Search

Item does not contain fulltext

Contains fulltext : 284413.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 242601.pdf (Publisher’s version ) (Closed access), BACKGROUND.: Occupational therapy (OT) may be an important intervention in patients with COPD, but studies show conflicting results. PURPOSE.: To evaluate the effectiveness of home-based monodisciplinary OT in COPD patients. METHOD.: We conducted an observational clinical study. Main outcomes were the mean differences in the Canadian Occupational Performance Measure (COPM) performance and satisfaction scores, pre and post intervention. FINDINGS.: Pre- and postintervention data were obtained from 41 patients. Statistically significant increases were observed in COPM performance (5.0 +/- 1.1 versus 6.9 +/- 0.9; P<0.001) and satisfaction (4.6 +/- 1.3 versus 6.9 +/- 1.0; P<0.001). The most frequently reported occupational performance problems were found in the domains of productivity (47%) and mobility (40%), fewer in self-care (10%) and the least in leisure (3%). IMPLICATIONS.: Home-based monodisciplinary OT can contribute significantly to the improvement of daily functioning of patients with COPD. OT should therefore be considered more often as part of the integrated management of these patients.

Radboud University, 17 november 2021, Promotores : Heuvel, M. van den, Wees, P.J. van der Co-promotor : Hul, A.J. van 't, Contains fulltext : 239949.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 229763.pdf (publisher's version ) (Open Access)

Contains fulltext : 220716.pdf (publisher's version ) (Open Access)

Contains fulltext : 225497.pdf (Publisher’s version ) (Open Access), A loss of physical functioning (i.e., a low physical capacity and/or a low physical activity) is a common feature in patients with chronic obstructive pulmonary disease (COPD). To date, the primary care physiotherapy and specialized pulmonary rehabilitation are clearly underused, and limited to patients with a moderate to very severe degree of airflow limitation (GOLD stage 2 or higher). However, improved referral rates are a necessity to lower the burden for patients with COPD and for society. Therefore, a multidisciplinary group of healthcare professionals and scientists proposes a new model for referral of patients with COPD to the right type of exercise-based care, irrespective of the degree of airflow limitation. Indeed, disease instability (recent hospitalization, yes/no), the burden of disease (no/low, mild/moderate or high), physical capacity (low or preserved) and physical activity (low or preserved) need to be used to allocate patients to one of the six distinct patient profiles. Patients with profile 1 or 2 will not be referred for physiotherapy; patients with profiles 3-5 will be referred for primary care physiotherapy; and patients with profile 6 will be referred for screening for specialized pulmonary rehabilitation. The proposed Dutch model has the intention to get the right patient with COPD allocated to the right type of exercise-based care and at the right moment.

Contains fulltext : 203249.pdf (publisher's version ) (Open Access)

Contains fulltext : 194377.pdf (publisher's version ) (Open Access)

Contains fulltext : 194514.pdf (publisher's version ) (Open Access)

Aim: The aim of this study is to determine the reproducibility and the criterion validity of a new instrument which measures the length of flexor muscles of the spastic forearm in acquired brain injury patients. Methods: To determine the inter-rater reproducibility four raters measured with this new instrument. After the first measurement by the first rater, a second rater measured the same participant after at least 30 minutes and maximally 24 hours. One of the four raters, this was always the same rater, repeated the measurements within one week to determine the intra-rater reproducibility. The criterion validity was determined by a measurement performed by the regular physiotherapist with a manual goniometer. Statistical analyses were done by evaluating the Intraclass Correlation Coefficients (ICC), Limits of Agreement (LoA), Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC). Results: ICCs revealed an excellent inter-rater (ICC [2.1]: 0.933) and intra-rater reliability (ICC [3.1]: 0.990). Inter-rater agreement resulted in LoA of -19.3°to 20.4°, SEM of 7.3° and SDC of 20.2°. Intra-rater agreement revealed LoA of -7.5° to 7.5°, SEM of 2.7° and SDC of 7.5°. Criterion validity with the manual goniometer was indicated as good (Spearman rank correlation coefficient, rs: 0.772). Conclusion: This study confirms an overall good reproducibility and criterion validity of a new instrument in a population in brain injury patients with a spastic wrist. However, a larger sample size is necessary to draw firm conclusions about the reproducibility and validity of this instrument. Clinical Relevance: Besides the measurements properties, the clinical relevance of this study implies that this new instrument has the potential to be used in clinical practice by only one health care professional to determine the muscle length of the spastic wrist.