The benefits of the 5-week Table Stars @school program as part of physical education in primary schools – A pilot intervention study

The Table Stars @school program was launched in 2010 to serve as a first introduction to table tennis in primary school children. The main aims of this pilot intervention study were 1. to evaluate the effect of Table Stars @school on the perceptuo-motor skills and selective attention in primary school children in comparison to regular physical education and 2. to find out how many and which children benefited more from Table Stars @school compared to regular physical education. A pilot intervention study was carried out including 177 children between 6 to 12 years from two regular primary schools. All children were tested by means of four perceptuo-motor tests (static balance, walking backwards, speed while dribbling, eye hand coordination) and a selective attention task (map mission). Both schools were exposed to both the Table Stars @school program and regular physical education in a different order. The results revealed no differences between the regular physical education classes and the Table Stars @school program on group level. However, both interventions showed different responders. Consequently, Table Stars @school seems to fit in as it meets the level of improvement of regular physical education classes and it can be of added value by addressing other children to improve perceptuo-motor skills and selective attention. Nevertheless, intensifying the program and/or integrating it into regular physical education is recommended to increase the effects and better add to the broader development of children

Aerobic exercise in children with oxidative phosphorylation defects

Fatigue and exercise intolerance are symptoms in children with metabolic myopathy. Frequently this is combined with muscle pain in children with mitochondrial myopathy. Offering therapeutic advice remains challenging in this patient group. Here we describe five children above the age of four years, with normal intelligence, myopathy, exercise intolerance, motor developmental delay, and fatigue, who were diagnosed with a mitochondrial dysfunction. Based on the positive experience of condition training in adults with mitochondrial disease and inactivity, aerobic exercise training was advised for all the children. Because of the lack of clear protocols for individualized mitochondrial myopathies, regular training was initiated. The Movement Assessment Battery of Children, the Jamar dynamometer for grip force, and the Bruce protocol treadmill test were applied for evaluation. No patient showed significant disease progression on a weekly scheme of strength training or on aerobic training during periods varying between 6 and 18 months. Only one out of the five patients has shown an improvement after a period of structured, aerobic training, demonstrating good compliance and motivation over the course of 18 months. Some patients developed severe muscle pain after explosive exercise. Even in a relatively homogenous, intelligent group of patients and motivated parents, we could not reach full compliance. With our case studies, we would like to draw attention to the importance and pitfalls of movement therapy in children with mitochondrial disease

Development of a standard set of outcome measures for non-specific low back pain in Dutch primary care physiotherapy practices: a Delphi study

Item does not contain fulltextPURPOSE: To develop a clinical standard set of outcome measures that are accepted for relevance and feasibility by stakeholders and useful for (a) interaction between patient and the professional, e.g. shared decision-making in goal-setting, monitoring and feedback based on outcomes, (b) internal quality improvement, and (c) external transparency in patients with non-specific low back pain (NSLBP) in primary care physical therapy. METHODS: We used a consensus-driven modified RAND-UCLA Delphi method in seven steps with panellists (patients, representatives of patient and physiotherapy associations, researchers, policy makers, health insurers): (1) literature search, (2) first online survey, (3) patient interviews, (4) an experts meeting, (5) a consensus meeting, (6) second online survey, and (7) final approval of an advisory board. Steps 1-4 resulted in potential outcome measures. In the consensus meeting after discussion panellists voted for inclusion per measure. In the second online survey the final standard set was rated on relevance and feasibility on a 9-point Likert scale; when the median score was >/= 7, the standard set was accepted and finally approved. RESULTS: Thirteen draft outcome measures were rated and discussed, and finally, six outcome measures were accepted. The standard set includes the Quebec Back Pain Disability Scale, Oswestry Disability Index, Patient-Specific Functional Scale, Numeric Pain Rating Scale, Global Perceived Effect (GPE-DV), and the STarT Back Screening Tool (SBT). CONCLUSION: This study presents a standard set of outcome measures for patients with NSLBP in primary care physiotherapy accepted for relevance and feasibility by stakeholders. The standard set is currently used in daily practice and tested on validity and reliability in a pilot study. These slides can be retrieved under Electronic Supplementary Material

