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De rolstoel: het icoon voor handicap, dat ding waar je in ‘belandt’, meestal afgebeeld in zwaar roestvrijstalen uitvouwbare uitvoering, bedoeld om in voortgeduwd te worden. Die rolstoel, die interesseert ons niet! Welke dan wel? De rolstoel die de gebruiker zijn individuele vrijheid teruggeeft, en stimuleert tot bewegen. Bovendien, de rolstoel die de gebruiker de fysieke activiteit die nog inzetbaar is duurzaam laat gebruiken. Dat wil zeggen inspanning van het bovenlichaam zonder overbelasting en pijn.

Physical activity monitoring with wearable technology has the potential to support stroke rehabilitation. Little is known about how physical therapists use and value the use of wearable activity monitors. This cross-sectional study explores the use, perspectives, and barriers to wearable activity monitoring in day-to-day stroke care routines amongst physical therapists. Over 300 physical therapists in primary and geriatric care and rehabilitation centers in the Netherlands were invited to fill in an online survey that was developed based on previous studies and interviews with experts. In total, 103 complete surveys were analyzed. Out of the 103 surveys, 27% of the respondents were already using activity monitoring. Of the suggested treatment purposes of activity monitoring, 86% were perceived as useful by more than 55% of the therapists. The most recognized barriers to clinical implementation were lack of skills and knowledge of patients (65%) and not knowing what brand and type of monitor to choose (54%). Of the non-users, 79% were willing to use it in the future. In conclusion, although the concept of remote activity monitoring was perceived as useful, it was not widely adopted by physical therapists involved in stroke care. To date, skills, beliefs, and attitudes of individual therapists determine the current use of wearable technology.

The purpose of this study was to compare the activity profiles of elite wheelchair tennis (WT) players during match-play for men, women and quad divisions and to explore how result and score margin affect these profiles. Activity profiles of seventeen of the top 8 ranked WT players from the men’s (n = 7), women’s (n = 6) and quad (n = 4) divisions were monitored during the NEC Wheelchair Tennis Masters 2017 using a radio frequency-based indoor tracking system (ITS) and inertial measurement units (IMU). Data were collected from 22 matches, resulting in 73 individual sets of data. Data were analysed with regards to the result of each set (win/loss) and margin of the result (small ≤ 3; large > 3 games differential). Distance, mean and peak speed and the time spent in fixed speed zones were analysed by the ITS. Acceleration, rotational velocity and rotational acceleration and direction of turns were quantified by the IMU. Activity profiles were elevated during men’s matches compared to both women’s and quads and for women’s matches compared to quads for most parameters. Few differences in activity profiles were observed between winning and losing sets. Alternatively, independent of result, distances covered, peak speed, time spent and number of high-speed activity (HSA) performed were significantly greater during sets with small score margins (p ≤ 0.035). Significant interactions between result and score margin were also observed for a number of parameters. Trivial to small differences (effect sizes [ES] ≤ 0.3) in mean speed, time spent and number of HSA performed were revealed when losing, regardless of margin, whereas large increases (ES ≥ 1.3) were revealed when winning by a small compared to large margin. In conclusion, activity profiles differ according to division and are typically elevated during sets with a small score margin in WT players, which should be taken into consideration by coaches and practitioners when monitoring and planning players physical training loads.&nbsp

PURPOSE: Given the impairment of the athletes in wheelchair sports, a lot of individual factors need to be taken into account in optimizing performance, but only limited information of wheelchair performance is available. Better insight in the resemblances and differences between sports could pinpoint to what extent performance knowledge across sports could be utilized, or when sport specific knowledge is required. METHODS: To quantify performance across sports, the wheelchair mobility performance monitor (WMPM) was used to measure 29 basketball athletes, 32 rugby athletes and 15 tennis athletes of national and international level during match play. RESULTS: As hypothesized based on sport characteristics, wheelchair basketball athletes show the best wheelchair mobility performance (WMP) outcomes and wheelchair rugby the lowest, whereas wheelchair tennis athletes range in-between for most outcomes. CONCLUSIONS: Based on the well quantified WMP profiles, the WMPM could be used to support in individual performance perfection, but also for optimizing wheelchair design and sport referral in the rehabilitation process. Future research, with large scale data collection could be used to obtain more detailed performance profiles, differentiated by classification, competition level or field position. Furthermore, the WMPM allows for calculation and representation of a wide variety of kinematic outcomes, with tailormade representation.

PURPOSE: Given the impairment of the athletes in wheelchair sports, a lot of individual factors need to be taken into account in optimizing performance, but only limited information of wheelchair performance is available. Better insight in the resemblances and differences between sports could pinpoint to what extent performance knowledge across sports could be utilized, or when sport specific knowledge is required. METHODS: To quantify performance across sports, the wheelchair mobility performance monitor (WMPM) was used to measure 29 basketball athletes, 32 rugby athletes and 15 tennis athletes of national and international level during match play. RESULTS: As hypothesized based on sport characteristics, wheelchair basketball athletes show the best wheelchair mobility performance (WMP) outcomes and wheelchair rugby the lowest, whereas wheelchair tennis athletes range in-between for most outcomes. CONCLUSIONS: Based on the well quantified WMP profiles, the WMPM could be used to support in individual performance perfection, but also for optimizing wheelchair design and sport referral in the rehabilitation process. Future research, with large scale data collection could be used to obtain more detailed performance profiles, differentiated by classification, competition level or field position. Furthermore, the WMPM allows for calculation and representation of a wide variety of kinematic outcomes, with tailormade representation.

