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919 results on '"Nollet, Frans"'

1. Improving Physical Activity in Adults Admitted to a Hospital With Interventions Developed and Implemented Through Cocreation: Protocol for a Pre-Post Embedded Mixed Methods Study

Author

Geelen, Sven J G, Giele, Boukje M, Nollet, Frans, Engelbert, Raoul H H, and van der Schaaf, Marike

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundAdmission to a hospital is often related with hospital-associated disabilities. Improving physical activity during hospitalization is considered effective to counteract hospital-associated disabilities, whereas many studies report on very low physical activity levels. Gradually developing and implementing interventions in cocreation with patients and health care professionals rather than implementing predefined interventions may be more effective in creating sustainable changes in everyday clinical practice. However, no studies have reported on the use of cocreation in the development and implementation of interventions aimed at improving physical activity. ObjectiveThis protocol presents a study that aims to investigate if interventions, which will be developed and implemented in cocreation, improve physical activity among patients in surgery, internal medicine, and cardiology hospital wards. The secondary aims are to investigate effectiveness in terms of the reduction in the time patients spend in bed, the length of hospital stay, and the proportion of patients going home after discharge. MethodsThe Better By Moving study takes place for 12 months at the following five different wards of a university hospital: two gastrointestinal and oncology surgery wards, one internal medicine hematology ward, one internal medicine infectious diseases ward, and one cardiology ward. The step-by-step implementation model of Grol and Wensing is used, and all interventions are developed and implemented in cocreation with health care professionals and patients. Outcome evaluation is performed across the different hospital wards and for each hospital ward individually. The primary outcome is the amount of physical activity in minutes assessed with the Physical Activity Monitor AM400 accelerometer in two individual groups of patients (preimplementation [n=110], and 13 months after the start of the implementation [n=110]). The secondary outcomes are time spent in bed measured using behavioral mapping protocols, and length of stay and discharge destination assessed using organizational data. A process evaluation using semistructured interviews and surveys is adopted to evaluate the implementation, mechanisms of impact, context, and perceived barriers and enablers. ResultsThis study is ongoing. The first participant was enrolled in January 2018. The last outcome evaluation and process evaluation are planned for May and June 2020, respectively. Results are expected in April 2021. ConclusionsThis study will provide information about the effectiveness of developing and implementing interventions in cocreation with regard to improving physical activity in different subgroups of hospitalized patients in a university hospital. By following step-by-step implementation and by performing process evaluation, we will identify the barriers and enablers for implementation and describe the effect of new interventions on improving physical activity among hospitalized patients. Trial RegistrationNetherlands Trial Register NL8480; https://www.trialregister.nl/trial/8480 International Registered Report Identifier (IRRID)DERR1-10.2196/19000

Published
2020
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4. Moderators of exercise effects on self-reported cognitive functioning in cancer survivors: an individual participant data meta-analysis

Author

Hiensch, Anouk E., Beckhaus, Julia, Witlox, Lenja, Monninkhof, Evelyn M., Schagen, Sanne B., van Vulpen, Jonna K., Sweegers, Maike G., Newton, Robert U., Aaronson, Neil K., Galvão, Daniel A., Steindorf, Karen, Stuiver, Martijn M., Mesters, Ilse, Knoop, Hans, Goedendorp, Martine M., Bohus, Martin, Thorsen, Lene, Schulz, Karl-Heinz, Schmidt, Martina E., Ulrich, Cornelia M., Sonke, Gabe S., van Harten, Wim H., Winters-Stone, Kerri M., Velthuis, Miranda J., Taaffe, Dennis R., van Mechelen, Willem, Kersten, Marie José, Nollet, Frans, Wiskemann, Joachim, Buffart, Laurien M, and May, Anne M

Published
2023
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18. Individualized Aerobic Exercise in Neuromuscular Diseases: A Pilot Study on the Feasibility and Preliminary Effectiveness to Improve Physical Fitness

Author

Voorn, Eric L., Koopman, Fieke S., Nollet, Frans, and Brehm, Merel-Anne

Subjects
Neuromuscular diseases -- Care and treatment, Aerobic exercises -- Methods -- Health aspects, Exercise therapy -- Testing, Health
Abstract

