Precision of trunk movement in people with chronic low back pain.

Background: Motor control exercise is commonly applied in people with chronic low back pain (CLBP), but possibly not all people with CLBP have motor control impairments. We suggest movement precision as measure to identify motor control impairments. Movement precision has been operationalized as trunk movement variability (TMV) and as trunk tracking error(s) (TTE).

Application of ultrasound to monitor in vivo residual bone movement within transtibial prosthetic sockets.

Transtibial prosthetic users do often struggle to achieve an optimal prosthetic fit, leading to residual limb pain and stump-socket instability. Prosthetists face challenges in objectively assessing the impact of prosthetic adjustments on residual limb loading. Understanding the mechanical behaviour of the pseudo-joint formed by the residual bone and prosthesis may facilitate prosthetic adjustments and achieving optimal fit.

Lifestyle factors and psychological factors are associated with central pain processing in service members with persistent low-back pain: A cross-sectional exploratory study.

Persistent low-back pain (LBP) is highly prevalent in the military. Altered central pain processing is one of the mechanisms found to underlie persistent LBP. Our aim was to explore which factors are associated with altered pain processing in Dutch service members with persistent LBP.

Trunk resistance to mechanical perturbations, associations with low back pain, pain-related cognitions and movement precision.

Background: Pain-related cognitions are associated with motor control changes in people with chronic low-back pain (CLBP). The mechanism underlying this association is unclear. We propose that perceived threat increases muscle-spindle-reflex-gains, which reduces the effect of mechanical perturbations, and simultaneously decreases movement precision.

The effect of cryotherapy on postural stabilization assessed by standardized horizontal perturbations of a movable platform.

Background: Cryotherapy is a frequently used therapy in the acute treatment of sports injuries, although it has possible negative effects on dynamic postural stabilization.

Research Question: What is the effect of cryotherapy on the postural stabilization assessed by imposed platform perturbations?

Methods: Twenty-four healthy participants (15 male, 9 female) performed 2 test sessions (before and after cryotherapy) consisting of 4 trials each. Each trial included 30 s single leg stance (SLS) on both legs and 4 testing blocks (2 for each leg) of 30 s for the dynamic testing.

A modified passive-dynamic ankle-foot orthosis: can it prevent amputation and arthrodesis in patients with ankle-foot trauma?

Introduction: High-energy lower extremity trauma (HELET) may cause severe damage within the foot-ankle complex. Occasionally, arthrodesis or amputation are the only remaining options to increase activity levels. The modified passive dynamic ankle-foot orthosis (PDAFO) may prove to be a nonsurgical alternative.

Reliability of a novel dynamic test of postural stability in high-level soccer players.

Postural stability of athletes is commonly tested with single-leg stance (SLS) tests. However, for this population, these tests are insufficiently challenging to achieve high sensitivity. Therefore, a new dynamic SLS test based on standardized translational surface perturbations was developed.

Identifying prognostic factors to determine the level of recovery in servicemembers with chronic low back pain: A prospective cohort study.

Objective: The main objective of this study was to identify general and military-related factors that are associated with the level of recovery in Dutch service members with chronic low back pain (CLBP) who followed a rehabilitation program.

Material And Method: One hundred five consecutive service members with CLBP were included in this study. The level of disability, was used to distinguish a recovered and non-recovered group.

The Pelvic Girdle Pain deadlock: 2. Topics that, so far, have remained out of focus.

Introduction: In our preceding paper, we concluded that Pelvic Girdle Pain (PGP) should be taken seriously. Still, we do not know its causes. Literature reviews on treatment fail to reveal a consistent pattern, and there are patients who do not respond well to treatment.

Postdeployment reintegration attitude of injured Dutch service members: a longitudinal study.

Objective: After deployment, service members can experience difficulties reintegrating. Sustaining injuries on the battlefield can disrupt the reintegration period. The first aim was to follow-up the reintegration attitude towards family, work and on a personal level after deployment in Dutch battlefield casualties (BCs).

Long-term participation of Dutch service members with combat-related injury.

Background: After deployment service members need to adapt to civilian life and return to participation in family, vocational and community life.

Aims: To assess the level of activity and participation of service members with combat-related injury after their rehabilitation intervention and to measure the effect of injury severity, adaptive coping, number of deployments and traumatic stress.

Methods: The physical functioning scale of the 36-Item Short Form Health Survey (SF-36 PF), the Assessment of Life Habits short version (LIFE-H), the Impact of Event Scale (IES-R) and the Cognitive Emotion Regulation Questionnaire (CERQ) were administered to service members who sustained combat-related injury.

Axial pelvis range of motion affects thorax-pelvis timing during gait.

During gait, patients with pelvic girdle pain and low back pain demonstrate an altered phase relationship between axial thorax and pelvis rotations (thorax-pelvis relative phase). This could be the result of an increase in axial pelvis range of motion (ROM) which has been observed in these patients as well. To establish this relationship, we investigated if altered axial pelvis ROM during gait affects thorax-pelvis relative phase in 12 healthy subjects.

