric nerve stimulation (TENS) has proven to be effective for postsurgical pain... more Transcutaneous electric nerve stimulation (TENS) has proven to be effective for postsurgical pain relief. However, there is a lack of well-constructed clinical trials investigating the effect of TENS after total knee arthroplasty (TKA). In addition, previous investigations reported that low- and high-frequency TENSs produced analgesic tolerance after 4 or 5 days of treatment. The aim of this study is to explore the effect of burst TENS on pain during hospitalization after TKA and to investigate whether burst TENS produces analgesic tolerance after 4 or 5 days of treatment. This stratified, triple blind, randomized controlled trial was approved by the University Hospital Brussels. Sixty-eight subjects were screened for eligibility before surgery; 54 were found eligible and 53 were included in the analyses. Patients were allocated to either a burst TENS or sham burst TENS group. TENS was applied daily during continuous passive mobilization. Knee pain intensity, knee range of motion, a...
Exercise is effective for reducing knee osteoarthritis (OA) pain but effect sizes vary widely. Mo... more Exercise is effective for reducing knee osteoarthritis (OA) pain but effect sizes vary widely. Moreover, not all knee OA patients perceive beneficial effects. Tailoring specific exercises to subgroups of knee OA patients may increase effectivity. Bone marrow lesions (BMLs) have been suggested as a criterion to define such subgroups. This study aimed to investigate whether BMLs' presence/absence is related to treatment outcomes in a group of knee OA patients who exercised for 18 weeks. Subjects with symptomatic knee OA started a strength or walking exercise program. BMLs' presence at baseline was assessed. Pain was assessed before and after the intervention with the intermittent and constant osteoarthritis pain (ICOAP) questionnaire. Also the global perceived effect (GPE) on the patient's complaints was rated. Thirty-five patients (strength (N = 17) and walking (N = 18)) were analyzed for BMLs. BMLs were present in 25 (71%) knees. Five (14%) patients dropped out and 19 (5...
Subjects with knee osteoarthritis walk differently compared to healthy subjects. Managing these g... more Subjects with knee osteoarthritis walk differently compared to healthy subjects. Managing these gait alterations has been proven effective for reducing pain and increasing function. The Stride Analyzer is a low cost gait analysis tool but its clinimetric properties have not been investigated yet in subjects with symptomatic knee osteoarthritis. The aim of this study was to investigate the reliability and validity of the SA compared with the Gold standard (Vicon) in persons with knee OA. Fifteen subjects with symptomatic knee osteoarthritis were instructed to walk at a self-selected speed in a gait laboratory. Temporospatial (TS) gait parameters were recorded simultaneously by the Stride Analyzer and by a 16-camera-infrared optoelectronic motion capturing system (Vicon). Validity and test-retest reliability of the Stride Analyzer were examined by Bland-Altman plots, intra-class correlation coefficients (ICC) and the standard error of measurement (SEM). Test-retest analyses showed good agreement for all TS parameters with ICC values ranging from 0.805 (single limb support right) to 0.949 (velocity) and SEM% values ranging from 0.78% (stance phase right (% of gait cycle)) to 4.52% (double limb support right (% of gait cycle)). Good agreement between Stride Analyzer and Vicon was found for the following TS parameters: velocity (z=1.01), cadence (z=-0.85), stride length (z=1.63) and gait cycle (z=0.86). All other gait parameters showed lower ICC values (<0.689). Our results suggest that the Stride Analyzer can be used in the clinical field to perform gait analysis in subjects with symptomatic knee osteoarthritis.
Exercise effectiveness is related to adherence, compliance and drop-out. The aim of this study is... more Exercise effectiveness is related to adherence, compliance and drop-out. The aim of this study is to investigate if exercise-induced pain and health status are related to these outcomes during two exercise programs in knee osteoarthritis patients. Symptomatic knee osteoarthritis patients were randomly allocated to a walking or strengthening program (N=19/group). At baseline, patients were categorized according to their health status. Exercise adherence and compliance were calculated and drop-out rate was registered. For exercise-induced pain, patients rated their pain on an 11-point numeric rating scale (NRS) before and after each training session. Before each session the maximal perceived pain of the last 24h (NRSmax24) was assessed. Patients rated their global self-perceived effect (GPE) on a 7-point ordinal scale after the intervention period. 53% of the participants felt they improved after the program, 6 patients dropped out. The mean adherence and compliance rates were higher ...
Exercise effectiveness is related to adherence, compliance and drop-out. The aim of this study is... more Exercise effectiveness is related to adherence, compliance and drop-out. The aim of this study is to investigate if exercise-induced pain and health status are related to these outcomes during two exercise programs in knee osteoarthritis patients. Symptomatic knee osteoarthritis patients were randomly allocated to a walking or strengthening program (N=19/group). At baseline, patients were categorized according to their health status. Exercise adherence and compliance were calculated and drop-out rate was registered. For exercise-induced pain, patients rated their pain on an 11-point numeric rating scale (NRS) before and after each training session. Before each session the maximal perceived pain of the last 24h (NRSmax24) was assessed. Patients rated their global self-perceived effect (GPE) on a 7-point ordinal scale after the intervention period. 53% of the participants felt they improved after the program, 6 patients dropped out. The mean adherence and compliance rates were higher than .83 in both groups. Worse health and higher exercise-induced pain were seen in drop-outs. NRSmax24 during the first 3weeks did not significantly increase compared to baseline, but correlated negatively with adherence during the home sessions (-.56, p<.05). Lower adherence during supervised sessions was significantly related with higher pre-exercise pain scores (ρ=-.35, p<.05). Patients who drop-out show a worse health condition and higher exercise-induced pain levels compared to patients that retained the program.
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