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The immediate influence of implicit motor learning strategies on spatiotemporal gait parameters in stroke patients

Objectives: To investigate immediate changes in walking performance associated with three implicit motor learning strategies and to explore patient experiences of each strategy. Design: Participants were randomly allocated to one of three implicit motor learning strategies. Within-group comparisons of spatiotemporal parameters at baseline and post strategy were performed. Setting: Laboratory setting. Subjects: A total of 56 community-dwelling post-stroke individuals. Interventions: Implicit learning strategies were analogy instructions, environmental constraints and action observation. Different analogy instructions and environmental constraints were used to facilitate specific gait parameters. Within action observation, only videotaped gait was shown. Main measures: Spatiotemporal measures (speed, step length, step width, step height) were recorded using Vicon 3D motion analysis. Patient experiences were assessed by questionnaire. Results: At a group level, three of the four analogy instructions (n=19) led to small but significant changes in speed (d=0.088m/s), step height (affected side d=0.006m) and step width (d=–0.019m), and one environmental constraint (n=17) led to significant changes in step width (d=–0.040m). At an individual level, results showed wide variation in the magnitude of changes. Within action observation (n=20), no significant changes were found. Overall, participants found it easy to use the different strategies and experienced some changes in their walking performance. Conclusion: Analogy instructions and environmental constraints can lead to specific, immediate changes in the walking performance and were in general experienced as feasible by the participants. However, the response of an individual patient may vary quite considerably.

How Much, What, When, with Whom and Where? a Deeper Understanding of Individual Patterns of Physical Activity Behavior in an Inpatient Rehabilitation Center

BACKGROUND: Although enhancing physical activity (PA) is important to improve physical and/or cognitive recovery, little is known about PA of patients admitted to an inpatient rehabilitation setting. Therefore, this study assessed the quantity, nature and context of inpatients PA admitted to a rehabilitation center. METHODOLOGY/PRINICIPAL FINDINGS: Prospective observational study using accelerometry & behavioral mapping. PA of patients admitted to inpatient rehabilitation was measured during one day between 7.00-22.00 by means of 3d-accelerometery (Activ8; percentage of sedentary/active time, number of sedentary/active bouts (continuous period of ≥1 minute), and active/sedentary bout lengths and behavioral mapping. Behavioral mapping consisted of observations (every 20 minutes) to assess: type of activity, body position, social context and physical location. Descriptive statistics were used to describe PA on group and individual level. At median the 15 patients spent 81% (IQR 74%-85%) being sedentary. Patients were most sedentary in the evening (maximum sedentary bout length minutes of 69 (IQR 54-95)). During 54% (IQR 50%-61%) of the observations patients were alone) and in their room (median 50% (IQR 45%-59%)), but individual patterns varied widely. CONCLUSION/SIGNIFICANCE: The results of this study enable a deeper understanding of the daily PA patterns of patients admitted for inpatient rehabilitation treatment. PA patterns of patients differ in both quantity, day structure, social and environmental contexts. This supports the need for individualized strategies to support PA behavior during inpatient rehabilitation treatment.

Experiences of elderly and health professionals with interactive physical activity routes

Introduction - Life long sport and PA pleasure in an inclusive environment (Nationaal Sportakkoord, 2020) - Aging population (Loket Gezond Leven, 2024) - Physical activity in elderly (65+) 38% (Loket Gezond Leven, 2024) - Loneliness is limiting factor (Volksgezondheid en Zorg, 2024) - Save and inviting outer space, also for elderly

Ontwikkeling en implementatie van een geriatrisch revalidatieprogramma CO-FIT+

Validity of three accelerometers to investigate lying, sitting, standing and walking

BACKGROUND: Hospital stays are associated with high levels of sedentary behavior and physical inactivity. To objectively investigate physical behavior of hospitalized patients, these is a need for valid measurement instruments. The aim of this study was to assess the criterion validity of three accelerometers to measure lying, sitting, standing and walking. METHODS: This cross-sectional study was performed in a university hospital. Participants carried out several mobility tasks according to a structured protocol while wearing three accelerometers (ActiGraph GT9X Link, Activ8 Professional and Dynaport MoveMonitor). The participants were guided through the protocol by a test leader and were recorded on video to serve as reference. Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) were determined for the categories lying, sitting, standing and walking. RESULTS: In total 12 subjects were included with a mean age of 49.5 (SD 21.5) years and a mean body mass index of 23.8 kg/m2 (SD 2.4). The ActiGraph GT9X Link showed an excellent sensitivity (90%) and PPV (98%) for walking, but a poor sensitivity for sitting and standing (57% and 53%), and a poor PPV (43%) for sitting. The Activ8 Professional showed an excellent sensitivity for sitting and walking (95% and 93%), excellent PPV (98%) for walking, but no sensitivity (0%) and PPV (0%) for lying. The Dynaport MoveMonitor showed an excellent sensitivity for sitting (94%), excellent PPV for lying and walking (100% and 99%), but a poor sensitivity (13%) and PPV (19%) for standing. CONCLUSIONS: The validity outcomes for the categories lying, sitting, standing and walking vary between the investigated accelerometers. All three accelerometers scored good to excellent in identifying walking. None of the accelerometers were able to identify all categories validly.

Onderzoek naar de zelfredzaamheid bij brand van senioren die in een seniorencomplex wonen

In het eerste van de 2 onderzoeken in het kader van RUIT-4 (studiejaar 2015-2016) werd onderzocht in hoeverre er sprake is van zelfredzaamheid bij brand van ouderen die zelfstandig wonen in een seniorencomplex in het werkgebied van de Veiligheidsregio Utrecht (VRU). Met dit project is inzicht gekregen in het kennisniveau van zelfstandig wonende ouderen (65+) over brand, de mate waarin deze doelgroep ook daadwerkelijk preventie maatregelen heeft getroffen en de manier waarop we deze doelgroep het beste kunnen bereiken om het brandveiligheidsbewustzijn te vergroten. Tweedejaars studenten Integrale Veiligheidskunde hebben in groepjes van 4 studenten bewoners geïnterviewd. In totaal hebben 12 groepen 450 respondenten gesproken verdeeld over de 12 door Woonzorg Nederland toegewezen complexen. Hiervoor is gebruik gemaakt van een gestructureerde vragenlijst (mondelinge enquête). De informatie uit de vragenlijsten werd verwerkt met SPSS. Op de voorpagina staat vermeld: Integrale Veiligheid Praktijkonderzoek jaar 2