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Projects 2014

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Name of project: 2beActive
Research question: Is a multidisciplinary programme with multiple modules more cost-effective than a graded activity programme for young people with chronic pain?

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Name of project: AMUSE: Activity Monitoring of Upper extremity use in Stroke patients during and after rehabilitation
Research question:

  1. To what extent do arm hand function (AHF) and arm-hand skill performance (AHSP) in stroke patients change during and after their clinical rehabilitation?
  2. To what extent does the rate of improvement or deterioration in arm-hand function and arm hand skill performance differ between 3 subgroups of stroke patients, i.e. the low, intermediate and high functional AHF group?
  3. Which patient characteristics are associated with either improvement or decline in actual arm-hand use during and after rehabilitation training?
  4. How does actual arm-hand use correlate to measures of AHF, AHSP, perceived functional health status, and perceived quality of life?
  5. To what extent does improvement in AHF and AHSP during clinical rehabilitation predict functional outcome at 12 months post-clinic?

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Name of project: Arm-hand strength in children with a disability
Research question: An investigation is being carried out into the reproducibility of isometric muscle strength tests in the upper extremity in children with cerebral palsy (CP).

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Name of project: Back on Track, chronic low back pain rehabilitation in primary care
Research question:

  1. What is the difference in cost-effectiveness between a new primary care bio-psychosocial treatment programme (Back on Track) and mainstream community-based physiotherapy amongst patients with aspecific chronic low back pain, whereby psychosocial factors play a minimum influential role in daily functioning (WPN2 classification)?
  2. Can the new primary-care bio-psychosocial treatment programme (Back on Track) be applied and be effective in reducing the functional disability level in patients with aspecific chronic low back pain whereby psychosocial factors play a moderately influential role in daily functioning and normally treated in secondary care (WPN3 classification)?

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Name of project: Brain markers for chronic pain
Research question:
Study 1: What are the distinguishing brain markers for chronic pain?
Study 2: Can the brain markers for anxiety and chronic pain be differentiated?
Study 3: Are there brain markers that can predict the success of Graded Exposure in Vivo?

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Name of project: COndensed client-centred Modular Spinal cord rehabilitation Service (CoMoSS)
Research question: The aim of this project is to assess the effects on functional health status, quality of life, satisfaction of care, level of participation, and cost effectiveness of a compact patient-oriented modular rehabilitation program for persons with spinal cord injury on the basis of a cohort study.

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Name of project: Development of an instrument to objectively quantify the quality of (impaired) arm-hand skilled performance in patients with central nervous system deficits (DOQUS)
Description: An accurate estimation or prediction of skilled arm-hand function outcome as early as possible during the rehabilitation phase is important for both the patient and the rehabilitation team. At the moment, reliable and valid tests to objectively quantify the quality of arm and hand skill performance (i.e. at activity level) are still lacking. This project focuses on the development of a new actual performance measure.

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Name of project: Effectiveness and cost-effectiveness of Motivational interviewing in the outpatient rehabilitation setting in non-specific chronic pain syndrome
Description: The primary aim of this project is to improve functioning, the quality of life of patients, satisfaction with the treatment and drop-out of patients with non-specific chronic pain syndrome who are eligible for rehabilitation treatment. As a result of the intervention, on the basis of motivational interviewing, optimum expectations with respect to pain rehabilitation will be created. Cost-effectiveness will also be assessed.

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Name of project: Evaluation of a dynamic hand orthosis, Saeboflex, for persons with a cervical spine injury
Description: The aim of the study is to optimise hand/arm skills training through integration of the SAEBOFLEX within the exiting arm and hand treatment programme. Persons with a cervical spinal cord injury are trained to widen the scope of possibilities available in their ADL.

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Name of project: Evaluation of the use of a functional hand orthosis for persons with a seriously restricted -hand function in a sub-acute stage after a CVA.
Research question:

  • To what extent can the SAEBOglove be used in the existing CARAS arm-hand training programme for persons with a UAT score of 2?
  • To what degree can possible improvements in arm-hand function, arm-hand skills and actual arm-hand use be achieved in persons in the sub-acute phase following a CVA with a arm-hand function level of UAT-2, who have followed 6 weeks of training with the SAEBOglove on top of the existing CARAS arm-hand training programme?

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Name of project: Exercise programmes for chronic pain
Research question:

  1. to develop the KNGF’s standard exercise programme for chronic pain and to model it in such a way that the information is provided to physiotherapists which is based on the latest available evidence.
  2. to formulate the KNGF’s standard exercise programme for chronic pain and, in a multidisciplinary manner, ensure that this fits in or is made compatible with the multidisciplinary guidelines for chronic pain.

