Objective. Hospital in Motion is a multidimensional implementation project aiming to improve movement behavior during hospitalization. The purpose of this study was to investigate the effectiveness of Hospital in Motion on movement behavior. Methods. This prospective study used a pre-implementation and post-implementation design. Hospital in Motion was conducted at 4 wards of an academic hospital in the Netherlands. In each ward, multidisciplinary teams followed a 10-month step-by-step approach, including the development and implementation of a ward-specific action plan with multiple interventions to improve movement behavior. Inpatient movement behavior was assessed before the start of the project and 1 year later using a behavioral mapping method in which patients were observed between 9:00 am and 4:00 pm. The primary outcome was the percentage of time spent lying down. In addition, sitting and moving, immobility-related complications, length of stay, discharge destination home, discharge destination rehabilitation setting, mortality, and 30-day readmissions were investigated. Differences between pre-implementation and post-implementation conditions were analyzed using the chi-square test for dichotomized variables, the Mann Whitney test for non-normal distributed data, or independent samples t test for normally distributed data. Results. Patient observations demonstrated that the primary outcome, the time spent lying down, changed from 60.1% to 52.2%. For secondary outcomes, the time spent sitting increased from 31.6% to 38.3%, and discharges to a rehabilitation setting reduced from 6 (4.4%) to 1 (0.7%). No statistical differences were found in the other secondary outcome measures. Conclusion. The implementation of the multidimensional project Hospital in Motion was associated with patients who were hospitalized spending less time lying in bed and with a reduced number of discharges to a rehabilitation setting. Impact. Inpatient movement behavior can be influenced by multidimensional interventions. Programs implementing interventions that specifically focus on improving time spent moving, in addition to decreasing time spent lying, are recommended.
Background and purpose The aim of this study is to investigate changes in movement behaviors, sedentary behavior and physical activity, and to identify potential movement behavior trajectory subgroups within the first two months after discharge from the hospital to the home setting in first-time stroke patients. Methods A total of 140 participants were included. Within three weeks after discharge, participants received an accelerometer, which they wore continuously for five weeks to objectively measure movement behavior outcomes. The movement behavior outcomes of interest were the mean time spent in sedentary behavior (SB), light physical activity (LPA) and moderate to vigorous physical activity (MVPA); the mean time spent in MVPA bouts ≥ 10 minutes; and the weighted median sedentary bout. Generalized estimation equation analyses were performed to investigate overall changes in movement behavior outcomes. Latent class growth analyses were performed to identify patient subgroups of movement behavior outcome trajectories. Results In the first week, the participants spent an average, of 9.22 hours (67.03%) per day in SB, 3.87 hours (27.95%) per day in LPA and 0.70 hours (5.02%) per day in MVPA. Within the entire sample, a small but significant decrease in SB and increase in LPA were found in the first weeks in the home setting. For each movement behavior outcome variable, two or three distinctive subgroup trajectories were found. Although subgroup trajectories for each movement behavior outcome were identified, no relevant changes over time were found. Conclusion Overall, the majority of stroke survivors are highly sedentary and a substantial part is inactive in the period immediately after discharge from hospital care. Movement behavior outcomes remain fairly stable during this period, although distinctive subgroup trajectories were found for each movement behavior outcome. Future research should investigate whether movement behavior outcomes cluster in patterns.
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Background: Observing and analyzing movement quality (MQ) in patients with non-specific low back pain (NS-LBP) is important in the clinical reasoning of primary care physiotherapists and exercise therapists. However, there is no standardized form of assessment. Research question: which MQ domains are measured with which instruments, and which activities are relevant, appropriate and methodologically sound for assessing MQ in patients with NS-LBP?Methods: The study had three phases. In phase 1 we conducted a systematic review in PubMed, CINAHL and SPORTDiscus of literature published until October 2018. The selected studies measured MQ domains with instruments that enabled us to 1) compare MQ in self-paced dynamic activities of patients with NS-LBP and healthy controls, and/or 2) determine change over time of MQ in patients with NS-LBP. In phase 2 we established relevant dynamic activities to assess in patients with NS-LBP. In phase 3 we determined appropriateness and methodological qualities of the selected instruments.Results: Thirty cross-sectional and three pre-post-test studies were eligible. The instruments consisted of complex (n = 19) and simple (n = 7) instrumented motion analysis systems and standardized observational tests (n = 7). We identified three domains representative for MQ: range of motion (ROM), inter-segmental coordination, and whole-body movements. In these domains, patients with NS-LBP significantly differed from healthy controls, respectively 7/12, 12/13 and 13/20 studies. Moreover, ROM and whole-body movements significantly improved over time in patients with NS-LBP (3/3 studies). Based on phase 3, we concluded that none of the instruments are appropriate to assess MQ in patients with NS-LBP in primary care.Significance: Forward bending, lifting, and walking seem the most relevant activities to evaluate in patients with NS-LBP. However, we found no suitable instruments to measure ROM, inter-segmental coordination, or whole-body movements as determinants of MQ in these activities in daily practice. We therefore recommend such an instrument be developed.
