Objective: To describe the development of a goal-directed movement intervention in two medical wards, including recommendations for implementation and evaluation. Design: Implementation Research. Setting: Pulmonology and nephrology/gastroenterology wards of the University Medical Centre Utrecht, The Netherlands. Participants: Seven focus groups were executed including 28 nurses, 7 physical therapists and 15 medical specialists. Patients' perceptions were repeatedly assessed during the iterative steps of the intervention development. Intervention: Interventions were targeted to each ward's specific character, following an Intervention Mapping approach using literature and research meetings. Main measures: Intervention components were linked to Behavior Change Techniques and implementation strategies will be selected using the Expert Recommendation Implementing Change tool. Evaluation outcomes like number of patients using the movement intervention will be measured, based on the taxonomy of Proctor. Results: The developed intervention consists of: insight in patients movement behavior (monitoring & feedback), goal setting (goals & planning) and adjustments to the environment (associations & antecedents). The following implementation strategies are recommended: to conduct educational meetings, prepare & identify champions and audit & provide feedback. To measure service and client outcomes, the mean level of physical activity per ward can be evaluated and the Net Promoter Score can be used. Conclusion(s): This study shows the development of a goal-directed movement intervention aligned with the needs of healthcare professionals. This resulted in an intervention consisting of feedback & monitoring of movement behavior, goal setting and adjustments in the environment. Using a step-by-step iterative implementation model to guide development and implementation is recommended.
DOCUMENT
Objective: To evaluate the preliminary effectiveness of a goal-directed movement intervention using a movement sensor on physical activity of hospitalized patients. Design: Prospective, pre-post study. Setting: A university medical center. Participants: Patients admitted to the pulmonology and nephrology/gastro-enterology wards. Intervention: The movement intervention consisted of (1) self-monitoring of patients' physical activity, (2) setting daily movement goals and (3) posters with exercises and walking routes. Physical activity was measured with a movement sensor (PAM AM400) which measures active minutes per day. Main measures: Primary outcome was the mean difference in active minutes per day pre- and post-implementation. Secondary outcomes were length of stay, discharge destination, immobility-related complications, physical functioning, perceived difficulty to move, 30-day readmission, 30-day mortality and the adoption of the intervention. Results: A total of 61 patients was included pre-implementation, and a total of 56 patients was included post-implementation. Pre-implementation, patients were active 38 ± 21 minutes (mean ± SD) per day, and post-implementation 50 ± 31 minutes per day (Δ12, P = 0.031). Perceived difficulty to move decreased from 3.4 to 1.7 (0-10) (Δ1.7, P = 0.008). No significant differences were found in other secondary outcomes. Conclusions: The goal-directed movement intervention seems to increase physical activity levels during hospitalization. Therefore, this intervention might be useful for other hospitals to stimulate inpatient physical activity.
DOCUMENT
Background Movement behaviors (i.e., physical activity levels, sedentary behavior) in people with stroke are not self-contained but cluster in patterns. Recent research identified three commonly distinct movement behavior patterns in people with stroke. However, it remains unknown if movement behavior patterns remain stable and if individuals change in movement behavior pattern over time. Objectives 1) To investigate the stability of the composition of movement behavior patterns over time, and 2) determine if individuals change their movement behavior resulting in allocation to another movement behavior pattern within the first two years after discharge to home in people with a first-ever stroke. Methods Accelerometer data of 200 people with stroke of the RISE-cohort study were analyzed. Ten movement behavior variables were compressed using Principal Componence Analysis and K-means clustering was used to identify movement behavior patterns at three weeks, six months, one year, and two years after home discharge. The stability of the components within movement behavior patterns was investigated. Frequencies of individuals’ movement behavior pattern and changes in movement behavior pattern allocation were objectified. Results The composition of the movement behavior patterns at discharge did not change over time. At baseline, there were 22% sedentary exercisers (active/sedentary), 45% sedentary movers (inactive/sedentary) and 33% sedentary prolongers (inactive/highly sedentary). Thirty-five percent of the stroke survivors allocated to another movement behavior pattern within the first two years, of whom 63% deteriorated to a movement behavior pattern with higher health risks. After two years there were, 19% sedentary exercisers, 42% sedentary movers, and 39% sedentary prolongers. Conclusions The composition of movement behavior patterns remains stable over time. However, individuals change their movement behavior. Significantly more people allocated to a movement behavior pattern with higher health risks. The increase of people allocated to sedentary movers and sedentary prolongers is of great concern. It underlines the importance of improving or maintaining healthy movement behavior to prevent future health risks after stroke.
MULTIFILE
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.
Road freight transport contributes to 75% of the global logistics CO2 emissions. Various European initiatives are calling for a drastic cut-down of CO2 emissions in this sector [1]. This requires advanced and very expensive technological innovations; i.e. re-design of vehicle units, hybridization of powertrains and autonomous vehicle technology. One particular innovation that aims to solve this problem is multi-articulated vehicles (road-trains). They have a smaller footprint and better efficiency of transport than traditional transport vehicles like trucks. In line with the missions for Energy Transition and Sustainability [2], road-trains can have zero-emission powertrains leading to clean and sustainable urban mobility of people and goods. However, multiple articulations in a vehicle pose a problem of reversing the vehicle. Since it is extremely difficult to predict the sideways movement of the vehicle combination while reversing, no driver can master this process. This is also the problem faced by the drivers of TRENS Solar Train’s vehicle, which is a multi-articulated modular electric road vehicle. It can be used for transporting cargo as well as passengers in tight environments, making it suitable for operation in urban areas. This project aims to develop a reverse assist system to help drivers reverse multi-articulated vehicles like the TRENS Solar Train, enabling them to maneuver backward when the need arises in its operations, safely and predictably. This will subsequently provide multi-articulated vehicle users with a sustainable and economically viable option for the transport of cargo and passengers with unrestricted maneuverability resulting in better application and adding to the innovation in sustainable road transport.
In societies where physical activity levels are declining, stimulating sports participation in youth is vital. While sports offer numerous benefits, injuries in youth are at an all-time high with potential long-term consequences. Particularly, women football's popularity surge has led to a rise in knee injuries, notably anterior cruciate ligament (ACL) injuries, with severe long-term effects. Urgent societal attention is warranted, supported by media coverage and calls for action by professional players. This project aims to evaluate the potential of novel artificial intelligence-based technology to enhance player monitoring for injury risk, and to integrate these monitoring pathways into regular training practice. Its success may pave the way for broader applications across different sports and injuries. Implementation of results from lab-based research into practice is hindered by the lack of skills and technology needed to perform the required measurements. There is a critical need for non-invasive systems used during regular training practice and allowing longitudinal monitoring. Markerless motion capture technology has recently been developed and has created new potential for field-based data collection in sport settings. This technology eliminates the need for marker/sensor placement on the participant and can be employed on-site, capturing movement patterns during training. Since a common AI algorithm for data processing is used, minimal technical knowledge by the operator is required. The experienced PLAYSAFE consortium will exploit this technology to monitor 300 young female football players over the course of 1 season. The successful implementation of non-invasive monitoring of football players’ movement patterns during regular practice is the primary objective of this project. In addition, the study will generate key insights into risk factors associated with ACL injury. Through this approach, PLAYSAFE aims to reduce the burden of ACL injuries in female football players.