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Name of project: FatiGo, Is multidisciplinary rehabilitation treatment more effective than mono-disciplinary cognitive behavioural therapy for patients with chronic fatigue syndrome?
Research question: Which treatment (cognitive behavioural therapy or multidisciplinary rehabilitation therapy) is the most effective (in terms of change in perceived fatigue and quality of life) and the most cost-effective for patients with a chronic fatigue syndrome?

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Name of project: Hypermobility: a reason for reduced functioning in adolescence?
Research question: What is the influence of hypermobility on the physical functioning in the adolescent phase (12-21 years)?

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Name of project: Individualised Technology and Robot-Assisted Virtual Learning Environment (I-TRAVLE)  www.i-travle.eu
Research question: To what extent (order of magnitude) does an intensive 6-week training regime, supported by a personalised and self-regulating training system, based on robotics, sensor technology and virtual training contexts (I-Travle), lead to an improvement in arm-hand functioning and arm-hand skills in persons with a low or moderate proximal shoulder or arm muscle strength as a result of MS or a CVA?

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Name of project: Level of daily functioning and participation after hand injury and its determinants
Research question:
The main research questions are:

  1. To what extent are both arm-hand skill performance and participation limited in patients with a traumatic hand injury six months after conventional hand rehabilitation treatment for the injury has finished, relative to matched non-injured controls?
  2. A. Which prognostic factors are associated with (limitations in) both arm-hand skill performance and participation in patients with a traumatic hand injury six months after conventional hand rehabilitation treatment for the injury has finished?
    B. Which patients with a traumatic hand injury lag behind expected outcome levels, despite having received conventional hand rehabilitation treatment and can be called poor-performers?
  3. Does a more functional therapy regime also addressing factors related to poor performers, adjunct to conventional hand rehabilitation treatment further improve both arm-hand skill performance and participation in poor-performers?

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Name of project: Mini-BIMT
Project coordinator: Y. Janssen-Potten
Project group: Y. Janssen, E. Rameckers
Period: 2014-2015
Collaboration and participating institutes: Primary health-care practices
Research question: The aim of the current project is to set up a treatment protocol for children with a spastic unilateral hand disorder in the age group from 6 months to 4 years with the aim of encouraging – together with the parents - use of the affected hand in the home situation in order to bring about an improvement in the motor system.

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Name of project: Multidisciplinary treatment of chronic pain and the added value of spiritual care

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Name of project: Optimal pre-surgical management for persons who undergo spinal fusion surgery – Incorporating an evidence based rehabilitation approach in a randomized Controlled Clinical Trail.
Research aim: The overall purpose of the study is to investigate if cognitive behavioral therapy (CBT), with a focus on reducing fear and psychological distress before surgery, will improve functioning and health-related quality of life more after surgery for degenerative spinal disorders as compared to usual care.

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Name of project: PACT: Patient Centred Tele-rehabilitation Phantom Limb Pain
Research aim: The objective of this PhD project is to develop patient-centred tele-rehabilitation for persons with a phantom pain after the amputation of a lower extremity and the evaluation of the practicability, technical performance and cost-effectiveness of the system.

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Name of project: Participation of young people with chronic pain and fatigue
Research question: What are the predictive factors for young persons with chronic pain and/or fatigue for a positive treatment result and in the long term? What are the measuring instruments for school participation and in what way can the concept of school participation (internationally) be defined?

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Name of project: Participation of children with a physical disability: Parents’ actions, challenges, and needs from a Family-centred service perspective
Research questions: What are the support needs of parents (and how many of them are there) to further the participation of their children, and how do the characteristics of the family and of the child relate to these needs? What are the top 5 support needs per category?

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Name of project: Patient-specific measurement in health-care
Description: The aim of this study is to identify, to improve and to assess the sustainability and the use of personalised measuring instruments by paramedics in community care in order to ultimately advance patient-focused ways of working.

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Name of project: Physical activity in patients with low back pain
Research aim: Objective identification of reliable, valid and sensitive aspects of movement patterns in a group of patients with chronic low-back pain.

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Name of project: Physiotherapist-led stress inoculation intervention integrated with exercise for acute whiplash injury
Research question: Is Stress Inoculation Training (SIT) integrated with standard physiotherapy exercise and delivered by physiotherapists more effective than physiotherapy exercise alone in reducing neck pain disability in individuals with acute WAD?

