Het platform voor open en praktijkgericht onderzoek

product

ACL rupture is a single leg injury but a double leg problem: too much focus on 'symmetry' alone and that's not enough!

PDF

product

ACL rupture is a single leg injury but a double leg problem: too much focus on 'symmetry' alone and that's not enough!

PDF

product

Principles of motor learning to support neuroplasticity after ACL injury

Athletes who wish to resume high-level activities after an injury to the anterior cruciate ligament (ACL) are often advised to undergo surgical reconstruction. Nevertheless, ACL reconstruction (ACLR) does not equate to normal function of the knee or reduced risk of subsequent injuries. In fact, recent evidence has shown that only around half of post-ACLR patients can expect to return to competitive level of sports. A rising concern is the high rate of second ACL injuries, particularly in young athletes, with up to 20% of those returning to sport in the first year from surgery experiencing a second ACL rupture. Aside from the increased risk of second injury, patients after ACLR have an increased risk of developing early onset of osteoarthritis. Given the recent findings, it is imperative that rehabilitation after ACLR is scrutinized so the second injury preventative strategies can be optimized. Unfortunately, current ACLR rehabilitation programs may not be optimally effective in addressing deficits related to the initial injury and the subsequent surgical intervention. Motor learning to (re-)acquire motor skills and neuroplastic capacities are not sufficiently incorporated during traditional rehabilitation, attesting to the high re-injury rates. The purpose of this article is to present novel clinically integrated motor learning principles to support neuroplasticity that can improve patient functional performance and reduce the risk of second ACL injury. The following key concepts to enhance rehabilitation and prepare the patient for re-integration to sports after an ACL injury that is as safe as possible are presented: (1) external focus of attention, (2) implicit learning, (3) differential learning, (4) self-controlled learning and contextual interference. The novel motor learning principles presented in this manuscript may optimize future rehabilitation programs to reduce second ACL injury risk and early development of osteoarthritis by targeting changes in neural networks.

LINK

product

Principles of motor learning to support neuroplasticity after ACL injury

Athletes who wish to resume high-level activities after an injury to the anterior cruciate ligament (ACL) are often advised to undergo surgical reconstruction. Nevertheless, ACL reconstruction (ACLR) does not equate to normal function of the knee or reduced risk of subsequent injuries. In fact, recent evidence has shown that only around half of post-ACLR patients can expect to return to competitive level of sports. A rising concern is the high rate of second ACL injuries, particularly in young athletes, with up to 20% of those returning to sport in the first year from surgery experiencing a second ACL rupture. Aside from the increased risk of second injury, patients after ACLR have an increased risk of developing early onset of osteoarthritis. Given the recent findings, it is imperative that rehabilitation after ACLR is scrutinized so the second injury preventative strategies can be optimized. Unfortunately, current ACLR rehabilitation programs may not be optimally effective in addressing deficits related to the initial injury and the subsequent surgical intervention. Motor learning to (re-)acquire motor skills and neuroplastic capacities are not sufficiently incorporated during traditional rehabilitation, attesting to the high re-injury rates. The purpose of this article is to present novel clinically integrated motor learning principles to support neuroplasticity that can improve patient functional performance and reduce the risk of second ACL injury. The following key concepts to enhance rehabilitation and prepare the patient for re-integration to sports after an ACL injury that is as safe as possible are presented: (1) external focus of attention, (2) implicit learning, (3) differential learning, (4) self-controlled learning and contextual interference. The novel motor learning principles presented in this manuscript may optimize future rehabilitation programs to reduce second ACL injury risk and early development of osteoarthritis by targeting changes in neural networks.

LINK

product

Failurists – When Things go Awry

Failure is a popular topic of research. It has long been a source of study in fields such as sociology and anthropology, science and technology studies, privacy and surveillance, cultural, feminist and media studies, art, theatre, film, and political science. When things go awry, breakdown, or rupture they lead to valuable insights into the mundane mechanisms of social worlds. Yet, while failure is a familiar topic of research, failure in and as a tactic of research is far less visible, valued, and explored.In this book the authors reflect upon the role of creative interventions as a critical mode for methods, research techniques, fieldwork, and knowledge transmission or impact. Here, failure is considered a productive part of engaging with and in the field. It is about acknowledging the ‘mess’ of the social and how we need methods, modes of attunement, and knowledge translation that address this complexity in nuanced ways. In this collection, interdisciplinary researchers and practitioners share their practices, insights, and challenges around rethinking failure beyond normalized tropes. What does failure mean? What does it do? What does putting failure under the microscope do to our assumptions around ontology and epistemologies? How can it be deployed to challenge norms in a time of great uncertainty, crisis, and anxiety? And what are some of the ways resilience and failure are interrelated?