Exploratory study for clinical signs of MODIC changes in patients with low-back pain in the Netherlands armed forces.

Background: Magnetic resonance imaging (MRI) is being used extensively in the search for pathoanatomical factors contributing to low back pain (LBP) such as Modic changes (MC). However, it remains unclear whether clinical findings can identify patients with MC. The purpose of this explorative study was to assess the predictive value of six clinical tests and three questionnaires commonly used with patients with low-back pain (LBP) on the presence of Modic changes (MC).

Axial Thorax-Pelvis Coordination During Gait is not Predictive of Apparent Trunk Stiffness.

The coordination of axial thorax and pelvis rotations during gait has been shown to be affected by several pathologies. This has been interpreted as an indication of increased apparent axial trunk stiffness, but arm swing may also affect these rotations. The objectives of this study were to assess the effect of trunk stiffness and arm swing on the relative timing ('coordination') between thorax and pelvis rotations, and to assess if apparent trunk stiffness can be inferred from thorax-pelvis kinematics.

Dynamic alignment using external socket reaction moments in trans-tibial amputees.

Background: Prosthetic alignment is used to optimize prosthetic functioning and comfort. Spatio-temporal and kinematic gait parameters are generally observed to guide this process. However, they have been shown to be influenced by compensations, which reduces their sensitivity to changes in alignment.

Combat-related foot injuries: impact on gait and functional outcome.

Introduction: Prior to deployment of the Netherlands Army Task Force Urozgan in Afghanistan, the Dutch Military and civilian healthcare systems had limited experience in treating blast injuries and their long-term consequences. This meant that guidelines for treatment and rehabilitation were lacking. The aim of this cohort study was to quantify kinematic and kinetic abnormalities in service members with foot injuries in relation to functional outcome using gait analysis.

Evidence of splinting in low back pain? A systematic review of perturbation studies.

Purpose: The purpose of this systematic review was to assess whether LBP patients demonstrate signs of splinting by evaluating the reactions to unexpected mechanical perturbations in terms of (1) trunk muscle activity, (2) kinetic and (3) kinematic trunk responses and (4) estimated mechanical properties of the trunk.

Methods: The literature was systematically reviewed to identify studies that compared responses to mechanical trunk perturbations between LBP patients and healthy controls in terms of muscle activation, kinematics, kinetics, and/or mechanical properties. If more than four studies reported an outcome, the results of these studies were pooled.

Motion-based equilibrium reprocessing therapy a novel treatment method for chronic peripheral vestibulopathies: A pilot study.

Rehabilitation for vestibular disease is a safe method to partially alleviate symptoms of vertigo. It was hypothesized that principles of military aviation vestibular desensitization procedures that have a success rate of more than 80% can be extrapolated to chronic vestibular disease as well.The virtual reality motion base computer-assisted rehabilitation environment was used as treatment modality in 17 patients.

The Effect of Alignment Changes on Unilateral Transtibial Amputee's Gait: A Systematic Review.

Introduction: Prosthetic alignment, positioning of a prosthetic foot relative to a socket, is an iterative process in which an amputee's gait is optimized through repetitive optical gait observation and induction of alignment adjustments when deviations are detected in spatiotemporal and kinematic gait parameters. An important limitation of the current prosthetic alignment approach is the subjectivity and the lack of standardized quantifiable baseline values. The purpose of this systematic review is to investigate if an optimal alignment criterion can be derived from published articles.

The influence of a user-adaptive prosthetic knee across varying walking speeds: A randomized cross-over trial.

Previously conducted trials comparing the gait pattern of individuals with a transfemoral amputation using a user-adaptive and a non-microprocessor-controlled prosthetic knee (NMPK) found mixed and conflicting results. Few trials, however, have compared user-adaptive to non-adaptive prosthetic knees across different walking speeds. Because of the ability of variable damping, the effect of user-adaptive knees might be more pronounced at lower or higher walking speeds.

Short-Term Results of a Rehabilitation Program for Service Members With Lower Leg Pain and the Evaluation of Patient Characteristics.

Introduction: Lower leg pain (LLP), including medial tibial stress syndrome (MTSS) and chronic exertional compartment syndrome (CECS), remains a major problem for the military.

Objective: Evaluation of patient characteristics and short-term results of the rehabilitation program for service members used in the Military Rehabilitation Centre Aardenburg.

Methods: This retrospective study includes 161 service members of the Netherlands Armed Forces.

The diagnostic value of three sacroiliac joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging.

Objectives: The aim of the current study was to investigate the diagnostic value of three sacroiliac (SI) joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging (MRI) and stratified by gender.

Method: Patients without clinical signs of nerve root compression were selected from a cohort of patients with persistent low back pain referred to an outpatient spine clinic. Data from Gaenslen's test, the thigh thrust test, and the long dorsal sacroilia ligament test and sacroiliitis identified by MRI were analysed.