Parallel sessie C
C1. Workshop: Developing and scaling-up innovative mobility solutions: how to contribute to and collaborate in a FieldLab ?
C2. Workshop: Chronic pain rehabilitation networks; collaborations between primary and specialist care
C3. Mini-symposium: Fatigue and fatigability - making the invisible visible: taxonomy, impact, assessment and treatment methods in diverse clinical populations
C4. Mini-symposium: Transfemoral protheses: state-of-the art and beyond. Recent developments in osseo-intgration, myoelectric control and powered prosthesis.
C5. Mini-symposium: Innovation in clinical practice: Implementation of a psychological screening in spinal cord injury rehabilitation
C6. Mini-symposium: Assessment and rehabilitation of visual disorders after acquired brain injury (in English)
C7. Mini-symposium: Home-monitoring and coaching in rehabilitation medicine: opportunities and challenges
C8. Mini-symposium: Innovating with a BIG and LOUD impact in Parkinson Rehabilitation: a road to functional recovery in daily life
Alle sessies worden in het Nederlands gegeven, tenzij dit anders staat vermeld achter de titel van de sessie.
Approximately 26% of the 3.1 million persons aged over 65 in The Netherlands face limitations in their mobility and these numbers will grow over the coming years. Innovative solutions to improve mobility are warranted to optimize daily mobility and physical activity behaviour. Innovative solutions will thereby contribute to, improved outcomes and participation of rehabilitation care and reduction of caregiver’s strain.
One of the main challenges in the innovation process is to connect the expertise of all stakeholders (e.g. patients and caregivers, healthcare professionals, researchers, students, ICT professionals, technicians and companies) to develop solutions with the highest potential for market-readiness and optimal outcomes. The FieldLab for Rehabilitation and Mobility (FieldLab R&M) aims to connect med-tech companies, knowledge institutions and health care providers to develop, test, apply, and scale-up innovative mobility solutions for commercial purpose. Projects can be brought into the FieldLab by a company/start-up (outside-in) or initiated from within health care (e.g. by a health care professional, i.e. inside-out).
Important prerequisites for a FieldLab are: the ability to speak and understand each other’s language, interests and needs. These prerequisites are fundamental for developing future-proof innovations based on the latest technological insights.
Chair(s):
- Klaasjan van Haastrecht, senior advisor Innovation, Basalt, Leiden and The Hague
Klaasjan works as senior advisor Innovation in Basalt Rehabilitation Centre and has 5+ years of experience in various innovation projects. Furthermore Klaasjan (co-)founded 3 LivingLabs in Rehabilitation care about home automation, exercise friendly rehabilitation centre and eRehabilitation.
Co-Chair(s):
- PhD Dick-Jan Zijda, health care innovator and founder of the Delft EHealth Academy (DEHA), Delft
Dick-Jan has more than 15 years of experience in care innovation at local and regional level. Dick-Jan is the founder of the Delft EHealth Academy (DEHA). A learning network of all stakeholders (citizens, healthcare providers, knowledge institutions, entrepreneurs, municipalities) aimed at scaling up, implementing and securing digital applications within the primary process of healthcare providers and the society. - MD Ferry Harberts, rehabilitation physician, Basalt, Leiden and The Hague
Ferry works as rehabilitation physician in Basalt and has a special interest for innovation in health care. - Martijn van der Ent, MSc, The Hague University of Applied Sciences, Cue2Walk International
Martijn is an Integral Product Developer specialised in human-product-interaction. Both as an entrepreneur and entrepreneur he works on projects to create new business by innovation. Creating healthy business requires a strong value proposition and a healthy flow of resources.
Outline session:
- Short introduction about FieldLab-RAM project
- The FieldLab-RAM from the perspective of a rehabilitation physician, entrepreneur, innovator
- Interactive session: how to contribute to and collaborate in a FieldLab
- Wrap-up
Learning objective(s):
This workshop will outline the setup of the sustainable FieldLab R&M within Basalt rehabilitation center, and afterwards participants will be able to:
- Recognize the added value of a FieldLab R&M for innovative mobility solutions.
- Acknowledge the importance of speaking and understanding each other's language, interests and needs.
