De behandeling van klompvoeten kan nog beter, vinden artsen en wetenschappers in Eindhoven. Daartoe worden kinderen met én zonder klompvoetjes onderzocht in een looplab.
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Purpose: The etiology of pain in osteoarthritis (OA) is complex andmultifactorial. A growing number of studies suggest that modificationof pain-transmission in the peripheral and central nervous system,leading to sensitization, plays a role in OA pain. Sensitization seems tobe associated with neuropathic pain-like symptoms and assessment ofthese symptoms can help to identify patients who could benefit fromadditional treatment options. Several questionnaires are available todistinguish neuropathic from nociceptive pain symptoms. The modifiedpainDETECT questionnaire (mPDQ) is a self-reported questionnairedeveloped to discriminate between nociceptive- and possible/likelyneuropathic pain in knee OA patients. Recently the mPDQ was translatedinto Dutch and adjusted to also fit hip OA patients. The aim of thisstudy was to assess the validity of the mPDQ-NL in patients with hip orknee OA.Methods: Primary hip and knee OA patients were recruited from threeDutch hospitals. Based on previous research, confirmatory factor analysisfor two principal components was performed to assess structuralvalidity. Construct validity (both convergent and divergent) wasassessed using hypothesis testing. Predefined hypotheses were formulatedconcerning the correlation between the mPDQ-NL and theSelf-reported Leeds Assessment of Neuropathic Symptoms and Signs (SLANSS),subscales of the Knee injury and Osteoarthritis Outcome score/Hip disability and Osteoarthritis Outcome Score (KOOS/HOOS), VisualAnalogue Scale for pain (VAS pain), and subscales of the RAND-36health survey (RAND-36). According to the COSMIN criteria, constructvalidity of a questionnaire is sufficient if 75% of predefined hypothesesare met. Additionally, convergent validity was assessed with blunt PainPressure Thresholds (PPTs) in a subsample of participants. A reducedPPT is a somatosensory abnormality that is considered an indication ofsensitization in OA. Therefore it was expected that reduction of PPTswas associated with higher mPDQ scores.Results: 168 participants were included. PPT measurements wereperformed in a sample of 46 participants. Factor analysis confirmed twoprincipal components. The items that loaded on the first componentcould be described as “evoked neuropathic sensations”, the items thatloaded on the second component as “spontaneous neuropathic sensations”.However there were two items that substantially loaded on bothcomponents. The item regarding pain pattern did not load on anycomponent. Considering construct analysis, 80% of the predefinedhypotheses concerning the correlation between mPDQ and self-reportedquestionnaires were met. Considering the correlation with PPTmeasurements, 50% of the predefined hypotheses were met.Conclusions: The mPDQ-NL seems to adequately reflect neuropathicpain-like symptoms experienced by hip and knee OA patients. Concerningstructural validity, two determinative components seem to bepresent, in line with previous research. However, one particular itemregarding pain pattern might not reflect the construct of neuropathicpain-like symptoms in hip or knee OA. Therefore, when using the mPDQin hip or knee OA patients, it might be considered to skip this particularitem. Construct validity can be considered sufficient, with over 75% ofthe predefined hypotheses regarding correlation between the mPDQNLand other questionnaires were met. However, only 50% of the hypotheses concerning PPT measurements were met, probably due toheterogeneity and limited sample size of this subgroup. To ourknowledge, this study is the first to assess the structural validity of themPDQ knee and hip by using factor analysis and to assess constructvalidity using elaborate hypothesis testing as proposed by the COSMINguidelines.
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Background: The modified painDETECT questionnaire (PDQ) is a self-reported questionnaire to discriminatebetween nociceptive and neuropathic-like pain in patients with knee/hip osteoarthritis (OA). This studyaims to assess the structural and construct validity of this questionnaire.Methods: Confirmatory factor analysis and hypothesis-testing was used. For 168 patients, predefinedhypotheses were formulated on the correlation between the modified painDETECT and several otherquestionnaires, and in a subsample of 46 with pain pressure thresholds (PPTs).Results: Two principal components were confirmed. The pain pattern item did not load on any component.Eighty per cent of the hypotheses on the correlation between modified PDQ and the questionnaireswere met, as were 50% concerning PPTs measurements.Conclusions: This study is the first to assess structural and construct validity of the modified PDQ knee/hip by using factor analysis and hypothesis-testing. This questionnaire seems to reflect neuropathic-like pain symptoms experienced by hip/knee OA-patients with adequate validity. The item on pain patternmight not reflect the construct. More than 75% of the predefined hypotheses regarding the modified PDQ and the other questionnaires were met. Only 50% of the hypotheses on PPTs measurements were met, probably due to heterogeneity and limited size of this subsample.
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Full text te downloaden via link. Anderhalf jaar na het uitbrengen van de eerste druk is dit handboek alweer toe aan een tweede druk. Daar zijn we erg blij mee. Het handboek wordt veelvuldig gebruikt door professionals, vrijwilligers en ouderen zelf om samen aan de slag te gaan rondom het thema gezondheid. In de eerste druk hebben we ons, als docenten en onderzoekers Social Work, vooral gericht op sociale gezondheid. Dit hebben we gedaan omdat sociale gezondheid vaak onderbelicht is, als het gaat over gezondheid, terwijl uit menig onderzoek blijkt dat sociale activiteiten een grote positieve invloed hebben op de gezondheid. Vanuit de Hogeschool Utrecht kwam de vraag naar meer beweegactiviteiten. Daarom hebben we nu (alleen voor de Nederlandse versie) een bijlage ontwikkeld met beweegactiviteiten, als extra-onderdeel bij het Handboek ‘Gezond Ouder worden’. Studenten, professionals en vrijwilligers kunnen hiermee aan de slag binnen hun contact met 65-plussers. Zij kunnen op een laagdrempelige manier allerlei activiteiten met ouderen doen, die ouderen wel laten bewegen, maar die niet expliciet tot sport gerekend kunnen worden. De sociale component is ook hierin aanwezig. Plezier staat voorop. Wij hopen dat deze bijlage een nuttig hulpmiddel zal zijn bij het bevorderen van het plezier in bewegen voor ouderen.
