Implementing Individually Tailored Prescription of Physical Activity in Routine Clinical Care: A Process Evaluation of the Physicians Implement Exercise = Medicine Project.

Background: Although the prescription of physical activity in clinical care has been advocated worldwide, in the Netherlands, "Exercise is Medicine" (E = M) is not yet routinely implemented in clinical care.

Methods: A set of implementation strategies was pilot implemented to test its feasibility for use in routine care by clinicians in 2 departments of a university medical center. An extensive learning process evaluation was performed, using structured mixed methods methodology, in accordance with the Reach, Effect, Adoption, Implementation, and Maintenance framework.

Physical Activity Levels, Correlates, and All-Cause Mortality Risk in People Living With Different Health Conditions.

Background: To better understand physical activity behavior and its health benefits in people living with health conditions, we studied people with and without 20 different self-reported health conditions with regard to (1) their physical activity levels, (2) factors correlated with these physical activity levels, and (3) the association between physical activity and all-cause mortality.

Methods: We used a subsample (n = 88,659) of the Lifelines cohort study from the Netherlands. For people living with and without 20 different self-reported health conditions, we studied the aforementioned factors in relation to physical activity.

Effectiveness and therapeutic validity of physiotherapeutic exercise starting within one year following total and unicompartmental knee arthroplasty for osteoarthritis: a systematic review.

Background: To determine the effectiveness and therapeutic validity of physiotherapeutic exercise after total and unicompartmental knee arthroplasty for osteoarthritis. It was hypothesized that interventions of high therapeutic validity result in superior functional recovery after total and unicompartmental knee arthroplasty versus interventions of low therapeutic validity.

Methods: A systematic review incorporating a comprehensive database search of five major databases relevant to the topic was conducted.

Therapeutic validity and effectiveness of exercise interventions after lower limb-salvage surgery for sarcoma: a systematic review.

Background: An increasing number of patients are surviving sarcoma after lower limb-salvage surgery (LSS) and are left with functional limitations. This systematic review aimed to determine the therapeutic validity and effectiveness of exercise interventions after lower limb-salvage surgery (LSS) for sarcoma.

Methods: A systematic review was conducted using formal narrative synthesis of intervention studies (with and without control group) identified through PubMed, Embase, Cochrane Library, CINAHL, and PEDro databases.

Implementing Exercise = Medicine in routine clinical care; needs for an online tool and key decisions for implementation of Exercise = Medicine within two Dutch academic hospitals.

Background: There is much evidence to implement physical activity interventions for medical reasons in healthcare settings. However, the prescription of physical activity as a treatment, referring to as 'Exercise is Medicine' (E = M) is currently mostly absent in routine hospital care in The Netherlands. To support E = M prescription by clinicians in hospitals, this study aimed: (1) to develop an E = M-tool for physical activity advice and referrals to facilitate the E = M prescription in hospital settings; and (2) to provide an E = M decision guide on key decisions for implementation to prepare for E = M prescription in hospital care.

Facilitators and barriers for the implementation of exercise are medicine in routine clinical care in Dutch university medical centres: a mixed methodology study on clinicians' perceptions.

Objectives: Despite the many proven advantages of a physically active lifestyle in patient populations, prescription of exercise is currently not widely implemented in routine clinical practice. The aims of this study were twofold: (1) to assess perceptions of clinicians on the current practice of exercise is medicine (E=M) prescription in two Dutch university medical centres and (2) to determine their perceived barriers and facilitators for the implementation of E=M in routine clinical care in Dutch university medical centres.

Design: A mixed methodologies study, using both online questionnaires and semi-structured interviews.

Self-report Versus Measured Physical Activity Levels During Outpatient Cardiac Rehabilitation.

Purpose: Many patients with coronary artery disease (CAD) do not achieve the recommended physical activity (PA) levels during and after cardiac rehabilitation (CR). The aim of this study was to analyze moderate to vigorous physical activity (MVPA) levels and the differences between perceived (self-reported) and measured (activity monitor) MVPA in CAD patients during CR. The second aim was to analyze which patient characteristics were associated with this difference.

