Background: Computer-based cognitive rehabilitation is used to improve cognitive functioning after stroke. However, knowledge on adherence rates of stroke patients is limited. Objective: To describe stroke patients’ adherence with a brain training program using two frequencies of health professionals’ supervision. Methods: This study is part of a randomized controlled trial comparing the effect of the brain training program (600 min playtime with weekly supervision) with a passive intervention in patients with self-perceived cognitive impairments after stroke. Patients randomized to the control condition were offered the brain training after the trial and received supervision twice (vs weekly in intervention group). Adherence was determined using data from the study website. Logistic regression analyses were used to examine the impact of supervision on adherence. Results: 53 patients allocated to the intervention group (group S8; 64% male, mean age 59) and 52 patients who were offered the intervention after the trial (group S2; 59% male, mean age 59) started the brain training. The median playtime was 562 min (range 63–1264) in group S8 vs. 193 min (range 27–2162) in group S2 (p < 0.001, Mann Whitney U). Conclusions: The overall adherence of stroke patients with a brain training was low and there are some implications that systematic, regular interaction with a supervisor can increase training adherence of stroke patients with a restitution-focused intervention performed at home. “This is an Accepted Manuscript of an article published by Taylor & Francis in "Topics in Stroke Rehabilitation" on 04/17/18, available online: https://doi.org/10.1080/10749357.2018.1459362. LinkedIn: https://www.linkedin.com/in/joritmeesters/ https://www.linkedin.com/in/moniqueberger/ https://www.linkedin.com/in/arend-de-kloet-4329102/
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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.
Introduction Around 25% of metastatic breast cancer (mBC) patients develop brain metastases, which vastly affects their overall survival and quality of life. According to the current clinical guidelines, regular magnetic resonance imaging screening is not recommended unless patients have recognized central nervous system-related symptoms. Patient Presentation The patient participated in the EFFECT study, a randomized controlled trial aimed to assess the effects of a 9-month structured, individualized and supervised exercise intervention on quality of life, fatigue and other cancer and treatment-related side effects in patients with mBC. She attended the training sessions regularly and was supervised by the same trainer throughout the exercise program. In month 7 of participation, her exercise trainer detected subtle symptoms (e.g., changes in movement pattern, eye movement or balance), which had not been noticed or reported by the patient herself or her family, and which were unlikely to have been detected by the oncologist or other health care providers at that point since symptoms were exercise related. When suspicion of brain metastases was brought to the attention of the oncologist by the exercise trainer, the response was immediate, and led to early detection and treatment of brain metastases. Conclusion and clinical implications The brain metastases of this patient were detected earlier due to the recognition of subtle symptoms detected by her exercise trainer and the trust and rapid action by the clinician. The implementation of physical exercise programs for cancer patients requires well-trained professionals who know how to recognize possible alterations in patients and also, good communication between trainers and the medical team to enable the necessary actions to be taken.
Fontys begeleidt een groep van 15 studenten tijdens hun afstuderen bij een MKB bedrijf intensiever dan gebruikelijk, opdat zij hun afstudeerstage met perspectiefrijke onderzoekstrajecten bij deze bedrijven kunnen vervolgen. Fontys begeleidt deze onderzoekstrajecten vakinhoudelijk, maar werkt met de bedrijven en studenten tevens aan de inhoudelijke verdieping en algemene vorming. Hiervoor werkt Fontys in deze pilot een traineeprogramma uit, alsook een werkwijze om studenten en bedrijven te verbinden. Een zorgvuldig ontworpen monitoring van de aanpak en resultaten zorgt voor tijdig bijsturen en een treffende evaluatie na afloop. Het Traineeprogramma richt zich op technologische MKB bedrijven in de Brainport regio. Zij vormen belangrijke schakels in de toeleverketens naar grote wereldmarktspelers als ASML, VDL en Philips. Vaak zijn zij ook zelfstandig actief aan de grenzen van de technische mogelijkheden. Sleuteltechnologieën als fotonica en fabrication technologies worden in hoog tempo omarmd om de wereldwijde concurrentie aan te kunnen. MKB bedrijven ontwikkelen mee aan de producten en diensten waardoor zij eveneens deze technologieën moeten beheersen. Maar, door de kleinere schaalgrootte ontbeert het vaak aan kennis en capaciteit. Deze pilot biedt mogelijk oplossingen voor beide. Met deze pilot beogen we innovatie in het MKB te bevorderen. Docent-onderzoekers van Fontys komen via de trajecten in direct inhoudelijk contact met de bedrijven en hun technologische uitdagingen. De bedrijven vormen met Fontys en de afgestudeerden een ‘learning community’ die op de high tech onderwerpen verdiepende kennis deelt en genereert. Deze community bestendigt de relatie met de hogeschool, maar heeft ook de potentie om zich na afloop te blijven ontwikkelen. Het Fontys Centre of Expertise HTSM is opgericht om bedrijfsleven en de hogeschool te verbinden. Het CoE verzorgt de werving en matching, regisseert het traineeprogramma en verbindt de onderzoekslijnen aan de actuele thema’s in de trainee-bedrijven. Daarmee versterkt het CoE eveneens haar eigen rol in de Brainport Regio.