De incidentie van niet aangeboren hersenletsel (NAH) bij personen in de leeftijd tot 25 jaar in Nederland is aanzienlijk, met ca. 18.000 nieuwe gevallen per jaar. Kinderen en jongeren met NAH hebben naast fysieke, cognitieve en emotionele beperkingen, een significant lager niveau van sociale participatie dan hun gezonde leeftijdgenoten. Het gebruik van de Nintendo Wii, een spelcomputer die bewegingen op natuurlijke en intuïtieve wijze uitlokt, lijkt mogelijkheden te bieden om contacten met anderen en actieve vrijetijdsbesteding bij jongeren met NAH te stimuleren. In deze studie wordt onderzocht wat het effect is van het gebruik van de Nintendo Wii bij kinderen en jongeren met NAH op fysiek, cognitief en sociaal functioneren. Om dit te onderzoeken is een multicenter, observationele pilotstudie verricht, bij 50 kinderen en jongeren met NAH in de leeftijd van 6-29 jaar die onder controle of behandeling zijn van een revalidatiearts. De interventie, van in totaal 12 weken, startte met 2 trainingssessies van 60 minuten, waarbij de toe te passen games werden gekozen passend bij zelf gekozen behandeldoelen (te verbeteren functies of activiteiten) en uitvoerbaar gezien de individuele beperkingen van de deelnemer. Vervolgens werd er minimaal 2 keer in de week gegamed. Er was wekelijks contact met een therapeut per telefoon of e-mail. De effectmetingen (vragenlijsten en een neuropsychologische test) werden verricht aan het begin en einde van de interventie en betroffen het fysiek, cognitief en sociaal functioneren. De statistische analyse bestond uit vergelijkingen van de uitkomstmaten tussen 0 en 12 weken met behulp van gepaarde t-toetsen, Wilcoxon-Signed-Rank tests en chi-kwadraat toetsen. Deze eerste pilotstudie naar de effecten van het gamen met de Nintendo Wii bij jongeren met NAH laat significante verbetering zien op het fysiek en cognitief functioneren, en niet op het sociaal functioneren. Deze resultaten zijn aanleiding om de effectiviteit van de Nintendo Wii in deze patiëntengroep in een grotere, gecontroleerde studie verder te onder ABSTRACT Aim: To explore the effects of usage of the Nintendo Wii on physical, cognitive and social functioning in patients with acquired brain injury (ABI). Methods: This multicenter, observational proof-of-concept study included children, adolescents and young adults with ABI aged 6-29 years. A standardized, yet individually tailored 12-week intervention with the Nintendo Wii was delivered by trained instructors. The treatment goals were set on an individual basis and included targets regarding physical, mental and/or social functioning. Outcome assessments were done at baseline and after 12 weeks, and included: the average number of minutes per week of recreational physical activity; the CAPE (Children's Assessment of Participation and Enjoyment); the ANT (Amsterdam Neuropsychological Tasks); the achievement of individual treatment goals (Goal Attainment Scaling); and quality of life (PedsQL; Pediatric Quality of Life Inventory). Statistical analyses included paired t-tests or Wilcoxon-Signed-Rank tests. Results: 50 patients were included, (31 boys and 19 girls; mean age 17.1 years (SD 4.4)), of whom 45 (90%) completed the study. Significant changes of the amount of physical activity, speed of information processing, attention, response inhibition and visual-motor coordination (p

To evaluate the propulsive forces in front crawl arm swimming, derived from a three-dimensional kinematic analysis, these values were compared with mean drag forces. The propulsive forces during front crawl swimming using the arms only were calculated using three-dimensional kinematic analysis combined with lift and drag coefficients obtained in fluid laboratories. Since, for any constant swimming speed, the mean propulsive force should be equal to the mean drag force acting on the body of the swimmer, mean values of the calculated propulsive forces were compared with the mean drag forces obtained from measurements on a Measuring Active Drag (MAD) system. The two methods yielded comparable results, the mean difference between them being only 5% (2 N). We conclude that propulsive forces obtained from three-dimensional kinematic analysis provide realistic values. The calculation of the propulsive force appears to be rather sensitive to the point on the hand at which the velocity is estimated and less sensitive to the orientation of the hand.

The results of the studies included in this thesis suggest that the incidence of ABI in children and youth is considerable. Moreover, it was found that relatively many have long-term health problems, including limitations in psychosocial functioning, participation and QoL and that the impact on their families is substantial. These findings underscore the need for an increasing awareness for the impact of paediatric ABI. One study explored the effects of usage of serious gaming found that physical activity, the speed of information processing, attention, response inhibition, and parent-perceived Quality of life (QoL) were improved directly after the intervention. Participation is the most relevant outcome of recovery and main goal of rehabilitation. However, a better general understanding and improvements of assessment and treatment are required to decrease the impact of paediatric ABI on participation of youth and their families. Recommendations based on this thesis are: a) implement the ICF-model to improve comprehension of participation (problems) after paediatric ABI; b) measure and monitor participation after paediatric TBI and NTBI and c) develop and evaluate trajectories optimising participation.