Validity and reliability of the VOAA-DDD to assess spontaneous hand use with a video observation tool in children with spastic unilateral cerebral palsy

Contains fulltext : 80999.pdf (publisher's version ) (Open Access)BACKGROUND: In 2003 new computer software, the VOAA (Video Observations Aarts and Aarts), was designed to score and evaluate two important aspects of spontaneous upper limb use, i.e. overall duration and frequency of specific behaviours. The aim of this study was to investigate the test-retest, interrater and intrarater reliability and the construct validity of a new module, the VOAA-DDD, to determine developmental disregard in children with spastic unilateral cerebral palsy (CP). METHODS: A test-retest design with three raters for reliability and a two-group design for construct validity were used. Subjects were a total of 20 children with spastic unilateral CP equally divided in two age groups (2.5-5 and 5-8 years), and 56 healthy children of the same age groups. Overall duration and frequency of specific behaviours of the affected arm and hand were assessed during a task demanding ('stringing beads') and a task stimulating ('decorating a muffin') the use of both hands. Reliability was estimated by intraclass correlation coefficients (ICCs). Construct validity was assessed by comparing children with CP to healthy children. RESULTS: All ICCs exceeded 0.87. In contrast with healthy children, children with CP used their affected hand less during the 'muffin' task compared to the 'beads' task. Of the children with CP, 90% in the age group of 2.5-5 years and 50% in the age group of 5-8 years showed values exceeding the extreme values of healthy controls, respectively, indicating developmental disregard. CONCLUSION: The VOAA-DDD is a reliable and valid instrument to assess spontaneous use of the affected arm and hand in order to determine developmental disregard in children with spastic unilateral CP

Effectiveness of modified constraint-induced movement therapy in children with unilateral spastic cerebral palsy: a randomized controlled trial.

Contains fulltext : 88752.pdf (publisher's version ) (Closed access)BACKGROUND: In children with unilateral spastic cerebral palsy (CP), there is only limited evidence for the effectiveness of modified constraint-induced movement therapy (mCIMT). OBJECTIVE: To investigate whether 6 weeks of mCIMT followed by 2 weeks of bimanual task-specific training (mCIMT-BiT) in children with unilateral spastic CP improves the spontaneous use of the affected limb in both qualitative and quantitative terms more than usual care (UC) of the same duration. METHODS: Children with unilateral spastic CP with Manual Ability Classification System (MACS) scores I, II, or III and aged 2.5 to 8 years were recruited and randomly allocated to either the mCIMT-BiT group (three 3-hour sessions per week: 6 weeks of mCIMT, followed by 2 weeks of task-specific training in goal-directed bimanual play and self-care activities) or to 1.5 hours of more general physical or occupational weekly plus encouragement to use the affected hand for the UC group. Primary outcome measures were the Assisting Hand Assessment and the ABILHAND-Kids. Secondary outcomes were the Melbourne Assessment of Unilateral Upper Limb Function, the Canadian Occupational Performance Measure, and the Goal Attainment Scale. RESULTS: Twenty-eight children were allocated to mCIMT-BiT and 24 to UC. Except for the Melbourne, all primary and secondary outcome measures demonstrated significant improvements in the mCIMT-BiT group. CONCLUSION: mCIMT followed by task-specific training of goal-directed bimanual play and self-care activities is an effective intervention to improve the spontaneous use of the more affected upper limb in children with relatively good baseline upper extremity function

Advies Evaluatie en optimalisatie van het bevolkingsonderzoek darmkanker

The colorectal cancer screening programme was introduced gradually from 2014. Since 2019, all people aged 55 to 75 have been invited to participate once every two years. In 2021, more than 1.6 million people took part in the screening programme, and colorectal cancer was detected in 2,700 participants, with an early stage of colorectal cancer being detected in 17,000 participants. At this stage, the screening programme has been running for too short a time to be able to scientifically demonstrate that it leads to less mortality from colorectal cancer; however, there are clear indications in that direction. Under the current circumstances, the benefits (prevention of colorectal cancer and associated mortality) outweigh the risks of the screening programme (screening test that detects no abnormalities but is taxing and causes concern, and cases of cancer that are missed). The Council therefore recommends that no modifications be made to the regular programme at this time. The Council does, however, recommend conducting a regional pilot population screening programme with one-off screening of people around 50 years of age. This will allow a review of to what extent such a programme would provide health benefits and whether the benefits would outweigh the risks. Based on the results, a decision can be made as to whether the age limit of the programme should be lowered. One promising development that may improve the screening programme in the long term is customised screening. As such, the Council recommends that this be reviewed. In addition, the Council recommends continuing investment in increasing participation rates