Creating and testing the first Brand Segmentation Model in Augmented Reality using Microsoft Hololens. Sanoma together with SAMR launched an online brand segmentation tool based on large scale research, The brand model uses several brand values divided over three axes. However they cannot be displayed clearly in a 2D model. The space of BSR Quality Planner can be seen as a 3-dimensional meaningful space that is defined by the terms used to typify the brands. The third axis concerns a behaviour-based dimension: from ‘quirky behaviour’ to ‘standardadjusted behaviour’ (respectful, tolerant, solidarity). ‘Virtual/augmented reality’ does make it possible to clearly display (and experience) 3D. The Academy for Digital Entertainment (ADE) of Breda University of Applied Sciences has created the BSR Quality Planner in Virtual Reality – as a hologram. It’s the world’s first segmentation model in AR. Breda University of Applied Sciences (professorship Digital Media Concepts) has deployed hologram technology in order to use and demonstrate the planning tool in 3D. The Microsoft HoloLens can be used to experience the model in 3D while the user still sees the actual surroundings (unlike VR, with AR the space in which the user is active remains visible). The HoloLens is wireless, so the user can easily walk around the hologram. The device is operated using finger gestures, eye movements or voice commands. On a computer screen, other people who are present can watch along with the user. Research showed the added value of the AR model.Partners:Sanoma MediaMarketResponse (SAMR)
Ballet en moderne dans zijn een vorm van topsport. De druk op dansers is enorm. Lange en intensieve werkdagen, veel reizen en verschillende werkplekken maken het lastig om lichaam en geest goed te verzorgen. Hierdoor liggen blessures en mentale klachten op de loer. Nederlandse dansgezelschappen willen meer aandacht gaan besteden aan preventieve maatregelen om fysieke en mentale problemen bij hun dansers te voorkomen. Het ontbreekt hen echter aan kennis en kunde om dit innovatieve vraagstuk op te kunnen pakken. Het Nationale Ballet en het Scapino Ballet hebben het lectoraat Performing Arts Medicine van Codarts (Hogeschool voor de Kunsten Rotterdam) benaderd om antwoord te krijgen op de vraag hoe dansers op de hoogste podia, op gezonde wijze, hun beste performance kunnen laten zien. Gezamenlijk is deze praktijkvraag omgevormd naar drie onderzoeksdoelstellingen: 1. Opstellen van meetinstrumenten om de fysieke en mentale gezondheid van dansers te screenen en te monitoren; 2. Ontwerpen van een web-based systeem dat automatisch en real-time informatie uit de ontwikkelde meetinstrumenten kan inlezen, analyseren en interpreteren; 3. Ontwikkelen van een Fit to Perform protocol dat aanbevelingen geeft ten aanzien van het verbeteren van de fysieke en mentale gesteldheid van de danser. Het consortium bestaat uit de volgende organisaties: - Praktijkgerichte onderzoeksinstellingen: Codarts Rotterdam en Hogeschool van Amsterdam; - Universiteiten: ErasmusMC, Technische Universiteit Eindhoven en Vrije Universiteit Amsterdam; - Praktijkinstellingen: Het Nationale Ballet en het Scapino Ballet; - Overige instellingen: het Nederlands Paramedisch Instituut (NPi) en het Nationale Centrum Performing Arts (NCPA). Bij de samenstelling van het consortium is gekozen voor een goede mix tussen praktijkorganisaties, onderzoeksinstituten en onderwijsinstellingen. Daarnaast is er sprake van cross-sectorale samenwerking doordat kennis vanuit de podiumkunsten, sport, gezondheidszorg, onderwijs en technologie met elkaar verbonden wordt.
Door de transitie naar een biobased en circulaire economie neemt de behoefte aan biomassa als bron van grondstoffen en chemicaliën toe. De teelt van vezelhennep staat daarom opnieuw in de belangstelling vanwege de veelzijdigheid van het gewas. De vezels uit de stengel worden bijvoorbeeld gebruikt voor textieltoepassingen en plantinhoudsstoffen uit de bladeren en bloemen (o.a. Cannabidiol (CBD)) worden gebruikt als voedingssupplement vanwege de gezondheidsbevorderende eigenschappen. Echter, vezelhennep bevat, naast het bekende CBD, nog een veel breder scala aan plantinhoudsstoffen waaraan gezondheidsbevorderende effecten worden toegeschreven. Afhankelijk van het productie/extractieproces en de gebruikte cultivars komen de andere plantinhoudsstoffen in meer of mindere mate in de producten terecht. Vanuit de producenten van vezelhennep extracten is er vraag naar betere karakterisatie van hun extracten en er is behoefte aan meer kennis over de gezondheidseffecten van de extracten zodat de toepasbaarheid vergroot kan worden. Het doel van dit project is dan ook om een relatie te leggen tussen samenstelling aan secundaire plantinhoudsstoffen van verschillende vezelhennepextracten en de gezondheidseffecten van deze extracten. Om dit doel te bereiken zal er onderzoek gedaan worden naar de invloed van verschillende extractiemethodes, cultivars en bewaarmethodes op de samenstelling aan plantinhoudsstoffen en zal een nieuwe methode voor het verkrijgen van plantinhoudsstoffen doorontwikkeld worden. Deze extracten worden vervolgens getest op hun effecten op de humane gezondheid middels een unieke combinatie aan modelsystemen om de relatie te kunnen leggen met specifieke samenstelling. Veroudering is hier als overkoepeld thema gekozen, omdat het in de vergrijzende samenleving steeds relevanter wordt om gezonder oud te worden. Als subthema’s is gekozen voor afweerfunctie, neuro-inflammatie en spierfunctie. De resultaten zullen worden toegepast om nieuwe, beter gekarakteriseerde extracten op de markt te kunnen brengen. Tevens is dit project, door het multidisciplinaire karakter, uitermate geschikt om een hybride leeromgeving te ontwikkelen waarin studenten worden geleerd om multidisciplinair te werken.
