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Supplemental material, sj-pdf-1-msj-10.1177_13524585211025780 for Performance validity in outpatients with multiple sclerosis and cognitive complaints by IM Nauta, D Bertens, M van Dam, M Huiskamp, S Driessen, JJG Geurts, BMJ Uitdehaag, L Fasotti, HE Hulst, BA de Jong and M Klein in Multiple Sclerosis Journal

Supplemental material, sj-pdf-2-msj-10.1177_13524585211025780 for Performance validity in outpatients with multiple sclerosis and cognitive complaints by IM Nauta, D Bertens, M van Dam, M Huiskamp, S Driessen, JJG Geurts, BMJ Uitdehaag, L Fasotti, HE Hulst, BA de Jong and M Klein in Multiple Sclerosis Journal

Supplemental material, sj-pdf-2-msj-10.1177_13524585211025780 for Performance validity in outpatients with multiple sclerosis and cognitive complaints by IM Nauta, D Bertens, M van Dam, M Huiskamp, S Driessen, JJG Geurts, BMJ Uitdehaag, L Fasotti, HE Hulst, BA de Jong and M Klein in Multiple Sclerosis Journal

Supplemental material, sj-pdf-1-msj-10.1177_13524585211025780 for Performance validity in outpatients with multiple sclerosis and cognitive complaints by IM Nauta, D Bertens, M van Dam, M Huiskamp, S Driessen, JJG Geurts, BMJ Uitdehaag, L Fasotti, HE Hulst, BA de Jong and M Klein in Multiple Sclerosis Journal

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Contains fulltext : 174645.pdf (Publisher’s version ) (Closed access) Background: Cognitive deficits frequently occur in patients with multiple sclerosis (MS), which profoundly affect their quality of life. So far, the best cognitive treatment options for MS patients are a matter of debate. Therefore, this study aims to investigate the efficacy of two promising non-pharmacological treatments: cognitive rehabilitation therapy (CRT) and mindfulness-based cognitive therapy (MBCT). Furthermore, this study aims to gain additional knowledge about the aetiology of cognitive deficits among MS patients, since this may help to develop and guide effective cognitive treatments. Method: In a dual-centre, single-blind randomised controlled trial (RCT), 120 MS patients will be randomised into one of three parallel groups: CRT, MBCT or a control group. Both CRT and MBCT consist of a structured 9-week program. Measurements will be performed at baseline, post-intervention and 6 months after the interventions. The primary outcome measure is subjective cognitive complaints. Secondary outcome measures are objective cognitive functioning, functional brain network measures (using magnetoencephalography), psychological symptoms, well-being, quality of life and daily life functioning. Discussion: To our knowledge, this will be the first RCT that investigates the effect of MBCT on cognitive functioning among MS patients. In addition, studying the effect of CRT on cognitive functioning may provide direction to the contradictory evidence that is currently available. This study will also provide information on functional brain network changes in relation to cognition. To conclude, this study may help to understand and treat cognitive deficits among MS patients. 1 p.

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Item does not contain fulltext Helft van patiënten met NAH last van vermoeidheid: Vermoeidheid is een van de meest voorkomende verschijnselen bij niet-aangeboren hersenletsel (NAH): ongeveer de helft van alle patiënten krijgt ermee te maken. Vermoeidheid heeft grote impact op alle terreinen van het leven, zoals werk, sociale relaties en hobby's. Hiernaast beïnvloedt vermoeidheid vaak ook de concentratie, het geheugen en de stemming. Hoe besteed je de beschikbare energie efficiënter? Het uitgangspunt van dit behandelprotocol is dat de vermoeidheid primair door het hersenletsel zelf wordt veroorzaakt. Het doel van de behandeling is dan ook niet om het energieniveau te herstellen tot het premorbide niveau, maar om de beschikbare energie efficiënter te besteden en patiënten te leren omgaan met de bestaande vermoeidheid. Meer energie door een betere lichamelijke conditie: De behandeling 'Omgaan met beperkte belastbaarheid' bestaat uit twee behandelsporen: een cognitieve behandeling en een Graded Activity Training. De Graded Activity Training richt zich op het vergroten van de lichamelijke conditie van de cliënt. Hierdoor hebben de deelnemers meer energie voor hun dagelijkse bezigheden, waardoor de vermoeidheid structureel vermindert. Opbouw van de behandeling: De behandeling duurt twaalf weken en wordt in kleine groepen (maximaal vier deelnemers) gegeven. De cognitieve behandeling vindt eenmaal per week plaats, gedurende twee uur. Deze kan worden gegeven door een psycholoog met neuropsychologische en cognitief gedragstherapeutische kennis en ervaring. De Graded Activity Training vindt tweemaal per week gedurende anderhalf uur plaats. Deze wordt gegeven door een fysiotherapeut met kennis van NAH. Beide behandelsporen omvatten een nauwgezet behandelprotocol en wekelijkse huiswerkopdrachten.

