Background: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. Objective: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-)effectiveness compared with care as usual. Methods: Development of a protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n = 48) receiving care as usual and of an intervention group (optimized provision process) (n = 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up.
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In wheelchair rugby (WR) athletes with tetraplegia, wheelchair performance may be impaired due to (partial) loss of innervation of upper extremity and trunk muscles, and low blood pressure (BP). The objective was to assess the effects of electrical stimulation (ES)-induced co-contraction of trunk muscles on trunk stability, arm force/power, BP, and WR performance.
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Background There currently is no field test available for measuring maximal exercise capacity in people with stroke. Objective To determine the feasibility, reproducibility and validity of the Shuttle Test (ST) to measure exercise capacity in people with stroke. Design Longitudinal study design. Setting Rehabilitation department, day care centres from a nursing home and private practices specialized in neuro rehabilitation. Subjects People with subacute or chronic stroke. Interventions A standardized protocol was used to determine feasibility, reproducibility and validity of the 10-meter Shuttle Test (10mST). Main measures Number of shuttles completed, 1stVentilatory Threshold (1stVT). Results The associations of the number of shuttles completed and cardiopulmonary capacity as measured with a portable gas analyser were r > 0.7, confirming good convergent validity in subacute and chronic people with stroke. Criterion validity, however, indicates it is not a valid test for measuring maximal cardiopulmonary capacity (VO2max). Only 60% of participants were able to reach the 1stVT. Higher cardiopulmonary capacity and a higher total score of the lower extremity Motricity Index contributed significantly to a higher number of shuttles walked (p = 0.001). Conclusions The Shuttle Test may be a safe and useful exercise test for people after stroke, but may not be appropriate for use with people who walk slower than 2 km/h or 0.56 m/s.
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