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.
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Purpose (1) To investigate the differences in the course of participation up to one year after stroke between distinct movement behavior patterns identified directly after discharge to the home setting, and (2) to investigate the longitudinal association between the development of movement behavior patterns over time and participation after stroke. Materials and methods 200 individuals with a first-ever stroke were assessed directly after discharge to the home setting, at six months and at one year. The Participation domain of the Stroke Impact Scale 3.0 was used to measure participation. Movement behavior was objectified using accelerometry for 14 days. Participants were categorized into three distinct movement behavior patterns: sedentary exercisers, sedentary movers and sedentary prolongers. Generalized estimating equations (GEE) were performed. Results People who were classified as sedentary prolongers directly after discharge was associated with a worse course of participation up to one year after stroke. The development of sedentary prolongers over time was also associated with worse participation compared to sedentary exercisers. Conclusions The course of participation after stroke differs across distinct movement behavior patterns after discharge to the home setting. Highly sedentary and inactive people with stroke are at risk for restrictions in participation over time. Implications for rehabilitation The course of participation in people with a first-ever stroke up to one year after discharge to the home setting differed based on three distinct movement behavior patterns, i.e., sedentary exercisers, sedentary movers and sedentary prolongers. Early identification of highly sedentary and inactive people with stroke after discharge to the home setting is important, as sedentary prolongers are at risk for restrictions in participation over time. Supporting people with stroke to adapt and maintain a healthy movement behavior after discharge to the home setting could prevent potential long-term restrictions in participation.
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Movement behaviors, that is, both physical activity and sedentary behavior, are independently associated with health risks. Although both behaviors have been investigated separately in people after stroke, little is known about the combined movement behavior patterns, differences in these patterns between individuals, or the factors associated with these patterns. Therefore, the objectives of this study are (1) to identify movement behavior patterns in people with first-ever stroke discharged to the home setting and (2) to explore factors associated with the identified patterns.
Design, Design Thinking, and Co-design have gained global recognition as powerful approaches for innovation and transformation. These methodologies foster stakeholder engagement, empathy, and collective sense-making, and are increasingly applied to tackle complex societal and institutional challenges. However, despite their collaborative potential, many initiatives encounter resistance, participation fatigue, or only result in superficial change. A key reason lies in the overlooked undercurrent—the hidden systemic dynamics that shape transitions. This one-year exploratory research project, initiated by the Expertise Network Systemic Co-design (ESC), aims to make systemic work accessible to creative professionals and companies working in social and transition design. It focuses on the development of a Toolkit for Systemic Work, enabling professionals to recognize underlying patterns, power structures, and behavioral dynamics that can block or accelerate innovation. The research builds on the shared learning agenda of the ESC network, which brings together universities of applied sciences, design practitioners, and organizations such as the Design Thinkers Group, Mindpact, and Vonken van Vernieuwing. By integrating systemic insights—drawing from fields like systemic therapy, constellation work, and behavioral sciences—into co-design practices, the project strengthens the capacity to not only design solutions but also navigate the forces that shape sustainable change. The central research question is: How can we make systemic work accessible to creative professionals, to support its application in social and transition design? Through the development and testing of practical tools and methods, this project bridges the gap between academic insights and the concrete needs of practitioners. It contributes to the professionalization of design for social innovation by embedding systemic awareness and collective learning into design processes, offering a foundation for deeper impact in societal transitions.
Supermarkets are essential urban household amenities, providing daily products, and for their social role in communities. Contrary to many other countries, including nearby ones, the Netherlands have a balanced distribution of supermarkets across villages and urban neighbourhoods. However, spatial supermarket patterns, are subject to influential developments. First, due to economies of scale, there is a tendency for supermarkets to increase their catchment areas and to disappear from peripheral villages. Second, supermarkets are now mainly located in residential areas, although the urban periphery appears to be attractive for the retail sector, perhaps including the rise of hypermarkets. Third, today, online grocery shopping is still lagging far behind on other online shopping products, but a breaks through will dilute population support for in-store supermarkets and can lead to dramatic ‘game changer’ shifts with major spatial and social effects. These three important trends will reinforce each other. Consequences are of natural community meeting places at the expense of social cohesion; reduced accessibility for daily products, leading to more travel, often by car; increasing delivery flows; real estate vacancies, and increasing suburban demand increase for retail and logistics. Expected changes in supermarket patterns require understanding, but academic literature on OGS is still scarce, and does hardly address household behaviour in changing spatial constellations. We develop likely spatial supermarket patterns, and model the consequences for travel demand, social cohesion and real estate demand, as well as the distribution between online and in-store grocery shopping, by developing a stated preference experiment, among Dutch households.
Despite the recognized benefits of running for promoting overall health, its widespread adoption faces a significant challenge due to high injury rates. In 2022, runners reported 660,000 injuries, constituting 13% of the total 5.1 million sports-related injuries in the Netherlands. This translates to a disturbing average of 5.5 injuries per 1,000 hours of running, significantly higher than other sports such as fitness (1.5 injuries per 1,000 hours). Moreover, running serves as the foundation of locomotion in various sports. This emphasizes the need for targeted injury prevention strategies and rehabilitation measures. Recognizing this social issue, wearable technologies have the potential to improve motor learning, reduce injury risks, and optimize overall running performance. However, unlocking their full potential requires a nuanced understanding of the information conveyed to runners. To address this, a collaborative project merges Movella’s motion capture technology with Saxion’s expertise in e-textiles and user-centered design. The result is the development of a smart garment with accurate motion capture technology and personalized haptic feedback. By integrating both sensor and actuator technology, feedback can be provided to communicate effective risks and intuitive directional information from a user-centered perspective, leaving visual and auditory cues available for other tasks. This exploratory project aims to prioritize wearability by focusing on robust sensor and actuator fixation, a suitable vibration intensity and responsiveness of the system. The developed prototype is used to identify appropriate body locations for vibrotactile stimulation, refine running styles and to design effective vibration patterns with the overarching objective to promote motor learning and reduce the risk of injuries. Ultimately, this collaboration aims to drive innovation in sports and health technology across different athletic disciplines and rehabilitation settings.