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BACKGROUND: Many brain-injured patients referred for outpatient rehabilitation have executive deficits, notably difficulties with planning, problem-solving and goal directed behaviour. Goal Management Training (GMT) has proven to be an efficacious cognitive treatment for these problems. GMT entails learning and applying an algorithm, in which daily tasks are subdivided into multiple steps. Main aim of the present study is to examine whether using an errorless learning approach (preventing the occurrence of errors during the acquisition phase of learning) contributes to the efficacy of Goal Management Training in the performance of complex daily tasks. METHODS/DESIGN: The study is a double blind randomized controlled trial, in which the efficacy of Goal Management Training with an errorless learning approach will be compared with conventional Goal Management Training, based on trial and error learning. In both conditions 32 patients with acquired brain injury of mixed etiology will be examined. Main outcome measure will be the performance on two individually chosen everyday-tasks before and after treatment, using a standardized observation scale and goal attainment scaling. DISCUSSION: This is the first study that introduces errorless learning in Goal Management Training. It is expected that the GMT-errorless learning approach will improve the execution of complex daily tasks in brain-injured patients with executive deficits. The study can contribute to a better treatment of executive deficits in cognitive rehabilitation. TRIAL REGISTRATION: (Dutch Trial Register): NTR3567.

Item does not contain fulltext In this paper, the effectiveness of interventions for executive disorders was reviewed. The objective was to evaluate the internal and external validity of intervention studies. A total of 46 papers, describing 54 studies, conducted in the last two decades meeting several preset inclusion criteria, was included in this review. The studies were categorized into three treatment approaches in order to enhance comparability. The overall results show that many interventions yield positive outcomes and seem to be effective in reducing executive problems in brain-injured subjects. However, several studies have only an explorative intent and are based on less sophisticated experimental designs. The verification of their results is generally more tenuous. The internal validity, or the set-up of experimental conditions necessary to draw valid conclusions about treatment effectiveness, including the choice of well-matched control groups, or the randomization of patients over treatment and control conditions, is not always strong. The same conclusion can be drawn for the external validity of a number of the intervention studies; often evidence of generalization to real-life situations, long-term follow-up, and transfer to non-trained situations, were (partially) lacking in the studies under review. The authors are aware that the design of proper randomized controlled trials for the investigation of the treatment effectiveness of executive disorders is cumbersome and time consuming. Nonetheless, the provisional results of several well-designed studies described in this review make the effort worthwhile.

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OBJECTIVE: To identify and interrelate static and dynamic characteristics of the restoration of quiet standing balance in a representative sample of stroke survivors in the Netherlands during their inpatient rehabilitation. DESIGN: Exploratory study using an inception cohort with findings related to reference values from healthy elderly persons. SETTING: Rehabilitation center. PARTICIPANTS: Thirty-seven inpatients (mean age, 61.6y; mean time poststroke, 10.0wk) with a first hemispheric intracerebral infarction or hematoma who were admitted to retrain standing balance and walking. INTERVENTION: Individualized therapy. MAIN OUTCOME MEASURES: Center of pressure fluctuations were registered under each foot and in the sagittal and frontal planes separately by using a dual-plate force platform. The first balance measurements took place as soon as patients were able to stand unassisted for at least 30 seconds as well as 2, 4, 8, and, 12 weeks later. Quiet standing was assessed under 4 conditions: with and without a visual midline reference, with the eyes closed, and while performing a concurrent arithmetic task. RESULTS: The stroke patients showed excessive postural sway and instability, particularly in the frontal plane, compared with reference values. Frontal plane balance was, however, also most responsive to the effects of balance training and recovery (P

