Nutritional ketosis improves exercise metabolism in patients with very long-chain acyl-CoA dehydrogenase deficiency.

A maladaptive shift from fat to carbohydrate (CHO) oxidation during exercise is thought to underlie myopathy and exercise-induced rhabdomyolysis in patients with fatty acid oxidation (FAO) disorders. We hypothesised that ingestion of a ketone ester (KE) drink prior to exercise could serve as an alternative oxidative substrate supply to boost muscular ATP homeostasis. To establish a rational basis for therapeutic use of KE supplementation in FAO, we tested this hypothesis in patients deficient in Very Long-Chain acyl-CoA Dehydrogenase (VLCAD).

[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.

Patterns of changes in wheelchair exercise capacity after spinal cord injury.

Objectives: (1) To identify different patterns of changes in wheelchair exercise capacity in the period between the start of active spinal cord injury (SCI) rehabilitation and 5 years after discharge; (2) to examine the pattern determinants of the change in wheelchair exercise capacity.

Design: Prospective cohort study. Measurements were recorded at the start of active inpatient rehabilitation, 3 months after the start, at discharge of inpatient rehabilitation, 1 year after discharge, and 5 years after discharge.

Different level, but a similar day pattern of physical activity in workers and sick-listed people with chronic nonspecific musculoskeletal pain.

Objective: To investigate whether physical activity (PA) levels and day patterns of sick-listed workers with chronic nonspecific musculoskeletal pain (CMP) admitted for multidisciplinary rehabilitation are different from those of workers with CMP.

Design: Cross-sectional.

Setting: Outpatient rehabilitation center and general community.

The effects of high custom made shoes on gait characteristics and patient satisfaction in hemiplegic gait.

Objective: To determine the effects of a temporary high custom made orthopaedic shoe on functional mobility, walking speed, and gait characteristics in hemiplegic stroke patients. In addition, interference of attentional demands and patient satisfaction were studied.

Design: Clinical experimental study.

Recovery of life satisfaction in persons with spinal cord injury during inpatient rehabilitation.

Objective: To determine the course of life satisfaction of persons with spinal cord injury and its determinants during inpatient rehabilitation and up to 1 yr after discharge.

Design: Prospective cohort study of 222 persons with spinal cord injury. Measurements at the start of active rehabilitation, after 3 mos, at discharge, and 1 yr after discharge.

Changes and determinants of life satisfaction after spinal cord injury: a cohort study in the Netherlands.

Objective: To determine the impact of spinal cord injury (SCI) on life satisfaction of persons with SCI 1 year after discharge of inpatient rehabilitation.

Design: A cohort study. Life satisfaction before SCI was retrospectively measured at the start of active rehabilitation.

Underlying mechanisms of improving physical activity behavior after rehabilitation.

Background: Regular physical activity is beneficial for the health and functioning of people with a disability. Effective components of successful physical activity promotion interventions should be identified and disseminated.

Purpose: To study the underlying mechanisms of the combined sport stimulation program "Rehabilitation & Sports" (R&S) and daily physical activity promotion program "Active after Rehabilitation" (AaR).

Prospective analysis of lipid profiles in persons with a spinal cord injury during and 1 year after inpatient rehabilitation.

Objectives: To investigate the course of lipid profiles during and 1 year after inpatient rehabilitation of persons with spinal cord injury, and to determine which personal, lesion, and lifestyle characteristics influence the changes in lipid profiles over time and among subjects.

Design: Multilevel regression analysis of measurement points during and after rehabilitation.

Setting: Eight rehabilitation centers in The Netherlands.

The Physical Activity Scale for Individuals with Physical Disabilities: test-retest reliability and comparison with an accelerometer.

Background: The objective was to determine the test-retest reliability and criterion validity of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD).

Methods: Forty-five non-wheelchair dependent subjects were recruited from three Dutch rehabilitation centers. Subjects' diagnoses were: stroke, spinal cord injury, whiplash, and neurological-, orthopedic- or back disorders.

Successfully improving physical activity behavior after rehabilitation.

Purpose: To determine the effects of the physical activity promotion programs Rehabilitation & Sports (R&S) and Active after Rehabilitation (AaR) on sport and daily physical activity 1 year after in- or outpatient rehabilitation.

Design: Subjects in intervention rehabilitation centers were randomized into a group receiving R&S only (n = 315) and a group receiving R&S and AaR (n = 284). Subjects in six control centers (n = 603) received usual care.

Rapid and extensive arterial adaptations after spinal cord injury.

Objective: To assess the time course of adaptations in leg vascular dimension and function within the first 6 weeks after a spinal cord injury (SCI).

Design: Longitudinal study design.

Setting: University medical center and rehabilitation clinic.

Course of gross mechanical efficiency in handrim wheelchair propulsion during rehabilitation of people with spinal cord injury: a prospective cohort study.

Objective: To investigate the course of mechanical efficiency of handrim wheelchair propulsion during rehabilitation of subjects with (in)complete paraplegia and tetraplegia.

Design: Subjects were tested at the start of active rehabilitation (t1), 3 months later (t2), and when discharged from inpatient rehabilitation (t3). They performed two 3-minute submaximal treadmill exercise blocks in a wheelchair.

Physical activity for people with a disability: a conceptual model.

The promotion of a physically active lifestyle has become an important issue in health policy in first-world countries. A physically active lifestyle is accompanied by several fitness and health benefits. Individuals with a disability can particularly benefit from an active lifestyle: not only does it reduce the risk for secondary health problems, but all levels of functioning can be influenced positively.

Mechanical loading of the low back and shoulders during pushing and pulling activities.

The objective of this study was to quantify the mechanical load on the low back and shoulders during pushing and pulling in combination with three task constraints: the use of one or two hands, three cart weights, and two handle heights. The second objective was to explore the relation between the initial and sustained exerted forces and the mechanical load on the low back and shoulders. Detailed biomechanical models of the low back and shoulder joint were used to estimate mechanical loading.

Time course of arterial vascular adaptations to inactivity and paralyses in humans.

Purpose: The aim of the present study was to assess the time course of vascular adaptations to inactivity and paralyses in humans. The spinal cord-injured (SCI) population offers a unique "human model of nature" to assess peripheral vascular adaptations and its time course to extreme inactivity and paralyses.

Methods: Arterial diameters and red blood cell velocity of the carotid artery (CA), common femoral artery (FA), and brachial artery (BA) were measured using echo Doppler ultrasound.

Low-back and shoulder complaints among workers with pushing and pulling tasks.

Objectives: Low-back and shoulder complaints were examined in relation to self-reported and objectively assessed exposure to work-related pushing and pulling.

Methods: Workers from several companies (eg, nursing homes and flower auctions) with pushing and pulling tasks and, as reference, workers without physically demanding tasks were invited to participate. Altogether 829 workers initially received a questionnaire, of whom 459 responded both initially and after 1 year of follow-up.

Normative values and determinants of physical capacity in individuals with spinal cord injury.

We reanalyzed data from five studies with similar or identical methodology performed by our laboratory to define normative values and determinants of physical capacity in individuals with tetraplegia and paraplegia. Each study consisted of a graded wheelchair exercise test to determine peak oxygen uptake and maximal power output and could additionally include a wheelchair sprint test to determine short-term (anaerobic) power output and/or an isometric strength test. The combined subject population included 166 individuals (20 women), varying considerably for age, body mass, lesion level, time since injury, and activity level.