- Translate the perspective of different stakeholders into the objectives of the FieldLab process to achieve innovative mobility solutions.
- Formulate relevant outside-in questions that can be addressed in the FieldLab R&M.
- Take home the FieldLab methodology for use in their own setting.
In the Netherlands, 2 million patients experience musculoskeletal chronic pain. This has a considerable socio-economical impact caused by healthcare costs and work disability. There is a large interindividual variation of the impact of biopsychosocial factors on the patients’ functioning and participation. Current healthcare organization for management of chronic pain is insufficient and inefficient. Often, a patient receives a large variety of treatments based on different frameworks and explanations for the pain problem. This time-consuming search, for often a solution for pain, repeatedly leads to disappointment. According to reports from the Taskforce ‘De juiste zorg op de juiste plek’ (2018) and the ‘Zorgstandaard Chronische Pijn (2017)’ an integrated biopsychosocial view, assessment and treatment is indicated. The workshop will explore initiatives, barriers and facilitators, and effectivity of organizing chronic pain rehabilitation networks.
All presented networks in this mini-symposium contain elements of:
- Transdisciplinary collaboration (within and between primary, secondary and tertiary care); lead to better understanding between healthcare professionals and a patient centered approach
- Integration of the biopsychosocial view
- Transparency in determination of complexity and referral of the patients to the right place based on the complexity of their complaints (Matched care).
- Transparency of the treatment protocols.
Chair(s): Dr. Ivan Huijnen, Adelante/Maastricht University
Outline session:
- Introduction: Dr. Huijnen
- Transdisciplinary care in chronic pain; a fundament for patient centered care, by Prof. Dr. C. Paul van Wilgen (Transcare and Vrije Universiteit Brussel)
- The health journey and satisfaction of patients suffering from chronic pain in Twente, by Dr. ir. Wendy Oude Nijeweme-d'Hollosy (University of Twente and Roessingh Research & Development (RRD)
- Results of a transmural network in chronic pain: the Network Pain Rehabilitation Limburg, by Cynthia Lamper, MSc. (Maastricht University)
- Specialist care in the primary care setting, by Vera Baadjou, MD PhD. (Maastricht University and Adelante)
- General discussion
Learning objective(s):
- Learn about examples of initiatives of organizing chronic pain rehabilitation in networks
- Learn about barriers and facilitators in starting and working in these networks.
C3. Mini-symposium: Fatigue and fatigability - making the invisible visible: taxonomy, impact, assessment and treatment methods in diverse clinical populations
Novel insights in fatigue and fatigability demonstrate that both are underestimated problems occurring in a large variety of pathologies. Despite their high prevalence and large impact on patients’ participation, quality of life and ability to participate in rehabilitation programs, these symptoms are often overlooked and their consequences in rehabilitation are insufficiently understood. In the current session, we aim to summarize the literature on definitions, taxonomy, assessment protocols, outcome measures and interventions for fatigue and fatigability in the domains of walking biomechanics, neuromotor, cardiorespiratory and paediatric rehabilitation. The definitions and underlying factors of different types of fatigue and fatigability, including trait and state fatigue and cognitive and motor fatigability, are discussed throughout the session and an updated taxonomy is presented. An overview of the different assessment methods, currently used clinical tools and novel methods based on innovative technologies will be discussed. Finally, the scientific evidence regarding different types of interventions for fatigue and fatigability is summarized, highlighting the importance of multidisciplinary and multimodal treatment programs. Hereby, attention is paid towards the implementation of these methods in clinical care.
Chair(s): Heremans Elke, PhD P.T., Research Expert Faculty of Rehabilitation Sciences, UHasselt
Speakers:
- Fanny Van Geel (PhD researcher Hasselt University) is an expert on walking fatigability and related symptoms in persons with MS.
- Maarten Van Herck (PhD researcher Hasselt University) investigates subjective fatigue in patients with lung diseases and the impact of rehabilitation upon fatigue.
- Kyra Theunissen (PhD researcher Maastricht University & Hasselt University) focuses on the biomechanics and energetics of walking fatigability in persons with MS and RA.