Is the level of eye-hand coordination and executive functioning related to performance in para table tennis players? – An explorative study

The goal of this explorative study was to explore whether eye-hand coordination and executive functions (i.e. cognitive flexibility, attention control and information processing) are related to the performance level in para table tennis players. The data of 11 elite (age 15-54) and 11 non-elite para table tennis players (age 13-49) were analyzed. The results showed that the elite players performed better than the median norm values for cognitive flexibility and attention control while the non-elite players demonstrated slower information processing than the median norm values (p 1000 points scored ≥ 24 catches per 30 s in the eye hand coordination task, whereas the players with 1000 and < 1000 rating scores in the executive functions tests. The results present a first profile of para table tennis players regarding their eye-hand coordination and executive functions and the relationship of these constructs with the performance level. Long-term international cooperation is recommended to understand the value of the measured constructs to predict future successes

The diagnostic accuracy of headache measurement instruments: A systematic review and meta-analysis focusing on headaches associated with musculoskeletal symptoms

Contains fulltext : 208202.pdf (publisher's version ) (Open Access)AIM: To systematically review the available literature on the diagnostic accuracy of questionnaires and measurement instruments for headaches associated with musculoskeletal symptoms. DESIGN: Articles were eligible for inclusion when the diagnostic accuracy (sensitivity/specificity) was established for measurement instruments for headaches associated with musculoskeletal symptoms in an adult population. The databases searched were PubMed (1966-2018), Cochrane (1898-2018) and Cinahl (1988-2018). Methodological quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for criterion validity. When possible, a meta-analysis was performed. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) recommendations were applied to establish the level of evidence per measurement instrument. RESULTS: From 3450 articles identified, 31 articles were included in this review. Eleven measurement instruments for migraine were identified, of which the ID-Migraine is recommended with a moderate level of evidence and a pooled sensitivity of 0.87 (95% CI: 0.85-0.89) and specificity of 0.75 (95% CI: 0.72-0.78). Six measurement instruments examined both migraine and tension-type headache and only the Headache Screening Questionnaire - Dutch version has a moderate level of evidence with a sensitivity of 0.69 (95% CI 0.55-0.80) and specificity of 0.90 (95% CI 0.77-0.96) for migraine, and a sensitivity of 0.36 (95% CI 0.21-0.54) and specificity of 0.86 (95% CI 0.74-0.92) for tension-type headache. For cervicogenic headache, only the cervical flexion rotation test was identified and had a very low level of evidence with a pooled sensitivity of 0.83 (95% CI 0.72-0.94) and specificity of 0.82 (95% CI 0.73-0.91). DISCUSSION: The current review is the first to establish an overview of the diagnostic accuracy of measurement instruments for headaches associated with musculoskeletal factors. However, as most measurement instruments were validated in one study, pooling was not always possible. Risk of bias was a serious problem for most studies, decreasing the level of evidence. More research is needed to enhance the level of evidence for existing measurement instruments for multiple headaches

Multiple case study to describe influencing factors on effectiveness of an interdisciplinary in-patient intervention for feeding problems in children

In children with chronic feeding problems diagnoses and physical, cognitive and behavioral impairments vary enormous. In addition to these variables, we hypothesize that personal and environmental factors also contribute to the success of intervention for feeding problems. This exploratory study describes the effectiveness and influencing factors of an intensive, multidisciplinary child and parent centered intervention on calorie intake and solid food consumption. The intervention included a behavioral program, oral motor training, parental coaching and dietary support. The children participating in the intervention could be separated into three groups: tube-fed (n=12), selective food refusal by texture (n=6) and unpredictable food refusal (n=11). For each group we present a descriptive representative case study. Outcome measures were calorie intake and amount of solid food consumed. The average duration of the in-patient feeding intervention was 4.3 weeks (SD 1.4 weeks). Three months after discharge, 50% of the children receiving tube feeding had complete oral intake. Children with selective food refusal by texture made small progresses during the intervention but solid food intake had increased at follow-up. Children with unpredictable food refusal increased their oral intake already during the intervention and maintained these gains at home. The intensive interdisciplinary intervention showed increased calorie and oral intake in most children and reduced tube feeding, but was less successful in children with metabolic dysfunction. Recovery time was longest in the tube feeding group but results varied considerably per child. Successful feeding intervention in children needs to take into account a child's underlying physical and behavioral and environmental factors

