Publications by authors named "Ilse Lamers"

Upper limb intention tremor in persons with multiple sclerosis (pwMS) affects the ability to perform activities of daily life and is difficult to treat. The study investigated the effect of peripheral upper limb cooling on tremor severity and functional performance in MS patients with intention tremor. In experiment 1, 17 patients underwent two 15 min cooling conditions for the forearm (cold pack and cryomanchet) and one control condition.

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Background: Multiple sclerosis often leads to proprioceptive impairments of the hand. However, it is challenging to objectively assess such deficits using clinical methods, thereby also impeding accurate tracking of disease progression and hence the application of personalized rehabilitation approaches.

Objective: We aimed to evaluate test-retest reliability, validity, and clinical usability of a novel robotic assessment of hand proprioceptive impairments in persons with multiple sclerosis (pwMS).

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Article Synopsis
  • Trunk control is crucial for movement and balance, yet it’s often overlooked in routine medical care for individuals with multiple sclerosis (MS).
  • A study examined trunk impairments and their relation to disability levels in 154 MS patients, finding trunk issues present even in those with mild disabilities and varying correlations with overall disability.
  • Results suggest incorporating trunk assessments early in MS treatment, especially focusing on pelvic elevation and trunk rotation, to improve rehabilitation outcomes.
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Article Synopsis
  • The study focuses on predicting outcomes of upper limb rehabilitation for individuals with multiple sclerosis (pwMS) in order to enhance therapy allocation.
  • Using machine learning alongside clinical data and digital health metrics, the researchers trained models to predict individual improvements based on specific tests like ARAT, BBT, and NHPT.
  • The results showed promising accuracy rates for predicting motor improvements, especially when incorporating digital health metrics, highlighting the potential for developing better prediction models in the future.
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Background: Technology-supported rehabilitation can help alleviate the increasing need for cost-effective rehabilitation of neurological conditions, but use in clinical practice remains limited. Agreement on a core set of reliable, valid and accessible outcome measures to assess rehabilitation outcomes is needed to generate strong evidence about effectiveness of rehabilitation approaches, including technologies. This paper collates and synthesizes a core set from multiple sources; combining existing evidence, clinical practice guidelines and expert consensus into European recommendations for Clinical Assessment of Upper Limb In Neurorehabilitation (CAULIN).

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Article Synopsis
  • High-quality clinical practice guidelines (CPGs) for managing multiple sclerosis (MS) provide evidence-based recommendations for rehabilitation but lack a comprehensive review of these guidelines.
  • A study aimed to compile evidence-based recommendations from high-quality multidisciplinary CPGs published between 2009 and 2019, assessing their quality and categorizing the recommendations according to established health classifications.
  • Out of five CPGs reviewed, 120 recommendations were identified, with varying levels of strength and evidence, highlighting the need for updated guidelines that focus more on activity and participation for better clinical practices across different healthcare settings.
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Article Synopsis
  • The rise of mobile technology and the Internet has opened up new opportunities for managing multiple sclerosis (MS) through mobile health applications (mHealth), focusing on rehabilitation and self-assessment.
  • A review analyzed 36 studies involving 22 mHealth applications, finding that while there is some evidence supporting their effectiveness, particularly in cognitive function and fatigue, the overall level of evidence is still unclear.
  • The results indicate that mHealth shows promise, especially for cognitive training and fatigue management, but more research is needed to validate these tools across different functioning problems in multiple sclerosis patients.
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Introduction: Persons with multiple sclerosis (pwMS) could have an impaired trunk and reduced postural control, which negatively impacts activities of daily living. Evidence is growing to consider the positive effects of trunk training on fall incidence and balance problems. Effects on trunk and upper limb performance is unknown.

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(1) Background: technology-based training systems are increasingly integrated in neurorehabilitation but are rarely combined with a client-centred task-oriented approach. To provide a low-cost client-centred task-oriented system, the intelligent activity-based client-centred task-oriented training (i-ACT) was developed. The objective was to evaluate the usability, credibility and treatment expectancy of i-ACT, and the motivation towards i-ACT use in rehabilitation over time.

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Pain is an important and frequent symptom in multiple sclerosis (MS), which leads to a low quality of life, increased disability level, and lack of employment and mental health. Recently, studies have shown increased interest in pain in MS and there is a growing evidence of its prevalence. However, the literature suffers from lack of experimental studies focusing on pain reduction.

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Digital health metrics promise to advance the understanding of impaired body functions, for example in neurological disorders. However, their clinical integration is challenged by an insufficient validation of the many existing and often abstract metrics. Here, we propose a data-driven framework to select and validate a clinically relevant core set of digital health metrics extracted from a technology-aided assessment.

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Introduction: Fatigability, a change in performance according to tasks and circumstances, can contribute to walking limitations in daily life. Walking-related fatigability (WF) has been assessed subjectively, but current knowledge on best objective measurement methods is limited. The aim of this study was to provide an overview of objective clinical measurement methods assessing WF in different populations.

