Biophysical aspects of handcycling performance in rehabilitation, daily life and recreational sports; a narrative review

Aim In this narrative review the potential and importance of handcycling are evaluated. Four conceptual models form the framework for this review; (1) the International Classification of Functioning, Disability and Health; (2) the Stress-Strain-Capacity model; (3) the Human-Activity-Assistive Technology model; and (4) the power balance model for cyclic exercise. Methods Based on international handcycle experience in (scientific) research and practice, evidence-based benefits of handcycling and optimization of handcycle settings are presented and discussed for rehabilitation, daily life and recreational sports. Results As the load can be distributed over the full 360° cycle in handcycling, peak stresses in the shoulder joint and upper body muscles reduce. Moreover, by handcycling regularly, the physical capacity can be improved. The potential of handcycling as an exercise mode for a healthy lifestyle should be recognized and advocated much more widely in rehabilitation and adapted sports practice. The interface between handcycle and its user should be optimized by choosing a suitable person-specific handcycle, but mainly by optimizing the handcycle dimensions to one’s needs and desires. These dimensions can influence efficient handcycle use and potentially improve both endurance and speed of handcycling. Conclusion To optimize performance in rehabilitation, daily life and recreational sports, continued and more systematic research is required. Implications for rehabilitation Handcycling allows users to travel farther distances at higher speeds and to train outdoors. It should be recognized as an alternative exercise modality for daily outdoor use, also already in early rehabilitation, while it contributes to a healthy lifestyle. To individualize handcycle performance, the user-handcycle (assistive device) interface as well as the vehicle mechanics should be optimized to minimize external power and reduce friction, so that the upper body capacity can be efficiently used. To optimize handcycling individual performance, both the physiological and biomechanical aspects of handcycling should be considered when monitoring or testing handcycle exercise

Finding focus in a difficult landscape: Therapists’ experiences with challenging video guidance processes for parent–infant dyads

Marte Meo video guidance uses filmed interaction of the actual parent–infant dyad in the guidance of caregivers. Exploring the challenges that therapists meet in the guidance of parent–infant dyads may illuminate important aspects of the method itself as well as the therapists’ role and requirements. This could lead to method development and improved practice, but is hitherto little addressed. In this paper, we explore how skilled therapists experience and handle challenging or failing guidance processes with parent–infant dyads. We analyzed interviews with 13 Marte Meo therapists/supervisors using team-based reflexive thematic analysis. Four main themes were identified: promoting relational growth in a coercive context, building an alliance that feels safe for the parents, looking at positive moments in difficult lives, and handling intense feelings as a therapist. Our findings show that therapists experience specific therapeutic and ethical challenges with a vulnerable subgroup of parent–infant dyads where child protective issues arise, where caregivers’ insecurities impede the therapeutic relationship, and where caregivers have unsolved relational or mental health problems. The therapists’ role becomes pivotal and demanding with regard to the therapeutic alliance, the therapeutic interventions in the guidance process, and their own need for regulation, supervision, and structure. Identification of these vulnerable dyads early in the process could facilitate a better adaptation and practice of video guidance. Our findings suggest a need for supporting structures, clinical supervision, and training that address these challenges.publishedVersio

Improving well-being in Higher Education: Adopting a compassionate approach

© Springer Nature Switzerland AG 2019. This is a post-peer-review, pre-copyedit version of a chapter published in the 'Values of the University in a Time of Uncertainty'. The final authenticated version is available online at: https://doi.org/10.1007/978-3-030-15970-2_18Peer reviewe

Subject- and injury-related factors influencing the course of manual wheelchair skill performance during initial inpatient rehabilitation of persons with spinal cord injury

Objectives: To study changes in wheelchair skills in subjects with spinal cord injury (SCI) during rehabilitation; to determine whether changes in wheelchair skill performance are related to the subject, lesion characteristics, secondary complications, and upper extremity pain; and to investigate if wheelchair skill performance at discharge can be predicted from these features. Design: Longitudinal. Subjects performed the Wheelchair Circuit 3 times during rehabilitation: at admission (t1), 3 months later (t2), and at discharge (t3). Setting: Eight rehabilitation centers in the Netherlands. Participants: One hundred twenty-one subjects with SCI. Interventions: Not applicable. Main Outcome Measures: The Wheelchair Circuit consists of 8 wheelchair skills and results in 3 test scores: ability, performance time, and physical strain. Results: All the scores of the Wheelchair Circuit improved significantly between t1 and t2, and between t2 and t3. The scores were related to age and lesion level, whereas changes in scores were related to age, sex, lesion level, and secondary complications. The variables age, body mass index, sex, lesion level, motor completeness, and secondary complications contributed significantly to the prediction of the scores at t3. Conclusions: Wheelchair skill performance improved during rehabilitation. Personal and lesion characteristics are most important for improving wheelchair skill performance and predicting wheelchair skill performance. © 2005 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Stability of an infectious pancreatic necrosis virus (IPNV) isolate stored under different laboratory conditions

An infectious pancreatic necrosis virus (IPNV) belonging to the Sp serotype, isolated from scallops Pecten maximus, was propagated and suspended in sterile water and cell culture medium with different salinities and incubated at temperatures ranging from -80 to 40 degrees C. Virus stability was examined by measuring virus titers under different storage conditions. Virus titers were also measured after repeated freezing and thawing, and in incubated sterile filtered scallop hepatopancreas, haemolymph and crystalline style samples, and salmon Salmo salar kidney homogenate. The virus was stable under most storage conditions. Temperatures ranging from -80 to +20 degrees C, as well as salinities from 0 to 40 parts per thousand, did not seem to influence the stability of the virus. A reduction was observed above 20 degrees C. Each freezing and thawing procedure resulted in a reduction of the virus titer. This reduction was larger at -80 than at -20 degrees C. The IPNV persisted for a long period in sterile filtered scallop haemolymph, dissolved crystalline style and hepatopancreas. In kidney homogenate from IPNV-infected salmon the virus titers were reduced at least 10-fold during the first day of incubation at all temperatures tested. When virus was propagated in cell culture and subsequently mixed with non-infected salmon kidney homogenate, the virus proved more persistent. Our results illustrate the importance of rapid and standardised laboratory processing of potentially virus-containing tissue samples, and are relevant when considering laboratory storage of samples containing IPNV

Health screening of wild Atlantic salmon (Salmo salar) from the Osterfjorden-area, western Norway

Wild Atlantic salmon (Salmo salar) were captured in four rivers in western Norway in 1989 and 1990. These were used as broodstock fish in a sea ranching project. In 1989 virological and bacteriological examinations of the fish were negative for Infectious Pancreatic Necrosis Virus, Renibacterium salmoniarum, Aeromonas salmonicida var. salmonicida and Yersinia ruckeri. In 1990 three fish were positive for IPNV and one fish was positive for Aeromonas salmonicida var. salmonicida. The results supply the mapping of the introduction of furunculosis at the Norwegian west coast in 1989-90, indicate a low prevalence of Infectious Pancreatic Necrosis Virus in the wild salmon stocks and states that the broodstock fish used in the sea ranching project in 1989 and 1990 were tested in accordance with the demands for a satisfactory health control