Purpose: Physical interventions during subacute rehabilitation have potential to improve functional recovery. This study explored the perspectives of children and adolescents with acquired brain injury (ABI) and their parents with respect to physical rehabilitation during the subacute phase. Methods: Thirteen children and adolescents with ABI and their parents were included and interviewed using semi-structured interviews. Interview transcripts were analysed using inductive thematic analysis approach. Results: Six themes were identified: 1) beliefs of physical rehabilitation, 2) content of physical rehabilitation, 3) tailored care, 4) impact of context, 5) communication and 6) transition. The importance of intensive physical practice was widely supported. The positive can-do mentality was emphasised to create an atmosphere of hope, meaning that every effort would be made to achieve maximum recovery. Intensive involvement of parents is considered essential during subacute rehabilitation including an open and mutual dialogue about the focus of rehabilitation, therapy goals and future participation in their own environment. Conclusions: Our findings highlight the need for an intensive rehabilitation approach, tailored to the individual’s needs. The perspectives of children and adolescents and their parents in our study contribute to a better understanding of factors that are important for optimal recovery through physical rehabilitation during the subacute phase.
De incidentie van niet aangeboren hersenletsel (NAH) bij personen in de leeftijd tot 25 jaar in Nederland is aanzienlijk, met ca. 18.000 nieuwe gevallen per jaar. Kinderen en jongeren met NAH hebben naast fysieke, cognitieve en emotionele beperkingen, een significant lager niveau van sociale participatie dan hun gezonde leeftijdgenoten. Het gebruik van de Nintendo Wii, een spelcomputer die bewegingen op natuurlijke en intuïtieve wijze uitlokt, lijkt mogelijkheden te bieden om contacten met anderen en actieve vrijetijdsbesteding bij jongeren met NAH te stimuleren. In deze studie wordt onderzocht wat het effect is van het gebruik van de Nintendo Wii bij kinderen en jongeren met NAH op fysiek, cognitief en sociaal functioneren. Om dit te onderzoeken is een multicenter, observationele pilotstudie verricht, bij 50 kinderen en jongeren met NAH in de leeftijd van 6-29 jaar die onder controle of behandeling zijn van een revalidatiearts. De interventie, van in totaal 12 weken, startte met 2 trainingssessies van 60 minuten, waarbij de toe te passen games werden gekozen passend bij zelf gekozen behandeldoelen (te verbeteren functies of activiteiten) en uitvoerbaar gezien de individuele beperkingen van de deelnemer. Vervolgens werd er minimaal 2 keer in de week gegamed. Er was wekelijks contact met een therapeut per telefoon of e-mail. De effectmetingen (vragenlijsten en een neuropsychologische test) werden verricht aan het begin en einde van de interventie en betroffen het fysiek, cognitief en sociaal functioneren. De statistische analyse bestond uit vergelijkingen van de uitkomstmaten tussen 0 en 12 weken met behulp van gepaarde t-toetsen, Wilcoxon-Signed-Rank tests en chi-kwadraat toetsen. Deze eerste pilotstudie naar de effecten van het gamen met de Nintendo Wii bij jongeren met NAH laat significante verbetering zien op het fysiek en cognitief functioneren, en niet op het sociaal functioneren. Deze resultaten zijn aanleiding om de effectiviteit van de Nintendo Wii in deze patiëntengroep in een grotere, gecontroleerde studie verder te onder ABSTRACT Aim: To explore the effects of usage of the Nintendo Wii on physical, cognitive and social functioning in patients with acquired brain injury (ABI). Methods: This multicenter, observational proof-of-concept study included children, adolescents and young adults with ABI aged 6-29 years. A standardized, yet individually tailored 12-week intervention with the Nintendo Wii was delivered by trained instructors. The treatment goals were set on an individual basis and included targets regarding physical, mental and/or social functioning. Outcome assessments were done at baseline and after 12 weeks, and included: the average number of minutes per week of recreational physical activity; the CAPE (Children's Assessment of Participation and Enjoyment); the ANT (Amsterdam Neuropsychological Tasks); the achievement of individual treatment goals (Goal Attainment Scaling); and quality of life (PedsQL; Pediatric Quality of Life Inventory). Statistical analyses included paired t-tests or Wilcoxon-Signed-Rank tests. Results: 50 patients were included, (31 boys and 19 girls; mean age 17.1 years (SD 4.4)), of whom 45 (90%) completed the study. Significant changes of the amount of physical activity, speed of information processing, attention, response inhibition and visual-motor coordination (p<0.05) were seen after 12 weeks, whereas there were no differences in CAPE or PedsQL scores. Two-thirds of the patients reported an improvement of the main treatment goal. Conclusion: This study supports the potential benefits of gaming in children and youth with ABI.
This research aims to obtain more insight in the perception of fabric drape and how fabric drape can be cat-egorized With the current 3D virtual technologies to simulate garments the fashion and clothing industry can speed up work processes, improve accuracy and reduce material consumption in fit, design and sales. Although the interest in 3D technology is increasing, the implementation on a large scale emerges only slowly. At the threshold between physical and virtual fitting the fashion industry faces new challenges and demands re-quiring responses out of rule. The measurement of fabric drape started in the first half of the previous cen-tury, after the introduction of 3D garment simulation fabric drape gained interest from more researchers to obtain information for the virtual drape. Intensive research has been undertaken to define ‘fabric hand’, however, research is limited for the definition of fabric drape. Better understanding of how fabrics drape and how they can be selected based on their drape might contribute to the understanding of the virtually as-sessed material and accelerate the selection process of virtually, as well as digitally presented fabrics. For this research the drape coefficient of 13 fabrics, selected based on their drape, was measured with the Cusick drape tester. Images and videos of the fabrics draped on pedestals were presented to an expert tex-tile panel who were asked to define the fabric drape. From these definitions categories, as well as identifying key-words, were derived. During a group session the expert panel evaluated the drape categories and identi-fying key-words. In the next phase an expert user panel, familiar with the assessment of fabrics in a virtual environment, assessed the appropriateness of the categories and identifying key-words which were present-ed along with the fabric drape images and videos. Moreover, both panels judged the stiffness and amount of drape, next to that they indicated similar draping fabrics. The relation between the subjective assessment of drape and the drape coefficient was investigated. The agreement of the user panel with the drape categories defined and evaluated by the textile panel was high. Further, the agreement of the majority of the user panel with the identifying key-words was above 78%. A strong relation was found between the measured drape coefficient and the subjectively assessed stiffness and amount of drape. Additionally, the analysis of the fabrics combined by the panels based on drape simi-larity, as well as the analysis of the drape coefficients, confirms with previous research, that significantly dif-ferent fabrics can have a similar drape. Fabrics can be divided in drape categories based on the way they drape, and the identifying key-words are useful to distinguish between significantly different fabrics with similar fabric drape. Moreover, the cate-gories are related to the drape coefficient.
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