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Hand function is often impaired after neurological injuries such as stroke. In order to design patient-specific rehabilitation, it is essential to quantitatively assess those deficits. Current clinical scores cannot provide the required level of detail, and most assessment devices have been developed for the proximal joints of the upper limb.

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Upper limb impairment is a common problem for people with neurological disabilities, affecting activity, performance, quality of life, and independence. Accurate, timely assessments are required for effective rehabilitation, and development of novel interventions. International consensus on upper limb assessment is needed to make research findings more meaningful, provide a benchmark for quality in clinical practice, more cost-effective neurorehabilitation and improved outcomes for neurological patients undergoing rehabilitation.

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Background: Task-oriented training promotes functional recovery in Multiple Sclerosis (MS). Know-how to determine an individualized training intensity and intensity-dependent effects are, however, unknown. The objective of the study was to investigate the feasibility and the clinical effects of a task-oriented upper limb training program at different individualized training intensities with conventional occupational therapy.

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Background: Cognitive-motor interference in multiple sclerosis has been well examined during walking, but not during upper limb (UL) performance.

Objectives: To examine the dual-task cost (DTC) in persons with multiple sclerosis (pwMS) and healthy controls (HC) in various type and complexity of UL motor tasks.

Method: In total, 30 pwMS without major UL impairment and 30 HC performed five different UL tasks, in single condition and combined with the phonemic word list generation task.

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Personalized treatment is highly desirable in multiple sclerosis (MS). We believe that multidisciplinary measurements including clinical, functional and patient-reported outcome measures in combination with extensive patient profiling can enhance personalized treatment and rehabilitation strategies. We elaborate on four reasons behind this statement: (1) MS disease activity and progression are complex and multidimensional concepts in nature and thereby defy a one-size-fits-all description, (2) functioning, progression, treatment, and rehabilitation effects are interdependent and should be investigated together, (3) personalized healthcare is based on the dynamics of system biology and on technology that confirms a patient's fundamental biology and (4) inclusion of patient-reported outcome measures can facilitate patient-relevant healthcare.

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Background: Gait velocity influences the ability of a person to move in different outdoor or indoor contexts and has accordingly been classified through the Modified Functional Walking Categories (MFWC). Community ambulation in persons with multiple sclerosis (PwMS) may give information on their social and productive participation, as well as independence in household activities.

Objectives: To investigate factors associated with walking and mobility restrictions as classified by the Modified Functional Walking Categories (MFWC) and analyze the influence of disease characteristics, demographical and walking factors on participation in PwMS.

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Background: Client-centred task-oriented training is important in neurological rehabilitation but is time consuming and costly in clinical practice. The use of technology, especially motion capture systems (MCS) which are low cost and easy to apply in clinical practice, may be used to support this kind of training, but knowledge and evidence of their use for training is scarce. The present review aims to investigate 1) which motion capture systems are used as training devices in neurological rehabilitation, 2) how they are applied, 3) in which target population, 4) what the content of the training and 5) efficacy of training with MCS is.

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Background: Persons with multiple sclerosis (PwMS) are often characterized by increased motor fatigability, which is a performance change on an objectively measured criterion after any type of voluntary muscle contractions. This review summarizes the existing literature to determine which protocols and outcome measures are best to detect or study motor fatigability and the underlying mechanisms in MS.

Methods: Two electronic databases, PubMed and Web of Science, were searched for relevant articles published until August 2016 with a combination of multiple sclerosis, fatigability, muscle fatigue, and motor fatigue.

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Objectives: To calculate the percentage of participation restrictions according to disability level in multiple sclerosis (MS), and to assess the relationship between participation restrictions and cognitive, gait, balance, and upper limb deficits.

Design: Cross-sectional study.

Setting: Rehabilitation unit.

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Impaired manual dexterity is a frequently reported disability in people with multiple sclerosis (MS) and is increasingly prevalent with worsening disease. While various tests and patient-reported outcome measures are available, the Nine-Hole Peg Test (NHPT) is considered as a gold standard measure of manual dexterity and most frequently used in MS research and clinical practice. The MS Outcome Assessments Consortium (MSOAC) includes representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS.

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Purpose: The current study aimed to investigate proof-of-concept efficacy of an individualized, robot-mediated training regime for people with MS (pwMS) and stroke patients.

Method: Thirteen pwMS and 14 chronic stroke patients performed 36 (stroke) or 40 (pwMS) training sessions with the I-TRAVLE system. Evaluation of upper limb function was performed at baseline, after training and at 3 months follow-up.

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Background: The need for cost-effective neurorehabilitation is driving investment into technologies for patient assessment and treatment. Translation of these technologies into clinical practice is limited by a paucity of evidence for cost-effectiveness. Methodological issues, including lack of agreement on assessment methods, limit the value of meta-analyses of trials.

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