BackgroundIdiopathic Toe Walking (ITW) is present in children older than 3 years of age still walking on their toes without signs of neurological, orthopaedic or psychiatric diseases. ITW has been estimated to occur in 7% to 24% of the childhood population. To study associations between Idiopathic Toe Walking (ITW) and decrease in range of joint motion of the ankle joint. To study associations between ITW (with stiff ankles) and stiffness in other joints, muscle strength and bone density.MethodsIn a cross-sectional study, 362 healthy children, adolescents and young adults (mean age (sd): 14.2 (3.9) years) participated. Range of joint motion (ROM), muscle strength, anthropometrics sport activities and bone density were measured.ResultsA prevalence of 12% of ITW was found. Nine percent had ITW and severely restricted ROM of the ankle joint. Children with ITW had three times higher chance of severe ROM restriction of the ankle joint. Participants with ITW and stiff ankle joints had a decreased ROM in other joints, whereas bone density and muscle strength were comparable.ConclusionITW and a decrease in ankle joint ROM might be due to local stiffness. Differential etiological diagnosis should be considered.
Inmiddels is er al weer een jaar verstreken sinds het project "These Shoes are made for walking" is gestart. Een project dat onderwijs ontwikkelt en uitvoert om orthopedische schoentechnici op te leiden voor de regio Zuidoost-Azië in Hanoi, Vietnam. Fontys paramedische hogeschool werkt hier samen met de universiteit voor Labour and Social Affairs (ULSA) in Hanoi, de Leprastichting en het Lilianne Fonds. Het project is mogelijk gemaakt door de deelnemers aan de Nationale Postcode Loterij.
Objective. Clinicians may use implicit or explicit motor learning approaches to facilitatemotor learning of patients with stroke. Implicit motor learning approaches have shown promising results in healthy populations. The purpose of this study was to assess whether an implicit motor learning walking intervention is more effective compared with an explicit motor learning walking intervention delivered at home regarding walking speed in people after stroke in the chronic phase of recovery. Methods. This randomized, controlled, single-blind trial was conducted in the home environment. The 79 participants, who were in the chronic phase after stroke (age = 66.4 [SD = 11.0] years; time poststroke = 70.1 [SD = 64.3] months; walking speed = 0.7 [SD = 0.3] m/s; Berg Balance Scale score = 44.5 [SD = 9.5]), were randomly assigned to an implicit (n = 38) or explicit (n = 41) group. Analogy learning was used as the implicit motor learning walking intervention, whereas the explicit motor learning walking intervention consisted of detailed verbal instructions. Both groups received 9 training sessions (30 minutes each), for a period of 3 weeks, targeted at improving quality of walking. The primary outcome was walking speed measured by the 10-MeterWalk Test at a comfortable walking pace. Outcomes were assessed at baseline, immediately after intervention, and 1 month postintervention. Results. No statistically or clinically relevant differences between groups were obtained postintervention (between-group difference was estimated at 0.02 m/s [95% CI = −0.04 to 0.08] and at follow-up (between-group difference estimated at −0.02 m/s [95% CI = −0.09 to 0.05]). Conclusion. Implicit motor learning was not superior to explicit motor learning to improve walking speed in people after stroke in the chronic phase of recovery. Impact. To our knowledge, this is the first study to examine the effects of implicit compared with explicit motor learning on a functional task in people after stroke. Results indicate that physical therapists can use (tailored) implicit and explicit motor learning strategies to improve walking speed in people after stroke who are in the chronic phase of recovery.
Every year the police are confronted with an ever increasing number of complex cases involving missing persons. About 100 people are reported missing every year in the Netherlands, of which, an unknown number become victims of crime, and presumed buried in clandestine graves. Similarly, according to NWVA, several dead animals are also often buried illegally in clandestine graves in farm lands, which may result in the spread of diseases that have significant consequences to other animals and humans in general. Forensic investigators from both the national police (NP) and NWVA are often confronted with a dilemma: speed versus carefulness and precision. However, the current forensic investigation process of identifying and localizing clandestine graves are often labor intensive, time consuming and employ classical techniques, such as walking sticks and dogs (Police), which are not effective. Therefore, there is an urgent request from the forensic investigators to develop a new method to detect and localize clandestine graves quickly, efficiently and effectively. In this project, together with practitioners, knowledge institutes, SMEs and Field labs, practical research will be carried out to devise a new forensic investigation process to identify clandestine graves using an autonomous Crime Scene Investigative (CSI) drone. The new work process will exploit the newly adopted EU-wide drone regulation that relaxes a number of previously imposed flight restrictions. Moreover, it will effectively optimize the available drone and perception technologies in order to achieve the desired functionality, performance and operational safety in detecting/localizing clandestine graves autonomously. The proposed method will be demonstrated and validated in practical operational environments. This project will also make a demonstrable contribution to the renewal of higher professional education. The police and NVWA will be equipped with operating procedures, legislative knowledge, skills and technological expertise needed to effectively and efficiently performed their forensic investigations.