MULTIFILE

product

Failurists – When Things go Awry

Failure is a popular topic of research. It has long been a source of study in fields such as sociology and anthropology, science and technology studies, privacy and surveillance, cultural, feminist and media studies, art, theatre, film, and political science. When things go awry, breakdown, or rupture they lead to valuable insights into the mundane mechanisms of social worlds. Yet, while failure is a familiar topic of research, failure in and as a tactic of research is far less visible, valued, and explored.In this book the authors reflect upon the role of creative interventions as a critical mode for methods, research techniques, fieldwork, and knowledge transmission or impact. Here, failure is considered a productive part of engaging with and in the field. It is about acknowledging the ‘mess’ of the social and how we need methods, modes of attunement, and knowledge translation that address this complexity in nuanced ways. In this collection, interdisciplinary researchers and practitioners share their practices, insights, and challenges around rethinking failure beyond normalized tropes. What does failure mean? What does it do? What does putting failure under the microscope do to our assumptions around ontology and epistemologies? How can it be deployed to challenge norms in a time of great uncertainty, crisis, and anxiety? And what are some of the ways resilience and failure are interrelated?

MULTIFILE

product

Regional variations in childbirth interventions and their correlations with adverse outcomes, birthplace and care provider

Background Variations in childbirth interventions may indicate inappropriate use. Most variation studies are limited by the lack of adjustments for maternal characteristics and do not investigate variations in adverse outcomes. This study aims to explore regional variations in the Netherlands and their correlations with referral rates, birthplace, interventions, and adverse outcomes, adjusted for maternal characteristics. Methods In this nationwide retrospective cohort study, using a national data register, intervention rates were analysed between twelve regions among single childbirths after 37 weeks’ gestation in 2010–2013 (n = 614,730). These were adjusted for maternal characteristics using multivariable logistic regression. Primary outcomes were intrapartum referral, birthplace, and interventions used in midwife- and obstetrician-led care. Correlations both between primary outcomes and between adverse outcomes were calculated with Spearman’s rank correlations. Findings Intrapartum referral rates varied between 55–68% (nulliparous) and 20–32% (multiparous women), with a negative correlation with receiving midwife-led care at the onset of labour in two-thirds of the regions. Regions with higher referral rates had higher rates of severe postpartum haemorrhages. Rates of home birth varied between 6–16% (nulliparous) and 16–31% (multiparous), and was negatively correlated with episiotomy and postpartum oxytocin rates. Among midwife-led births, episiotomy rates varied between 14–42% (nulliparous) and 3–13% (multiparous) and in obstetrician-led births from 46–67% and 14–28% respectively. Rates of postpartum oxytocin varied between 59–88% (nulliparous) and 50–85% (multiparous) and artificial rupture of membranes between 43–52% and 54–61% respectively. A north-south gradient was visible with regard to birthplace, episiotomy, and oxytocin. Conclusions Our study suggests that attitudes towards interventions vary, independent of maternal characteristics. Care providers and policy makers need to be aware of reducing unwarranted variation in birthplace, episiotomy and the postpartum use of oxytocin. Further research is needed to identify explanations and explore ways to reduce unwarranted intervention rates.

PDF

product

Regional variations in childbirth interventions and their correlations with adverse outcomes, birthplace and care provider

