Development and validation of a clinically applicable ARM use monitor for people after stroke

Objective: To develop and validate a clinically applicable and easy-to-use accelerometry-based device to measure arm use in people after stroke; the Ac-tiv8 arm use monitor (Activ8-AUM). Design: Development and validation study. Patients: A total of 25 people at different stages of rehabilitation after stroke were included in this study. Methods: The Activ8-AUM consists of 3 single-sensor Activ8s: one on the unaffected thigh and one on each wrist. Arm use was calculated by combining movement intensity of the arms with data from body posture and movements on the leg sensor. Data were divided into 2 sets: one for determining situation-specific movement intensity thresholds for arm use, and the other to validate the Activ8-AUM using video recordings. Results: Overall agreement between the Activ8-AUM and video recordings was 75%, sensitivity was 73% and specificity was 77%. Agreement between the different categories of arm use ranged from 42% to 93% for the affected arm and from 24% to 82% for the unaffected arm. Conclusion: By combining the movement intensity threshold with body posture and movements, good agreement was reached between the Activ8-AUM and video recordings. This result, together with the easy-to-use configuration, makes the Activ8-AUM a promising device to measure arm use in people after stroke

Effect of different operationalizations of sedentary behavior in people with chronic stroke

Purpose: Sedentary behavior is common in people with stroke and has devastating impact on their health. Quantifying it is important to provide people with stroke with adequate physical behavior recommendations. Sedentary behavior can be quantified in terms of posture (sitting) or intensity (low energy expenditure). We compared the effect of different operationalizations of sedentary behavior on sedentary behavior outcomes (total time; way of accumulation) in people with stroke. Methods: Sedentary behavior was analyzed in 44 people with chronic stroke with an activity monitor that measured both body postures and movement intensity. It was operationalized as: (1) combining postural and intensity data; (2) using only postural data; (3) using only intensity data. For each operationalization, we quantified a set of outcomes. Repeated measures ANOVA and Bland–Altman plots were used to compare the operationalizations. Results: All sedentary behavior outcomes differed significantly between all operationalizations (p < 0.01). Bland–Altman plots showed large limits of agreement for all outcomes, showing large individual differences between operationalizations. Conclusions: Although it was neither possible nor our aim to investigate the validity of the two-component definition of sedentary behavior, our study shows that the type of operationalization of sedentary behavior si

The Accuracy of the Detection of Body Postures and Movements Using a Physical Activity Monitor in People after a Stroke

Background: In stroke rehabilitation not only are the levels of physical activity important, but body postures and movements performed during one&rsquo;s daily-life are also important. This information is provided by a new one-sensor accelerometer that is commercially available, low-cost, and user-friendly. The present study examines the accuracy of this activity monitor (Activ8) in detecting several classes of body postures and movements in people after a stroke. Methods: Twenty-five people after a stroke participated in an activity protocol with either basic activities or daily-life activities performed in a laboratory and/or at home. Participants wore an Activ8 on their less-affected thigh. The primary outcome was the difference in registered time for the merged class &ldquo;upright position&rdquo; (standing/walking/running) between the Activ8 and the video recording (the reference method). Secondary analyses focused on classes other than &ldquo;upright position&rdquo;. Results: The Activ8 underestimated the merged class &ldquo;upright position&rdquo; by 3.8% (775 s). The secondary analyses showed an overestimation of &ldquo;lying/sitting&rdquo; (4.5% (569 s)) and of &ldquo;cycling&rdquo; (6.5% (206 s)). The differences were lowest for basic activities in the laboratory and highest for daily-life activities at home. Conclusions: The Activ8 is sufficiently accurate in detecting different classes of body postures and movements of people after a stroke during basic activities and daily-life activities in a laboratory and/or at home

Toelatings- en Begeleidingsonderzoek VSO/IBO I

Kritische analyse van toelatingsonderzoeken voor VSO en Individueel Beroepsonderwijs (IBO

Leren werken volgens een leerlingvolgsysteem met behulp van teamgerichte nascholing

Een pedagogisch leerlingvolgsysteem invoeren m.b.v. de didactiek van teamgerichte nascholin