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Name of project: Plasticity, motor learning and functional recovery induced by task-oriented learning of arm and hand for persons with Tetraplegia: a pilot study
Research question:

  1. What basic neural mechanisms of motor learning targeting brain plasticity, in terms of changes in cortical activity, and targeting motor control, in terms of kinematics, take place during client-centred, task-oriented training of the upper limb?
  2. What are the effects of task specificity, i.e. ‘constant practice’ in contrast to ‘practice variability’, within client-centred task-oriented training a) on the level of arm hand skilled performance (including task-specific and transfer effects) and body function (including kinematics) after training? b) on basic neural mechanisms targeting brain plasticity in terms of changes in cortical activity after training?

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Name of project: PRESTO: Prevention study on physical complaints in conservatory students.
Research question: Is a prevention programme targeting conservatory students (cost-)effective in reducing pain in the musculoskeletal system?

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Name of project: PROMETHEUS: PROtocol for paraMEdical THerapy and Evaluation of fractUreS
Research question: What is the feasibility of implementing the PROMETHEUS protocol in the complex farcture care chain?

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Name of project: PROMIS
Research question: Are the Dutch-language PROMIS item banks ‘Ability to Participate in Social Roles and Activities’ and ‘Satisfaction with Social Roles and Activities’ valid measuring instruments for measuring the participation of the various target groups?

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Name of project: REMOVE
Description: The study compares two treatments for CRPS-I: 
graded exposure in vivo or standardised physiotherapy. Primary outcome measurements are the self-reported limitations, secondary outcome measurements are pain-related anxiety, pain and quality of life. In addition, participants wear an actimeter for every measurement over a period of 10 days. Cost-effectiveness will also be identified.

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Name of project: See moving, makes you move; development of graded exposure group training for chronic low back pain.
Research question: Based on the idea that anxiety can play a crucial role in the perpetuation of a chronic pain syndrome, gradual in vivo exposure is used on patients with a pain-related fear. Gradual in vivo exposure means that the patient is given steady exposure to the ‘dreaded’ exercise.

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Name of project: ‘Supported Fast Track Trauma Rehabilitation Service’ towards implementation.
Description: The aim of this project is to develop aids for rehabilitation teams both in hospitals and in rehabilitation clinics who are involved in the rehabilitation of trauma patients. These aids will enable the parties referred to in the implementation of the ‘Supported Fast Track Trauma Rehabilitation Service’ without causing too much difficulty.
The implementation of a pilot-study, in which aids, training sessions, workshops, instructional material and indicator sets will be tested in two trauma regions, the results of which will be enshrined in an implementation plan.

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Name of project: Therapeutic toys
Project coordinator: Rameckers E.
Project group: E. Rameckers, R. Smeets
Period: 2014 - 2015
Collaboration and participating institutes: Noosdesign
Research question: Development of toys for children with an arm impairment which can be used on a therapeutic basis at home and in the centre to train specific skills with respect to precision, speed and strength.

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Name of project: TOAST-CP
Research question: Does functional strength training for the upper extremity have an effect on strength and on performing daily activities?

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Name of project: Upper extremity strength in children and young persons with and without unilateral Cerebral Palsy
Research question: What is the reproducibility of the isometric muscle strength measurements taken with the HHD/E-link/functional muscle strength tests in children with and without CP in the 7-to-18 age group?  What are the standard values of the isometric muscle strength measurements taken with the HHD/E-link/functional muscle strength tests in children with a “normal development” with and without CP in the 7-to-18 age group?

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Name of project: Unravelling the deconditioning paradigm 
Research question: Do patients with chronic lower back pain have a lower aerobic capacity than matched controls?

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Name of project: What works for whom and how much in pain rehabilitation
Research question: This programme aims to make the composition of a treatment programme more transparent, uniform and efficient. This will be achieved in the first place by giving a clearly defined description of the content of the treatment in order to gain a better insight into a) the magnitude of the effects in relation to the specific treatment components and into b) a dose-response relationship.

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Name of project: WikiTherapy Collaborative Value Creation through Embodied Programmable Therapy
Research question: How can domain specialists in knowledge-intensive domains become actively involved in a co-creation process of product and service combinations implemented on non-conventional interactive platforms like robots and tangible interactive systems?

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Name of project: Work Injury Screening and Early intervention (WISE) Study
Description: The primary aim of the study is to determine if implementation of an early identification and intervention protocol for injured workers (who have been assessed as being at high risk for delayed return to work)results in better outcomes compared to usual care (current practice) for similar high-risk injured workers. The better outcomes we anticipate are: 1. Reduced costs of workers compensation claims 2. More sustained RTW in the 12 month

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Name of project: Are the activity levels and key life goals of adolescents with chronic pain different from those of healthy adolescents?
Description: This project started out as an AIOS study theme. However, after concluding N. Stommen’s studies, the project was followed up by two articles written for an international journal.

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