Objective. Clear guidelines to prescribe aerobic exercise in neuromuscular diseases (NMD) are lacking, which hampers effective application in neuromuscular rehabilitation. This pilot study evaluated the feasibility and preliminary effectiveness of an individualized aerobic exercise program according to a recently developed training guide (B-FIT) to improve physical fitness in individuals with NMD. Methods. Thirty-one individuals who were ambulatory and had 15 different slowly progressive NMD participated in a 4-month, polarized, home-based, aerobic exercise program. The program included 2 low-intensity sessions and 1 high-intensity session per week. Feasibility outcomes were the following: completion rate, proportion of followed sessions, adverse events, and participant and therapist satisfaction based on a self-designed questionnaire. Submaximal incremental exercise tests were used to assess the effects on physical fitness. Results. Twenty-six participants (84%) completed the B-FIT program, and the proportion of followed sessions was >75%>. Three adverse events were reported and resolved. Regarding satisfaction, participants (based on n = 9) reported feeling fitter, but training was considered insufficiently challenging. Physical therapists (n = 5) reported that B-FIT provides a clear, well-grounded guidance. They perceived the time investment for initiating the program and the carry-over to primary care as the main barriers. The mean (SD) submaximal heart rate (based on n = 20) reduced significantly by -6.5 beats per minute (95% CI = -11.8 to -1.2), from 121.7 (16.5) at baseline to 115.2 (14.3) after intervention. Submaximal ratings of perceived exertion, anaerobic threshold, and peak workload also improved significantly (P < .05). Conclusion. The outcomes of this pilot study suggest that individualized aerobic exercise according to B-FIT is feasible and has potential to improve physical fitness in a wide variety of slowly progressive NMD. However, some barriers must be addressed before investigating the efficacy in a randomized controlled trial. Impact. The outcomes of this study demonstrate the feasibility of individualized aerobic exercise according to the B-FIT training guide and the potential to improve physical fitness in NMD. Physical therapists indicated that the use of B-FIT provides a clear, well-grounded guidance. The training guide can support health care professionals in the application of aerobic exercise in adult neuromuscular rehabilitation. Lay Summary. Individualized exercise according to the B-FIT training guide is feasible in a wide variety of slowly progressive NMD and might help improve physical fitness. Keywords: Aerobic Exercise, Neuromuscular Diseases, Feasibility, Rehabilitation, Physical Fitness, Introduction Physical inactivity is a common problem in individuals with neuromuscular diseases (NMD) and is caused by symptoms of muscle weakness, fatigue, and pain. (1-3) Inactivity leads to reduced physical [...]

Published
2021
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29. Moderators of Exercise Effects on Cancer-related Fatigue: A Meta-analysis of Individual Patient Data

Author

VAN VULPEN, JONNA K., SWEEGERS, MAIKE G., PEETERS, PETRA H. M., COURNEYA, KERRY S., NEWTON, ROBERT U., AARONSON, NEIL K., JACOBSEN, PAUL B., GALVÃO, DANIEL A., CHINAPAW, MAI J., STEINDORF, KAREN, IRWIN, MELINDA L., STUIVER, MARTIJN M., HAYES, SANDI, GRIFFITH, KATHLEEN A., MESTERS, ILSE, KNOOP, HANS, GOEDENDORP, MARTINE M., MUTRIE, NANETTE, DALEY, AMANDA J., MCCONNACHIE, ALEX, BOHUS, MARTIN, THORSEN, LENE, SCHULZ, KARL-HEINZ, SHORT, CAMILLE E., JAMES, ERICA L., PLOTNIKOFF, RONALD C., SCHMIDT, MARTINA E., ULRICH, CORNELIA M., VAN BEURDEN, MARC, OLDENBURG, HESTER S., SONKE, GABE S., VAN HARTEN, WIM H., SCHMITZ, KATHRYN H., WINTERS-STONE, KERRI M., VELTHUIS, MIRANDA J., TAAFFE, DENNIS R., VAN MECHELEN, WILLEM, KERSTEN, MARIE JOSÉ, NOLLET, FRANS, WENZEL, JENNIFER, WISKEMANN, JOACHIM, VERDONCK-DE LEEUW, IRMA M., BRUG, JOHANNES, MAY, ANNE M., and BUFFART, LAURIEN M.

