Integrating physical therapy sessions and an online application (e-Exercise) might support people with hip osteoarthritis (OA), knee OA, or both (hip/knee OA) in taking an active role in the management of their chronic condition and may reduce the number of physical therapy sessions. The objective of this study was to investigate the short- and long-term effectiveness of e-Exercise compared to usual physical therapy in people with hip/knee OA. The design was a prospective, single-blind, multicenter, superiority, cluster-randomized controlled trial. e-Exercise is a 3-month intervention in which about 5 face-to-face physical therapy sessions were integrated with an online application consisting of graded activity, exercise, and information modules. Usual physical therapy was conducted according to the Dutch physical therapy guidelines on hip and knee OA. Primary outcomes, measured at baseline after 3 and 12 months, were physical functioning and free-living physical activity. Secondary outcome measures were pain, tiredness, quality of life, self-efficacy, and the number of physical therapy sessions.
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/Objectives: Homecare staff often take over activities instead of “doing activities with” clients, thereby hampering clients from remaining active in daily life. Training and supporting staff to integrate reablement into their working practices may reduce clients' sedentary behavior and improve their independence. This study evaluated the effectiveness of the “Stay Active at Home” (SAaH) reablement training program for homecare staff on older homecare clients' sedentary behavior. Design: Cluster randomized controlled trial (c-RCT). Setting: Dutch homecare (10 nursing teams comprising a total of 313 staff members). Participants: 264 clients (aged ≥65 years). Intervention: SAaH seeks to equip staff with knowledge, attitude, and skills on reablement, and to provide social and organizational support to implement reablement in homecare practice. SAaH consists of program meetings, practical assignments, and weekly newsletters over a 9-month period. The control group received no additional training and delivered care as usual. Measurements: Sedentary behavior (primary outcome) was measured using tri-axial wrist-worn accelerometers. Secondary outcomes included daily functioning (GARS), physical functioning (SPPB), psychological functioning (PHQ-9), and falls. Data were collected at baseline and at 12 months; data on falls were also collected at 6 months. Intention-to-treat analyses using mixed-effects linear and logistic regression were performed. Results: We found no statistically significant differences between the study groups for sedentary time expressed as daily minutes (adjusted mean difference: β 18.5 (95% confidence interval [CI] 22.4, 59.3), p = 0.374) and as proportion of wake/wear time (β 0.6 [95% CI 1.5, 2.6], p = 0.589) or for most secondary outcomes. Conclusion: Our c-RCT showed no evidence for the effectiveness of SAaH for all client outcomes. Refining SAaH, by adding components that intervene directly on homecare clients, may optimize the program and require further research. Additional research should explore the effectiveness of SAaH on behavioral determinants of clients and staff and cost-effectiveness.
The livability of the cities and attractiveness of our environment can be improved by smarter choices for mobility products and travel modes. A change from current car-dependent lifestyles towards the use of healthier and less polluted transport modes, such as cycling, is needed. With awareness campaigns, cycling facilities and cycle infrastructure, the use of the bicycle will be stimulated. But which campaigns are effective? Can we stimulate cycling by adding cycling facilities along the cycle path? How can we design the best cycle infrastructure for a region? And what impact does good cycle infrastructure have on the increase of cycling?To find answers for these questions and come up with a future approach to stimulate bicycle use, BUas is participating in the InterReg V NWE-project CHIPS; Cycle Highways Innovation for smarter People transport and Spatial planning. Together with the city of Tilburg and other partners from The Netherlands, Belgium, Germany and United Kingdom we explore and demonstrate infrastructural improvements and tackle crucial elements related to engaging users and successful promotion of cycle highways. BUas is responsible for the monitoring and evaluation of the project. To measure the impact and effectiveness of cycle highway innovations we use Cyclespex and Cycleprint.With Cyclespex a virtual living lab is created which we will use to test several readability and wayfinding measures for cycle infrastructure. Cyclespex gives us the opportunity to test different scenario’s in virtual reality that will help us to make decisions about the final solution that will be realized on the cycle highway. Cycleprint will be used to develop a monitoring dashboard where municipalities of cities can easily monitor and evaluate the local bicycle use.
Effectiveness of Supported Education for students with mental health problems, an experimental study.The onset of mental health problems generally occurs between the ages of 16 and 23 – the years in which young people follow postsecondary education, which is a major channel in ourso ciety to prepare for a career and enhance life goals. Several studies have shown that students with mental health problems have a higher chance of early school leaving. Supported Education services have been developed to support students with mental health to remain at school. The current project aims to study the effect of an individually tailored Supported Education intervention on educational and mental health outcomes of students with mental health problems at a university of applied sciences and a community college. To that end, a mixed methods design will be used. This design combines quantitative research (Randomized Controlled Trial) with qualitative research (focus groups, monitoring, interviews). 100 students recruited from the two educational institutes will be randomly allocated to either the intervention or control group.
The Netherlands has approximately 220,000 industrial accidents per year (with 60 people who die). That is why every employer is obliged to organize company emergency response (BHV), including emergency response training. Despite this, only one-third of all companies map out their occupational risks via a Risk Inventory & Evaluation (RI&E) and the share of employees with an occupational accident remains high. That is why there is continuous innovation to optimize emergency response training, for example by means of Virtual Reality (VR). VR is not new, but it has evolved and become more affordable. VR offers the possibility to develop safe realistic emergency response simulations where the student has the feeling that they are really there. Despite the increase in VR-BHV training, little research has been done on the effect of VR in ER training and results are contradictory. In addition, there are new technological developments that make it possible to measure viewing behavior in VR using Eye-Tracking. During an emergency response training, Eye-Tracking can be used to measure how an instruction is followed, whether students are distracted and observe important elements (danger and solutions) during the simulation. However, emergency response training with VR and Eye-Tracking (interactions) does not exist. In this project, a prototype is being developed in which Eye-Tracking is incorporated into a VR-BHV training that was developed in 2021, in which emergency situations such as an office fire are simulated (the BHVR application). The prototype will be tested by means of an experiment in order to partly answer the question to what extent and in what way Eye-Tracking in VR offers added value for (RI&E) emergency response training. This project is therefore in line with the mission-driven innovation policy 'The Safety Professional' and helps SMEs that often lack resources and knowledge for research into the effectiveness of innovative technologies in education/training. The project will include a prototype, a production report and research article, and is open to new participants when writing a larger application about the application and effect of VR and Eye-Tracking in emergency response training.