- Lieke Brauers (PhD researcher Maastricht University & Hasselt University) investigates motor fatigability in the upper limbs of children with CP.
Outline session:
We bring together four experts from different domains, i.e. biomechanics, neuromotor, cardiorespiratory and paediatric rehabilitation. The speakers are experts in research on fatigue and fatigability in patients with multiple sclerosis (MS), rheumatoid arthritis (RA), cerebral palsy (CP), chronic obstructive pulmonary disease, asthma and osteoarthritis.
- Fatigue and fatigability: an updated taxonomy
- Impact and prevalence of fatigue and fatigability in adults and children
- Assessment of fatigue and fatigability: golden standard and innovative methods
- Combining novel methods for understanding the relationship between walking mechanics and fatigue
- Novel interventions for treatment of fatigue and fatigability
- Group discussion
Learning objective(s):
- To clarify the definitions of different types of fatigue and fatigability and provide the audience with a clear taxonomy for future use in scientific research and clinical practice;
- To give an overview of the different assessment methods for fatigue and fatigability and the reliability of the available measurement instruments, including the presentation of novel technological assessment methods;
- To summarize novel evidence regarding fatigue and fatigability in the field of biomechanics and neuromotor, cardiorespiratory and pediatric rehabilitation;
- To provide an overview of currently used and investigated treatment methods for fatigue and fatigability and their effectiveness
C4. Mini-symposium: Transfemoral protheses: state-of-the art and beyond. Recent developments in osseo-intgration, myoelectric control and powered prosthesis
In recent years, substantial improvements have been made in the design of lower-limb prosthetics. The majority of this work is still in the research phase, but it is expected that these will transfer into daily clinical care in the foreseeable future. It is therefore of clinical importance to get an overview of the current state-of-the-art in research.
Most research endeavours are focussing on increasing the functionality and intuitiveness of lower-limb prosthetics. Functionality can primarily be improved by developing powered prostheses. These are able to generate energy and can provide push-off and active knee flexion. Intuitiveness can be increased by giving the user more direct control over the prosthesis. This can either achieved by using signals from the residual muscles to predict the activity that the user wants to perform. This information can then be used to control the prosthesis. Intuitiveness can also be increased by osseointegration. Attaching the prosthesis directly to the bone provides osseoperception as well as a direct way to move the prosthesis.
This workshop will provide an overview of the current state-of-the-art in lower-limb prosthetics as well as an overview of current advancements within research.
Chair(s): Prof Hans Rietman, MD, PhD
Outline session:
- Introduction symposium and overview of current state-of-the-art, bij chair Prof. Hans Rietman, MD, PhD
- Developments in osseo-integration for lower-limb prosthetics, by Henk van der Meent, MD, PhD
- Development of myolectric control algorithms for a transfemoral prosthesis, by Erik Prinsen, PhD
- Development of control algorithms for a powered tranfemoral prosthesis, by René Fluit, PhD
- General discussion and questions, by chair Prof. Hans Rietman, MD, PhD
Learning objective(s):
- To obtain an overview of the current state-of-the-art in lower-limb prostheses
- To obtain an overview of the state-of-the-art in osseointegration for lower-limb amputation
- To understand how the use of myoelectric signals can improve the control of transfemoral prostheses
- To understand how advanced control algorithm can improve the control of powered transfemoral prostheses
C5. Mini-symposium: Innovation in clinical practice: Implementation of a psychological screening in spinal cord injury rehabilitation
Topic: Spinal cord injury (SCI) is one of the greater calamities that can happen to a person, often leading to severe physical impairments and psychological distress. In two previous studies, we distinguished five distinct life satisfaction and mental health trajectories. These trajectories give professionals insight into how persons differ in their adaptation to SCI. The results of these studies suggest possibilities to predict long-term life satisfaction and mental health and to identify persons who might be considered for psychological treatment early in rehabilitation.
Relevance: In this workshop, we present the set-up of a psychological screening for persons with SCI in all Dutch rehabilitation centers specialized in SCI at the start of inpatient rehabilitation and at discharge.