Implementing Individually Tailored Prescription of Physical Activity in Routine Clinical Care: Protocol of the Physicians Implement Exercise = Medicine (PIE=M) Development and Implementation Project.

Background: The prescription of physical activity (PA) in clinical care has been advocated worldwide. This "exercise is medicine" (E=M) concept can be used to prevent, manage, and cure various lifestyle-related chronic diseases. Due to several challenges, E=M is not yet routinely implemented in clinical care.

Rhythmic neural activity is comodulated with short-term gait modifications during first-time use of a dummy prosthesis: a pilot study.

Background: After transfemoral amputation, many hours of practice are needed to re-learn walking with a prosthesis. The long adaptation process that consolidates a novel gait pattern seems to depend on cerebellar function for reinforcement of specific gait modifications, but the precise, step-by-step gait modifications (e.g.

Rehabilitation: mobility, exercise & sports; a critical position stand on current and future research perspectives.

Background: Human movement, rehabilitation, and allied sciences have embraced their ambitions within the cycle of "RehabMove" congresses over the past 30 years. This combination of disciplines and collaborations in the Netherlands has tried to provide answers to questions in the fields of rehabilitation and adapted sports, while simultaneously generating new questions and challenges. These research questions help us to further deepen our understanding of (impaired) human movement and functioning, with and without supportive technologies, and stress the importance of continued multidisciplinary (inter)national collaboration.

Standing task difficulty related increase in agonist-agonist and agonist-antagonist common inputs are driven by corticospinal and subcortical inputs respectively.

In standing, coordinated activation of lower extremity muscles can be simplified by common neural inputs to muscles comprising a functional synergy. We examined the effect of task difficulty on common inputs to agonist-agonist (AG-AG) pairs supporting direction specific reciprocal muscle control and agonist-antagonist (AG-ANT) pairs supporting stiffness control. Since excessive stiffness is energetically costly and limits the flexibility of responses to perturbations, compared to AG-ANT, we expected greater AG-AG common inputs and a larger increase with increasing task difficulty.

In Standing, Corticospinal Excitability Is Proportional to COP Velocity Whereas M1 Excitability Is Participant-Specific.

Reductions in the base of support (BOS) make standing difficult and require adjustments in the neural control of sway. In healthy young adults, we determined the effects of reductions in mediolateral (ML) BOS on peroneus longus (PL) motor evoked potential (MEP), intracortical facilitation (ICF), short interval intracortical inhibition (SICI) and long interval intracortical inhibition (LICI) using transcranial magnetic stimulation (TMS). We also examined whether participant-specific neural excitability influences the responses to increasing standing difficulty.

Predicting mobility outcome in lower limb amputees with motor ability tests used in early rehabilitation.

Study Design: Retrospective cohort study.

Background: Persons with a lower limb amputation can regain mobility using a prosthetic device. For fast and adequate prescription of prosthetic components, it is necessary to predict the mobility outcome early in rehabilitation.

Postural challenge affects motor cortical activity in young and old adults.

When humans voluntarily activate a muscle, intracortical inhibition decreases. Such a decrease also occurs in the presence of a postural challenge and more so with increasing age. Here, we examined age-related changes in motor cortical activity during postural and non-postural contractions with varying levels of postural challenge.

Validation and User Evaluation of a Sensor-Based Method for Detecting Mobility-Related Activities in Older Adults.

Regular physical activity is essential for older adults to stay healthy and independent. However, daily physical activity is generally low among older adults and mainly consists of activities such as standing and shuffling around indoors. Accurate measurement of this low-energy expenditure daily physical activity is crucial for stimulation of activity.

Immersive virtual reality improves movement patterns in patients after ACL reconstruction: implications for enhanced criteria-based return-to-sport rehabilitation.

