Background: Computer-based cognitive rehabilitation is used to improve cognitive functioning after stroke. However, knowledge on adherence rates of stroke patients is limited. Objective: To describe stroke patients’ adherence with a brain training program using two frequencies of health professionals’ supervision. Methods: This study is part of a randomized controlled trial comparing the effect of the brain training program (600 min playtime with weekly supervision) with a passive intervention in patients with self-perceived cognitive impairments after stroke. Patients randomized to the control condition were offered the brain training after the trial and received supervision twice (vs weekly in intervention group). Adherence was determined using data from the study website. Logistic regression analyses were used to examine the impact of supervision on adherence. Results: 53 patients allocated to the intervention group (group S8; 64% male, mean age 59) and 52 patients who were offered the intervention after the trial (group S2; 59% male, mean age 59) started the brain training. The median playtime was 562 min (range 63–1264) in group S8 vs. 193 min (range 27–2162) in group S2 (p < 0.001, Mann Whitney U). Conclusions: The overall adherence of stroke patients with a brain training was low and there are some implications that systematic, regular interaction with a supervisor can increase training adherence of stroke patients with a restitution-focused intervention performed at home. “This is an Accepted Manuscript of an article published by Taylor & Francis in "Topics in Stroke Rehabilitation" on 04/17/18, available online: https://doi.org/10.1080/10749357.2018.1459362. LinkedIn: https://www.linkedin.com/in/joritmeesters/ https://www.linkedin.com/in/moniqueberger/ https://www.linkedin.com/in/arend-de-kloet-4329102/
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Objectives: Participation is considerably restricted in children and adolescents with acquired brain injury (ABI) as compared to their healthy peers. This systematic review aims to identify which factors are associated with participation in children and adolescents with ABI. Methods: A systematic search in Medline and various other electronic databases from January 2001–November 2014 was performed. All clinical studies describing determinants of participation at least 1 year after the diagnosis of ABI by means of one or more pre-defined instruments in patients up to 18 years of age were included. Extracted data included study characteristics, patient characteristics, participation outcome and determinants of participation (categorized into: health conditions (including characteristics of ABI), body functions and structures, activities, personal factors and environmental factors). The methodological quality of the studies was evaluated based on three quality aspects (selection, information and statistical analysis bias) and scored as low, moderate or high. Results: Eight studies using an explicit participation outcome measure were selected after review, including a total of 1863 patients, with a follow-up ranging from 1 up to 288 months. Three studies included patients with a traumatic or a non-traumatic brain injury (TBI or NTBI) and five studies with only TBI patients. Factors consistently found to be associated with more participation restrictions were: greater severity of ABI, impaired motor, cognitive, behavioural and/or sensory functioning, limited accessibility of the physical environmentand worse family functioning. Fewer participation problems were associated with a supportive/nurturing parenting style, higher household income, acceptance and support in the community and availability of special programmes. The overall methodological quality of the included studies was high in two and moderate in six studies. Conclusion: This systematic review shows that only a few, moderate quality, studies on the determinants of participation after paediatric ABI using recommended explicit measurement instruments are available. Various components of the ICF model: health condition, body functions and structures and environmental factors were consistently found to be associated with participation. More methodologically sound studies, using the recommended explicit outcome measures, a standardized set of potential determinants and longterm follow-up are suggested to increase the knowledge on participation in children and youth with ABI.
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AIM To examine which instruments used to assess participation of children with acquired brain injury (ABI) or cerebral palsy (CP) align with attendance and/or involvement constructs of participation; and to systematically review measurement properties of these instruments in children with ABI or CP, to guide instrument selection. METHOD Five databases were searched. Instruments that quantified ‘attendance’ and/or ‘involvement’ aspects of participation according to the family of participation-related constructs were selected. Data on measurement properties were extracted and methodological quality of the studies assessed. RESULTS Thirty-seven instruments were used to assess participation in children with ABI or CP. Of those, 12 measured attendance and/or involvement. The reliability, validity, and responsiveness of eight of these instruments were examined in 14 studies with children with ABI or CP. Sufficient measurement properties were reported for most of the measures, but no instrument had been assessed on all relevant properties. Moreover, most psychometric studies have marked methodological limitations. INTERPRETATION Instruments to assess participation of children with ABI or CP should be selected carefully, as many available measures do not align with attendance and/or involvement. Evidence for measurement properties is limited, mainly caused by low methodological study quality. Future studies should follow recommended methodological guidelines.
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Fontys begeleidt een groep van 15 studenten tijdens hun afstuderen bij een MKB bedrijf intensiever dan gebruikelijk, opdat zij hun afstudeerstage met perspectiefrijke onderzoekstrajecten bij deze bedrijven kunnen vervolgen. Fontys begeleidt deze onderzoekstrajecten vakinhoudelijk, maar werkt met de bedrijven en studenten tevens aan de inhoudelijke verdieping en algemene vorming. Hiervoor werkt Fontys in deze pilot een traineeprogramma uit, alsook een werkwijze om studenten en bedrijven te verbinden. Een zorgvuldig ontworpen monitoring van de aanpak en resultaten zorgt voor tijdig bijsturen en een treffende evaluatie na afloop. Het Traineeprogramma richt zich op technologische MKB bedrijven in de Brainport regio. Zij vormen belangrijke schakels in de toeleverketens naar grote wereldmarktspelers als ASML, VDL en Philips. Vaak zijn zij ook zelfstandig actief aan de grenzen van de technische mogelijkheden. Sleuteltechnologieën als fotonica en fabrication technologies worden in hoog tempo omarmd om de wereldwijde concurrentie aan te kunnen. MKB bedrijven ontwikkelen mee aan de producten en diensten waardoor zij eveneens deze technologieën moeten beheersen. Maar, door de kleinere schaalgrootte ontbeert het vaak aan kennis en capaciteit. Deze pilot biedt mogelijk oplossingen voor beide. Met deze pilot beogen we innovatie in het MKB te bevorderen. Docent-onderzoekers van Fontys komen via de trajecten in direct inhoudelijk contact met de bedrijven en hun technologische uitdagingen. De bedrijven vormen met Fontys en de afgestudeerden een ‘learning community’ die op de high tech onderwerpen verdiepende kennis deelt en genereert. Deze community bestendigt de relatie met de hogeschool, maar heeft ook de potentie om zich na afloop te blijven ontwikkelen. Het Fontys Centre of Expertise HTSM is opgericht om bedrijfsleven en de hogeschool te verbinden. Het CoE verzorgt de werving en matching, regisseert het traineeprogramma en verbindt de onderzoekslijnen aan de actuele thema’s in de trainee-bedrijven. Daarmee versterkt het CoE eveneens haar eigen rol in de Brainport Regio.