Current status: To date, seven out of eighth centres continue the application of the screening as part of the psychological rehabilitation care. The eighth SCI-specialized rehabilitation centre is also planning to implement the screening. Based on the evaluation of the implementation, recommendations have been developed for further use of the screening among other patient groups.
Plan of action: To implement the psychological screening as usual care in persons with SCI during inpatient rehabilitation.
Chair(s):
Christel van Leeuwen, PhD, Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands and Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, the Netherlands
Author(s): Christel van Leeuwen, PhD 1, 2,Heleen Kuiper, MSc 1,3, Tijn van Diemen, MSc 1,3,4, Marcel Post, PhD 1,3
1 Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
2 Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, the Netherlands
3 University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands
4 Sint Maartenskliniek, Department of Rehabilitation, Nijmegen, The Netherlands
Outline session
- Marcel Post will describe the insights that have led to the current psychological screening in the Netherlands.
- Christel van Leeuwen will present the contents of the screening and the considerations for the choice of questionnaires.
- Heleen Kuiper will use data from the psychological screening to describe psychological factors and mood among persons with SCI at admission and discharge from inpatient rehabilitation.
- Tijn van Diemen will explain how the psychological screening is used in clinical practice. Which part of the psychological screening is used for treatment? What is interesting to know for team members? How are results communicated to persons with SCI?
Learning objective(s):
To implement the psychological screening as usual care in persons with SCI during inpatient rehabilitation.
C6. Mini-symposium: Assessment and rehabilitation of visual disorders after acquired brain injury
Due to the complexity of neurological disorders and the individual nature of impairments, neuropsychological rehabilitation after stroke, traumatic brain injury and other neurological diseases such as multiple sclerose is a challenging endeavor. First, disorders and the nature of impairments may vary from patient to patient. Second, since visual perception interacts with other cognitive functions, disturbances of the visual system have an effect on and are influenced by other functions. Third, disorders of visual function may take place at lower and/or at higher function levels and may vary from visual visual field defects and specific agnosias to non-specific visual complaints such as blurred vision or experienced alteration in contrast sensitivity.
In this mini-symposium recent developments on the assessments and rehabilitation options for this range of visual disorders are discussed in the light of recent studies and developments.
Chair(s):
- G.A. (Gera) de Haan PhD, University of Groningen, department of Clinical and Developmental Neuropsychology and Royal Dutch Visio, Centre of Expertise for blind and partially sighted people
- J.H.C. (Joost) Heutink PhD, University of Groningen, department of Clinical and Developmental Neuropsychology and Royal Dutch Visio, Centre of Expertise for blind and partially sighted people
Speakers:
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Christine Hazelton PhD, Glasgow Caledonian University, Glasgow, United Kingdom
-
Prof. Dr. Georg Kerkhoff, Klinische Neuropsychologie Universität des Saarlandes, Saarbrücken, Germany
Outline session
- PIONEER: a scoping review of interventions for perceptual problems in stroke, by Christine Hazelton PhD
- Update on neurovision rehabilitation after acquired brain damage, Prof. Dr. Georg Kerkhoff
- Assessment and rehabilitation of specific and non-specific complaints in patients with ABI, Joost Heutink PhD
- Visual complaints and disorders in patients with multiple sclerosis, by Gera de Haan PhD
Learning objective(s):
Getting acquainted about recent developments on the assessments and rehabilitation options for this range of visual disorders are discussed in the light of recent studies and developments.
C7. Mini-symposium: Home-monitoring and coaching in rehabilitation medicine: opportunities and challenges
Telehealth models of care involving home-monitoring have shown clear benefits for patients with chronic disease while reducing unnecessary clinic visits. These models of care show promise in empowering patients to better manage their health and to participate in their care, thereby improving compliance with treatment and their satisfaction with care. Furthermore, they enable health care professionals to provide timely intervention and personalized care. Despite the increasing evidence of effectiveness of telehealth technologies obtained from small-scale studies, the adoption of telehealth solutions in rehabilitation remains limited. Benefits of home monitoring may apply to several diagnostic groups in rehabilitation medicine such as neuromuscular diseases, spinal cord injury, cerebral palsy and chronic pain disorder. Barriers that need to be overcome to achieve widespread adoption of telehealth include acceptance of this technology by patients and health care professionals, economically sustainable reimbursement systems and interoperability between electronic patient record systems. In this interactive mini-symposium we will introduce examples of currently used models of rehabilitation care based on home-monitoring with special focus on the scalability and sustainability of these care innovations. The audience will be invited to reflect on the opportunities and challenges of home-monitoring in rehabilitation populations to identify strategies to promote implementation and advance adoption of home-monitoring and coaching in rehabilitation medicine.