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Dit handboek richt zich vooral op zelfmanagement-vaardigheden. Dat houdt in: het ontwikkelen van een effectieve en positieve manier van omgaan met onze gezondheid. We behandelen alledaagse en veelvoorkomende onderwerpen zoals drinken, voeding, sport en bewegen, geloof in de toekomst, veerkrachtigheid, sociale participatie en het voorkomen van eenzaamheid. Naast beknopte achtergrondinformatie biedt dit handboek ook verschillende oefeningen die je kunt gebruiken om je persoonlijke gezondheidstoestand te beoordelen, veranderen of te verbeteren. Als je leidinggevende bent of een groep ouderen leidt dan kun je dit handboek gebruiken om meer te leren over groepsbegeleiding.
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In het najaar van 2007 bezoek ik in de V.S. een internationaal vermaard centrum uit de zeventiger jaren: Esalen in Big Sur. Ter voorbereiding op dit bezoek herlees ik in april 2007 een boek uit 1973. In dit boek staan reisbrieven over ervaringen van Leo Lion in 1971 met Esalen. Ik ontdek dan nog meer in dit boek. De Amerikaanse begintijd van TGI en twee workshops die de auteur volgde bij Ruth Cohn worden beschreven.
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In het basismodule wetenschappelijke vaardigheden ontwikkelen de studenten meer begrip van methodologie en statistiek binnen de sport en beweegsector, alsook een kritische houding ten aanzien van onderzoeksresultaten. Omdat de Master of Sports een deeltijdstudie is en alle studenten ook werken in de beroepspraktijk, kan de student een bijdrage leveren aan het meer evidence-based maken van de beroepspraktijk op zijn werkplek. Zo heeft Bart van Gastel in opdracht van de Gelderse Sport Federatie een praktijkonderzoek uitgevoerd naar het effect van het aanleren van een B-Fit pauze-activiteit in de gymles op het spelen op het schoolplein bij 11- en 12-jarige meisjes.
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OBJECTIVES: Patients with hip or knee osteoarthritis (OA) may experience functional limitations in work settings. In the Cohort Hip and Cohort Knee study (CHECK) physical function was both self-reported and measured performance-based, using Functional Capacity Evaluation (FCE). Relations between self-reported scores on SF-36 and WOMAC (Western Ontario and McMaster Arthritis Index, function scales) and FCE performance were studied, and their diagnostic value for clinicians in predicting observed physical work limitations was assessed.METHODS: Ninety-two subjects scored physical function on SF-36 (scale 0-100, 100 indicating the best health level) and WOMAC (scale 0-68, 68 indicates maximum restriction) and performed the FCE. Correlations were calculated between all scores. Cross-tables were constructed using both questionnaires as diagnostic tests to identify work limitations. Subjects lifting <22.5 kg on the FCE-test 'lifting-low' were labeled as having physical work limitations. Diagnostic aspects at different cut-off scores for both questionnaires were analysed.RESULTS: Statistically significant correlations (Spearman's rho 0.34-0.49) were found between questionnaire scores and lifting and carrying tests. Results of a diagnostic cross-table with cut-off point <60 on SF-36 'physical functioning' were: sensitivity 0.34, specificity 0.97 and positive predictive value (PV+) 0.95. Cut-off point > or =21 on WOMAC 'function' resulted in sensitivity 0.51, specificity 0.88 and PV+ 0.88.CONCLUSION: Low self-reported function scores on SF-36 and WOMAC diagnosed subjects with limitations on the FCE. However, high scores did not guarantee performance without physical work limitations. These results are specific to the tested persons with early OA, in populations with a different prevalence of limitations, different diagnostic values will be found. FCE may be indicated to help clinicians to assess actual work capacity.
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OBJECTIVE: The prevalence of osteoarthritis (OA) increases, but the impact of the disorder on peoples' functional capacity is not known. Therefore, the objective of this study was to compare self-reported health status and functional capacity of subjects with early OA of hip and/or knee to reference data of healthy working subjects and to assess whether this capacity is sufficient to meet physical job demands.METHODS: Self-reported health status and functional capacity of 93 subjects from the Cohort Hip and Cohort Knee (CHECK) were measured using the Short-Form 36 Health Survey and 6 tests of the Work Well Systems Functional Capacity Evaluation. Results were compared with reference data from 275 healthy workers, using t-tests. To compare the functional capacity with job demands, the proportions of subjects with OA performing lower than the p(5) of reference data were calculated.RESULTS: Compared to healthy workers, the subjects (mean age 56) from CHECK at baseline reported a significantly worse physical health status, whereas the women (n = 78) also reported a worse mental health status. On the FCE female OA subjects performed significantly lower than their healthy working counterparts on all 6 tests. Male OA subjects performed lower than male workers on 3 tests. A substantial proportion of women demonstrated functional capacities that could be considered insufficient to perform jobs with low physical demands.CONCLUSIONS: Functional capacity and self-reported health of subjects with early OA of the hips and knees were worse compared to healthy ageing workers. A substantial proportion of female subjects did not meet physical job demands.
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