Background Variations in childbirth interventions may indicate inappropriate use. Most variation studies are limited by the lack of adjustments for maternal characteristics and do not investigate variations in adverse outcomes. This study aims to explore regional variations in the Netherlands and their correlations with referral rates, birthplace, interventions, and adverse outcomes, adjusted for maternal characteristics. Methods In this nationwide retrospective cohort study, using a national data register, intervention rates were analysed between twelve regions among single childbirths after 37 weeks’ gestation in 2010–2013 (n = 614,730). These were adjusted for maternal characteristics using multivariable logistic regression. Primary outcomes were intrapartum referral, birthplace, and interventions used in midwife- and obstetrician-led care. Correlations both between primary outcomes and between adverse outcomes were calculated with Spearman’s rank correlations. Findings Intrapartum referral rates varied between 55–68% (nulliparous) and 20–32% (multiparous women), with a negative correlation with receiving midwife-led care at the onset of labour in two-thirds of the regions. Regions with higher referral rates had higher rates of severe postpartum haemorrhages. Rates of home birth varied between 6–16% (nulliparous) and 16–31% (multiparous), and was negatively correlated with episiotomy and postpartum oxytocin rates. Among midwife-led births, episiotomy rates varied between 14–42% (nulliparous) and 3–13% (multiparous) and in obstetrician-led births from 46–67% and 14–28% respectively. Rates of postpartum oxytocin varied between 59–88% (nulliparous) and 50–85% (multiparous) and artificial rupture of membranes between 43–52% and 54–61% respectively. A north-south gradient was visible with regard to birthplace, episiotomy, and oxytocin. Conclusions Our study suggests that attitudes towards interventions vary, independent of maternal characteristics. Care providers and policy makers need to be aware of reducing unwarranted variation in birthplace, episiotomy and the postpartum use of oxytocin. Further research is needed to identify explanations and explore ways to reduce unwarranted intervention rates.

PDF

product

Objective parameters to measure (in)stability of the knee joint during gait

BACKGROUND: Instability of the knee joint during gait is frequently reported by patients with knee osteoarthritis or an anterior cruciate ligament rupture. The assessment of instability in clinical practice and clinical research studies mainly relies on self-reporting. Alternatively, parameters measured with gait analysis have been explored as suitable objective indicators of dynamic knee (in)stability.RESEARCH QUESTION: This literature review aimed to establish an inventory of objective parameters of knee stability during gait.METHODS: Five electronic databases (Pubmed, Embase, Cochrane, Cinahl and SPORTDiscuss) were systematically searched, with keywords concerning knee, stability and gait. Eligible studies used an objective parameter(s) to assess knee (in)stability during gait, being stated in the introduction or methods section. Out of 10717 studies, 89 studies were considered eligible.RESULTS: Fourteen different patient populations were investigated with kinematic, kinetic and/or electromyography measurements during (challenged) gait. Thirty-three possible objective parameters were identified for knee stability, of which the majority was based on kinematic (14 parameters) or electromyography (12 parameters) measurements. Thirty-nine studies used challenged gait (i.e. external perturbations, downhill walking) to provoke knee joint instability. Limited or conflicting results were reported on the validity of the 33 parameters.SIGNIFICANCE: In conclusion, a large number of different candidates for an objective knee stability gait parameter were found in literature, all without compelling evidence. A clear conceptual definition for dynamic knee joint stability is lacking, for which we suggest : "The capacity to respond to a challenge during gait within the natural boundaries of the knee". Furthermore biomechanical gait laboratory protocols should be harmonized, to enable future developments on clinically relevant measure(s) of knee stability during gait.

LINK

Zoekresultaten

Producten 182

ACL rupture is a single leg injury but a double leg problem: too much focus on 'symmetry' alone and that's not enough!

ACL rupture is a single leg injury but a double leg problem: too much focus on 'symmetry' alone and that's not enough!

Principles of motor learning to support neuroplasticity after ACL injury

Principles of motor learning to support neuroplasticity after ACL injury

Failurists – When Things go Awry

Failurists – When Things go Awry

Regional variations in childbirth interventions and their correlations with adverse outcomes, birthplace and care provider

Regional variations in childbirth interventions and their correlations with adverse outcomes, birthplace and care provider

Objective parameters to measure (in)stability of the knee joint during gait

Projecten 1

De patiënt (weer) in zijn kracht: Revalidatie op maat door zelf-monitoring van herstel bij een orthopedische aandoening

Navigeer naar

Categorieën

Filters

Producten 182

ACL rupture is a single leg injury but a double leg problem: too much focus on 'symmetry' alone and that's not enough!

ACL rupture is a single leg injury but a double leg problem: too much focus on 'symmetry' alone and that's not enough!

Principles of motor learning to support neuroplasticity after ACL injury

Principles of motor learning to support neuroplasticity after ACL injury

Failurists – When Things go Awry

Failurists – When Things go Awry

Regional variations in childbirth interventions and their correlations with adverse outcomes, birthplace and care provider

Regional variations in childbirth interventions and their correlations with adverse outcomes, birthplace and care provider

Objective parameters to measure (in)stability of the knee joint during gait

Projecten 1

De patiënt (weer) in zijn kracht: Revalidatie op maat door zelf-monitoring van herstel bij een orthopedische aandoening