Chairs:
- Esther Kruitwagen, MD, Rehabilitation specialist, Dept. of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht
- Anita Beelen, PhD, Senior Researcher Neuromuscular diseases, Dept of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht
Speakers:
- Pearl van Lonkhuizen MSc, Dept of Public Health and Primary Care, Leiden University Medical Center
- Dr. PhD Manon Dontje,Dept of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht
- Prof. MD PhD Nico Wulffraat, Dept of Pediatric Rheumatology and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht
Program outline:
- Introduction by drs. Esther Kruitwagen and Dr. Anita Beelen
- Development of a European eHealth care model to improve quality of life in Huntington’s Disease: a user-centered design study, by Pearl van Lonkhuizen
- Nationwide implementation of ALS Home monitoring and Coaching, by Manon Dontje
- Home monitoring by juvenile arthritis adolescents or parents using an App Reuma2Go. Can it be used to replace clinical visits? by Prof. Nico Wulffraat, MD PhD
- Reflection and discussion
Learning objectives:
At the end of the mini-symposium participants understand the value of care models based on home monitoring and recognize the challenges of promoting implementation and advancing adoption of home-monitoring in rehabilitation medicine.
Recent research has dramatically changed the insights on Parkinson’s. It used to be seen as a neurodegenerative brain disease with merely motor symptoms due to loss of dopamine production in the substantia nigra with no possibility of functional recovery. Brain Research of Parkinson’s have shown an important role for sensory-motor disorders in the basal ganglia, leading to microkinesia and hypophonia with specific complex impairments. To challenge these the broad multidisciplinary functional insight of Rehabilitation Medicine is needed in conjunction with medication to make the most of the neuroplasticity to fight the neurodegenerative disease.
As pioneer in Parkinson Rehabilitation in the Netherlands, Meander MC has successfully introduced an interdisciplinary short intense treatment aiming in restoring the amplitude affected due to microkinesia and hypophonia. In these treatments patients are taught to nominalize their movement and speech in daily life by increasing their amplitude with specific daily exercises. Research shows that patients not only improve during training, but are able to show improvement with the daily exercise even after the Rehabilitation has stopped. Given all these findings it’s important that the knowledge on Rehabilitation Medicine of Parkinson’s is shared to improve treatment for all patients with Parkinson’s.
Chair(s): Willem Jacob Oudegeest (1974-) is the leading consultant Physical Rehabilitation Medicine in the Netherlands for Parkinson Rehabilitation. He works in Meander Medical Center in Amersfoort the Netherlands, and is also President of the Workgroup Parkinson and related Movement disorders of the Netherlands Society of Rehabilitation Medicine and core member of the Parkinson Advisory Board of the Parkinson Association Netherlands. His aim is to continues improve Parkinson Rehabilitation by implementing the newest treatments and sharing his knowledge with patients and colleagues.
Speakers:
- W.J. Oudegeest, physiast Meander MC, Amersfoort
- B.M. (Tineke) Snoeijer, physiotherapist Meander MC, Amersfoort
- M.G. (Monique) Hermans, Speech therapist Meander MC, Amersfoort
Outline session:
- New insights in Parkinson: basal ganglia and microkinesia by W.J. Oudegeest
- BIG movements adressing microkinesia, by B.M. (Tineke) Snoeijer
- LOUD voice adressing hypophonia, by M.G. Hermans
Learning objective(s):
Understanding the new insights of Parkinson with a central role for the basal ganglia and microkinesia and hypophonia and knowing how to adress these in an interdisciplinary intense Rehabilitation treatment toe empower the patient to fight the neurodegenerative disease in their daily life.