In 2012, our randomised trial demonstrated that stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults.1 These episodic cramp attacks are characteristic: painful, sustained, involuntary muscle contractions of the calf muscles, hamstrings or feet. The sharp and intense pain may last from seconds to several minutes, accompanied by firm and tender muscles, and in some cases, with plantar flexion of feet and toes.2–5 In his letter, Garrison argues that prophylactic stretching is unlikely to prevent nocturnal leg cramps.
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Een aantal steden blijft groeien met gevolgen als verdichting, een hoger geluidspeil en meer fijnstof. Daarnaast hebben steden door te veel harde oppervlaktes last van hittestress en wateroverlast. Meer groenvoorzieningen, zoals parken, kunnen deze gevolgen verzachten. De omgevingspsychologie geeft inzicht in de relatie tussen groen en welzijn van mensen in de stedelijke omgeving. Ontwerpers van stedelijke omgevingen kunnen kennis uit de omgevingspsychologie benutten voor een betere beleving en stressvermindering van inwoners.
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Background: Neurodevelopmental treatment (NDT) is a rehabilitation approach increasingly used in the care of stroke patients, although no evidence has been provided for its efficacy. Objective: To investigate the effects of NDT on the functional status and quality of life (QoL) of patients with stroke during one year after stroke onset. Methods: 324 consecutive patients with stroke from 12 Dutch hospitals were included in a prospective, non-randomised, parallel group study. In the experimental group (n = 223), nurses and physiotherapists from six neurological wards used the NDT approach, while conventional treatment was used in six control wards (n = 101). Functional status was assessed by the Barthel index. Primary outcome was poor outcome, defined as Barthel index ,12 or death after one year. QoL was assessed with the 30 item version of the sickness impact profile (SA-SIP30) and the visual analogue scale. Results: At 12 months, 59 patients (27%) in the NDT group and 24 (24%) in the non-NDT group had poor outcome (corresponding adjusted odds ratio = 1.7 (95% confidence interval, 0.8 to 3.5)). At discharge the adjusted odds ratio was 0.8 (0.4 to 1.5) and after six months it was 1.6 (0.8 to 3.2). Adjusted mean differences in the two QoL measures showed no significant differences between the study groups at six or 12 months after stroke onset. Conclusions: The NDT approach was not found effective in the care of stroke patients in the hospital setting. Health care professionals need to reconsider the use of this approach.
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