Low back pain is the leading cause of disability worldwide and a significant contributor to work incapacity. Although effective therapeutic options are scarce, exercises supervised by a physiotherapist have shown to be effective. However, the effects found in research studies tend to be small, likely due to the heterogeneous nature of patients' complaints and movement limitations. Personalized treatment is necessary as a 'one-size-fits-all' approach is not sufficient. High-tech solutions consisting of motions sensors supported by artificial intelligence will facilitate physiotherapists to achieve this goal. To date, physiotherapists use questionnaires and physical examinations, which provide subjective results and therefore limited support for treatment decisions. Objective measurement data obtained by motion sensors can help to determine abnormal movement patterns. This information may be crucial in evaluating the prognosis and designing the physiotherapy treatment plan. The proposed study is a small cohort study (n=30) that involves low back pain patients visiting a physiotherapist and performing simple movement tasks such as walking and repeated forward bending. The movements will be recorded using sensors that estimate orientation from accelerations, angular velocities and magnetometer data. Participants complete questionnaires about their pain and functioning before and after treatment. Artificial analysis techniques will be used to link the sensor and questionnaire data to identify clinically relevant subgroups based on movement patterns, and to determine if there are differences in prognosis between these subgroups that serve as a starting point of personalized treatments. This pilot study aims to investigate the potential benefits of using motion sensors to personalize the treatment of low back pain. It serves as a foundation for future research into the use of motion sensors in the treatment of low back pain and other musculoskeletal or neurological movement disorders.
Zwaar verkeer draagt voor ruim 40 % bij aan de Europese wegvervoersemissies. Voor zware voertuigen (trekker-oplegger) over langere afstand is puur elektrische aandrijving nog geen optie. Een interessante mogelijkheid is om de trekker te laten ondersteunen door een elektrische aandrijving op de oplegger waardoor brandstof wordt bespaard, en energie kan worden terug gewonnen bij remmen. Een dergelijk project, E-Trailer, is eerder opgestart door Kraker Trailers waarvoor de HAN is gevraagd om de regelaar te ontwikkelen. Voor een specifieke combinatie van trekker en oplegger is dat technisch haalbaar. Voortschrijdend inzicht in dat project geeft aan dat dit voor een gezonde businesscase niet voldoende is. De noodzakelijke opschaalbaarheid naar willekeurige trekker-oplegger combinaties stelt extra eisen aan de regelaar. Daarnaast biedt het systeem kansen die vooralsnog niet in ontwerp zijn meegenomen, zoals de mogelijkheid om puur elektrisch te rijden zonder dat ingeboet wordt op de actieradius (relevant voor zero-emission zones, wat de combinatie uniek maakt omdat er nog nauwelijks hybride zware voertuigen bestaan), of het ook te gebruiken als aandrijving van een ‘walking floor’, hydraulische pomp, of een koelunit, waardoor de conventionele systemen kunnen worden vermeden, en extra besparing wordt gerealiseerd. Tenslotte biedt de energiewinning bij remmen mogelijkheden om de huidige motorrem (retarder) te beperken of zelfs weg te laten. Het project EVENT onderzoekt de mogelijke uitbreiding van de regelaar cf. bovengenoemde punten, behandelt de nadere tuning van de uitgebreide regelsoftware (in software en vooral via experimenten), en omvat de experimentele validatie ervan om te komen tot een gevalideerde verbeterde regelaar met een gunstiger kosten-baten verhouding. Partners in het project beoordelen de consequenties voor het totale trailerontwerp. De verdere fysieke uitwerking kan plaats vinden in een vervolgtraject.
