Zoekresultaten

Do clinical assessments, steady-state or daily-life gait characteristics predict falls in ambulatory chronic stroke survivors?

Objective: This exploratory study investigated to what extent gait characteristics and clinical physical therapy assessments predict falls in chronic stroke survivors. Design: Prospective study. Subjects: Chronic fall-prone and non-fall-prone stroke survivors. Methods: Steady-state gait characteristics were collected from 40 participants while walking on a treadmill with motion capture of spatio-temporal, variability, and stability measures. An accelerometer was used to collect daily-life gait characteristics during 7 days. Six physical and psychological assessments were administered. Fall events were determined using a “fall calendar” and monthly phone calls over a 6-month period. After data reduction through principal component analysis, the predictive capacity of each method was determined by logistic regression. Results: Thirty-eight percent of the participants were classified as fallers. Laboratory-based and daily-life gait characteristics predicted falls acceptably well, with an area under the curve of, 0.73 and 0.72, respectively, while fall predictions from clinical assessments were limited (0.64). Conclusion: Independent of the type of gait assessment, qualitative gait characteristics are better fall predictors than clinical assessments. Clinicians should therefore consider gait analyses as an alternative for identifying fall-prone stroke survivors.

Combining accelerometry and GPS to assess neighborhood-based physical activity

This study explored associations between perceived neighborhood walkability and neighborhood-based physical activity (NB-PA) and assessed possible moderation effects of the amount of time spent in the home neighborhood and individual characteristics (i.e., educational level and health-related problems). In 2016 to 2017, 509 Dutch adults, living in the South Limburg area, were included. Context-specific PA levels were measured using the Actigraph GT3X+ accelerometer and the Qstarz BTQ1000XT GPS-logger. Perceived neighborhood walkability, level of education, work status, and health-related quality of life were measured with validated self-report instruments. Results showed that individuals with a lower level of education or health-related problems spent more time in the home neighborhood. The perceived neighborhood walkability only affected NB-PA for individuals spending a relatively large amount of time in their home neighborhood. PA-facilitating features in the home neighborhood, for example, aesthetics, were only associated with more NB-PA for individuals without health-related problems or with a higher level of education.

Deep learning to predict falls in older adults based on daily-life trunk accelerometry

Een leven lang bewegen

Lectorale rede van Dave van Kann gehouden ter gelegenheid van zijn inauguratie als lector ‘Leren Bewegen in en rondom de School’ bij Lectoraat Move to Be van Fontys Sporthogeschool. Dave geeft in zijn rede aan op welke directe thematische focus hij zich in het bijzonder zal gaan richten in zijn lectorschap (de themalijnen Leren Bewegen en Beweegvriendelijke Omgeving). In lijn met de lectoraatsprojecten en -ambities geeft Dave zijn zienswijze op de thematiek ‘Leren Bewegen in en rondom de School’ weer en houd hij een pleidooi om in gezamenlijkheid met alle betrokkenen de komende jaren te werken aan een actieve generatie waarin bewegen meer vanzelfsprekend is en voor iedereen mogelijk.

Active Living: development and quasi-experimental evaluation of a school-centered physical activity intervention for primary school children

Background: The worldwide increase in the rates of childhood overweight and physical inactivity requires successful prevention and intervention programs for children. The aim of the Active Living project is to increase physical activity and decrease sedentary behavior of Dutch primary school children by developing and implementing tailored, multicomponent interventions at and around schools. Methods/design: In this project, school-centered interventions have been developed at 10 schools in the south of the Netherlands, using a combined top-down and bottom-up approach in which a research unit and a practice unit continuously interact. The interventions consist of a combination of physical and social interventions tailored to local needs of intervention schools. The process and short- and long-term effectiveness of the interventions will be evaluated using a quasi-experimental study design in which 10 intervention schools are matched with 10 control schools. Baseline and follow-up measurements (after 12 and 24 months) have been conducted in grades 6 and 7 and included accelerometry, GPS, and questionnaires. Primary outcome of the Active Living study is the change in physical activity levels, i.e. sedentary behavior (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and counts-per-minute (CPM). Multilevel regression analyses will be used to assess the effectiveness of isolated and combined physical and social interventions on children’s PA levels. Discussion: The current intervention study is unique in its combined approach of physical and social environmental PA interventions both at school(yard)s as well as in the local neighborhood around the schools. The strength of the study lies in the quasi-experimental design including objective measurement techniques, i.e. accelerometry and GPS, combined with more subjective techniques, i.e. questionnaires, implementation logbooks, and neighborhood observations. LinkedIn: https://www.linkedin.com/in/sanned/

Validation of the actical and actiheart monitor in ambulatory children with spina bifida

BACKGROUND: Ambulatory children with Spina Bifida (SB) often show a decline in physical activity leading to deconditioning and functional decline. Therefore, assessment and promotion of physical activity is important. Because energy expenditure during activities is higher in these children, the use of existing pediatric equations to predict physical activity energy expenditure (PAEE) may not be valid. AIMS: (1) To evaluate criterion validity of existing predictions converting accelerocounts into PAEE in ambulatory children with SB and (2) to establish new disease-specific equations for PAEE. METHODS: Simultaneous measurements using the Actical, the Actiheart, and indirect calorimetry took place to determine PAEE in 26 ambulatory children with SB. DATA ANALYSIS: Paired T-tests, Intra-class correlations limits of agreement (LoA), and explained variance (R2) were used to analyze validity of the prediction equations using true PAEE as criterion. New equations were derived using regression techniques. RESULTS: While T-tests showed no significant differences for some models, the predictions developed in healthy children showed moderate ICC’s and large LoA with true PAEE. The best regression models to predict PAEE were: PAEE = 174.049 + 3.861 × HRAR – 60.285 × ambulatory status (R2 = 0.720) and PAEE = 220.484 + 0.67 × Actical counts – 60.717 × ambulatory status (R2 = 0.681). CONCLUSIONS: Existing equations to predict PAEE are not valid for use in children with SB for the individual evaluation of PAEE. The best regression model was based on HRAR in combination with ambulatory status, followed by a new model for the Actical monitor. A benefit of HRAR is that it does not require the use of expensive accelerometry equipment. Further cross-validation of these models is still needed.