Contains fulltext : 57774.pdf (Publisher’s version ) (Closed access)

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Contains fulltext : 213539.pdf (Publisher’s version ) (Open Access) Radboud University, 26 november 2019 Promotores : Desain, P.W.M., Fasotti, L. Co-promotor : Farquhar, J.D.R. 116 p.

Contains fulltext : 191621.pdf (Publisher’s version ) (Open Access) Radboud University, 29 juni 2018 Promotores : Geurts, A.C.H., Fasotti, L., Heugten, C.M. van Co-promotor : Rasquin, S.M.C.

Contains fulltext : 191297.pdf (Publisher’s version ) (Open Access) Radboud University, 25 juni 2018 Promotores : Kessels, R.P.C., Fasotti, L. Co-promotor : Oosterman, J.M. 127 p.

Contains fulltext : 166754.pdf (Publisher’s version ) (Open Access) Radboud University, 10 februari 2017 Promotores : Fasotti, L., Kessels, R.P.C. 185 p.

Contains fulltext : 132138.pdf (Publisher’s version ) (Open Access) Radboud Universiteit Nijmegen, 26 november 2014 Promotores : Fasotti, L., Brouwer, W.H. 210 p.

Contains fulltext : 112927.pdf (Publisher’s version ) (Open Access) Radboud Universiteit Nijmegen, 17 oktober 2013 Promotores : Fasotti, L., Geurts, A.C.H., Kessels, R.P.C. 194 p.

Contains fulltext : 87197.pdf (Publisher’s version ) (Open Access) Radboud Universiteit Nijmegen, 28 juni 2011 Promotores : Fasotti, L., Kessels, R.P.C., Brouwer, W.H. Co-promotor : Spikman, J.M. 196 p.

Contains fulltext : 90830.pdf (Publisher’s version ) (Open Access) The thesis describes the study of visual restorative function training (RFT) effects in patients with hemianopia. The training consists of repetitive stimulus detection threshold measurements in the border area of the visual field defect. The main result is ‘shrinkage’ of the defect-size. A computerized version of the training was made available in 1998. This met large scepticism, because it is yet unknown what the ‘shrinkage’ means for activities in daily life. Also, it is unknown how the method leads to ‘shrinkage’. Therefore, the main questions in my studies were: (1) Which perceptional and behavioural benefits can be expected after training? (2) Which patients will benefit? (3) Does RFT induce structural changes in the brain and if so, what are these changes? The main findings are: 1. defect shrinkage is training-induced, of a cerebral origin, not caused by increasingly larger eye movements towards the presented test stimulus and independent of patient age and ‘lesion age’. 2. colour/shape discrimination and peripheral acuity is improved in the regained part of the visual field. 3. this results in increased reading speed and increased number of eye movements towards the defect in a driving simulator (leading to improved driving) 4. these changes are only observed in cases where the visual field enlargement exceeds a threshold enlargement (explaining why field enlargement does not automatically leads to improvement in daily life) 5. these changes are accompanied by some structural brain changes, which were observed in a pilot-study. They could only account for a part of the observed enlargement. In conclusion, RFT induces significant perceptional and behavioural improvements for at least a portion of the stroke patients with visual field defects. Radboud Universiteit Nijmegen, 05 september 2011 Promotores : Fernandez, G.S.E., Fasotti, L. Co-promotores : Berg, A.V. van den, Wildt, G.J. van der 160 p.

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