Purpose: The purpose of this study was to evaluate the influence of immersion in a virtual reality environment on knee biomechanics in patients after ACL reconstruction (ACLR). It was hypothesized that virtual reality techniques aimed to change attentional focus would influence altered knee flexion angle, knee extension moment and peak vertical ground reaction force (vGRF) in patients following ACLR.

Methods: Twenty athletes following ACLR and 20 healthy controls (CTRL) performed a step-down task in both a non-virtual reality environment and a virtual reality environment displaying a pedestrian traffic scene.

[Sport performance with a prosthesis].

Technology is a contributory factor to sporting success in many Paralympic sports. This article is about upper and lower limb prostheses that are used in sports. The characteristics of lower limb prosthesis can be modified to respond to predictable leg movements such as with running.

Postural control of elderly: moving to predictable and unpredictable targets.

Impaired postural control with muscle weakness is an important predictor of falls within the elderly population.Particular daily activities that require weight shifting in order to be able to reach a specific target (a cup on a table) require continuous adjustments to keep the body's center of mass balanced. In the present study postural control was examined in healthy elderly and young subjects during a task in which subjects had to move the body's center of mass towards a virtual target on a screen that appeared at predictable and unpredictable locations.

Controlling horizontal deceleration during gait termination in transfemoral amputees: measurements and simulations.

In this study we investigated how leading limb angles combined with active ankle moments of a sound ankle or passive stiffness of a prosthetic ankle, influence the center of mass (CoM) velocity during the single limb support phase in gait termination. Also, we studied how the trailing limb velocity influences the CoM velocity during this phase. We analyzed force plate data from a group of experienced transfermoral (TF) amputee subjects using a prosthetic limb, and the outcome from a two-dimensional mathematical forward dynamics model.

Principles of obstacle avoidance with a transfemoral prosthetic limb.

In this study, conditions that enable a prosthetic knee flexion strategy in transfemoral amputee subjects during obstacle avoidance were investigated. This study explored the hip torque principle and the static ground principle as object avoidance strategies. A prosthetic limb simulator device was used to study the influence of applied hip torques and static ground friction on the prosthetic foot trajectory.

Stabilizing moments of force on a prosthetic knee during stance in the first steps after gait initiation.

In this study, the occurrences of stabilizing and destabilizing external moments of force on a prosthetic knee during stance, in the first steps after gait initiation, in inexperienced users were investigated. Primary aim was to identify the differences in the external moments during gait initiation with the sound leg leading and the prosthetic leg leading. A prosthetic leg simulator device, with a flexible knee, was used to test able-bodied subject, with no walking aid experience.

Gait adjustments in obstacle crossing, gait initiation and gait termination after a recent lower limb amputation.

Objective: To describe the adjustments in gait characteristics of obstacle crossing, gait initiation and gait termination that occur in subjects with a recent lower limb amputation during the rehabilitation process.

Design: Prospective and descriptive study.

Subjects: Fourteen subjects with a recent transfemoral, knee disarticulation or transtibial amputation.

Comparative roll-over analysis of prosthetic feet.

A prosthetic foot is a key element of a prosthetic leg, literally forming the basis for a stable and efficient amputee gait. We determined the roll-over characteristics of a broad range of prosthetic feet and examined the effect of a variety of shoes on these characteristics. The body weight of a person acting on a prosthetic foot during roll-over was emulated by means of an inverted pendulum-like apparatus.

Controlling propulsive forces in gait initiation in transfemoral amputees.

During prosthetic gait initiation, transfemoral (TF) amputees control the spatial and temporal parameters that modulate the propulsive forces, the positions of the center of pressure (CoP), and the center of mass (CoM). Whether their sound leg or the prosthetic leg is leading, the TF amputees reach the same end velocity. We wondered how the CoM velocity build up is influenced by the differences in propulsive components in the legs and how the trajectory of the CoP differs from the CoP trajectory in able bodied (AB) subjects.