Dying to be born again: Mortality, immortality and the fashion model

The primary focus of this thesis is limited to the relationship between sartorial fashion and the fashion model within the world of representation. This includes the forms of fashion display and dissemination that existed prior to the establishment of the modern fashion system—fashion dolls, fashion plates and illustration and the mannequin de monde—as well as the fields where the fashion model as a modern phenomenon came into being—fashion photography and the fashion parade. While the portrait of feminine beauty and ideals in the fashion image betrays the imprint of the representation of the female body in art, pornography and the entertainment industries, this thesis argues for a reading of the fashion image and the fashion model specifically through the prism of fashion which, as a quasi-autonomous system, operates according to its own rules and has its own mode of being. Since its inception, fashion has frustrated its critics and delighted its proponents with a nonchalant rejection of the creations it had hitherto enthroned as essential. This dedication to perpetual change and the ephemeral—the ‘death-wish’ that ensures the continuation of fashion as a structure even as individual fashions are discarded—has fascinated both those who have seriously contemplated fashion and those who document the vicissitudes of fashion’s creations. For its critics, the sin fashion commits in refusing to manifest itself in a permanent form of beauty is compounded by its perceived attacks upon the body, cloaking it in a layer of artifice that distorts it into ‘unnatural’ forms. This imposition by fashion on the body made from flesh and blood is never fully realised. Rather it is only on the body in representation that fashion can begin to escape the limitations imposed upon it by the human form and give full reign to its creative impulse. In the fashion image the fundamental principles of fashion—change and artifice—are metaphorically expressed by the interplay of mortality and immortality on the body of the model which, ultimately, serves as the blank canvas where fashion is free to invent its imaginary self

A blended electronic illness management and recovery program for people with severe mental illness : qualitative process evaluation alongside a randomized controlled trial

Background: We conducted a trial to test the electronic Illness Management and Recovery (e-IMR) intervention to provide conclusions on the potential efficacy of eHealth for people with severe mental illness (SMI). In the e-IMR intervention, we used the standard IMR program content and methodology and combined face-to-face sessions with internet-based strategies on the constructed e-IMR internet platform. During the trial, the e-IMR platform was sparsely used. Objective: This study aimed to evaluate the added value of the e-IMR intervention and the barriers and facilitators that can explain the low use of the e-IMR platform. Methods: This process evaluation was designed alongside a multicenter, cluster randomized controlled trial. In this study, we included all available participants and trainers from the intervention arm of the trial. Baseline characteristics were used to compare users with nonusers. Qualitative data were gathered at the end of the semistructured interviews. Using theoretical thematic analyses, the data were analyzed deductively using a pre-existing coding frame. Results: Out of 41 eligible participants and 14 trainers, 27 participants and 11 trainers were interviewed. Of the 27 participants, 10 were identified as users. eHealth components that had added value were the persuasive nature of the goal-tracking sheets, monitoring, and the peer testimonials, which had the potential to enhance group discussions and disclosure by participants. The low use of the e-IMR platform was influenced by the inflexibility of the platform, the lack of information technology (IT) resources, the group context, participants' low computer skills and disabilities, and the hesitant eHealth attitude of the trainers. Conclusions: The extent of eHealth readiness and correlations with vulnerabilities in persons with SMI need further investigation. This study shows that flexible options were needed for the use of e-IMR components and that options should be provided only in response to a participant's need. Use of the e-IMR intervention in the future is preconditioned by checking the available IT resources (such as tablets for participants) providing computer or internet guidance to participants outside the group sessions, evaluating the eHealth attitude and skills of trainers, and tailoring eHealth training to increase the skills of future e-IMR trainers