Published
2020
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32. Moderators of exercise effects on self-reported cognitive functioning in cancer survivors:an individual participant data meta-analysis

Author

Hiensch, Anouk E., Beckhaus, Julia, Witlox, Lenja, Monninkhof, Evelyn M., Schagen, Sanne B., van Vulpen, Jonna K., Sweegers, Maike G., Newton, Robert U., Aaronson, Neil K., Galvão, Daniel A., Steindorf, Karen, Stuiver, Martijn M., Mesters, Ilse, Knoop, Hans, Goedendorp, Martine M., Bohus, Martin, Thorsen, Lene, Schulz, Karl-Heinz, Schmidt, Martina E., Ulrich, Cornelia M., Sonke, Gabe S., van Harten, Wim H., Winters-Stone, Kerri M., Velthuis, Miranda J., Taaffe, Dennis R., van Mechelen, Willem, Kersten, Marie José, Nollet, Frans, Wiskemann, Joachim, Buffart, Laurien M., May, Anne M., Master Evidence Based Practice, APH - Health Behaviors & Chronic Diseases, APH - Quality of Care, CCA - Cancer Treatment and Quality of Life, Medical Psychology, APH - Mental Health, Clinical Haematology, AII - Cancer immunology, CCA - Cancer biology and immunology, Rehabilitation medicine, AMS - Rehabilitation & Development, EURO-NMD, Public and occupational health, and APH - Societal Participation & Health

Subjects
Oncology (nursing), Survivorship, RANDOMIZED CONTROLLED-TRIAL, FATIGUE, Cognitive functioning, PROSTATE-CANCER, INCREASING PHYSICAL-ACTIVITY, ADJUVANT CHEMOTHERAPY, Sociology, Oncology, QUALITY-OF-LIFE, Individual participant data meta-analysis, ANDROGEN DEPRIVATION THERAPY, Human medicine, AEROBIC EXERCISE, HIGH-INTENSITY, Exercise, Biology, RESISTANCE, Cancer
Abstract

Purpose This individual participant data meta-analysis (IPD-MA) assesses exercise effects on self-reported cognitive functioning (CF) and investigates whether effects differ by patient-, intervention-, and exercise-related characteristics. Methods IPD from 16 exercise RCTs, including 1987 patients across multiple types of non-metastatic cancer, was pooled. A one-stage IPD-MA using linear mixed-effect models was performed to assess exercise effects on self-reported CF (z-score) and to identify whether the effect was moderated by sociodemographic, clinical, intervention- and exercise-related characteristics, or fatigue, depression, anxiety, and self-reported CF levels at start of the intervention (i.e., baseline). Models were adjusted for baseline CF and included a random intercept at study level to account for clustering of patients within studies. A sensitivity analysis was performed in patients who reported cognitive problems at baseline. Results Minimal significant beneficial exercise effects on self-reported CF (β=−0.09 [−0.16; −0.02]) were observed, with slightly larger effects when the intervention was delivered post-treatment (n=745, β=−0.13 [−0.24; −0.02]), and no significant effect during cancer treatment (n=1,162, β=−0.08 [−0.18; 0.02]). Larger effects were observed in interventions of 12 weeks or shorter (β=−0.14 [−0.25; −0.04]) or 24 weeks or longer (β=−0.18 [−0.32; −0.02]), whereas no effects were observed in interventions of 12–24 weeks (β=0.01 [−0.13; 0.15]). Exercise interventions were most beneficial when provided to patients without anxiety symptoms (β=−0.10 [−0.19; −0.02]) or after completion of treatment in patients with cognitive problems (β=−0.19 [−0.31; −0.06]). No other significant moderators were identified. Conclusions This cross-cancer IPD meta-analysis observed small beneficial exercise effects on self-reported CF when the intervention was delivered post-treatment, especially in patients who reported cognitive problems at baseline. Implications for Cancer Survivors This study provides some evidence to support the prescription of exercise to improve cognitive functioning. Sufficiently powered trials are warranted to make more definitive recommendations and include these in the exercise guidelines for cancer survivors.

Published
2023

47. de Morton Mobility Index is feasible, reliable, and valid in patients with critical illness

Author

Sommers, Juultje, Vredeveld, Tom, Lindeboom, Robert, Nollet, Frans, Engelbert, Raoul H.H., and van der Schaaf, Marike

Subjects
Medical equipment -- Usage, Diseases -- Care and treatment, Intensive care units -- Management, Treatment outcome -- Analysis, Physiological apparatus -- Usage, Company business management, Health
Abstract

Background. Intensive care unit (ICU) stays often lead to reduced physical functioning. Change in physical functioning in patients in the ICU is inadequately assessed through available instruments. The de Morton Mobility Index (DEMMI), developed to assess mobility in elderly hospitalized patients, is promising for use in patients who are critically ill. Objective. The aim of this study was to evaluate the clinimetric properties of the DEMMI for patients in the ICU. Design. A prospective, observational reliability and validity study was conducted. Methods. To evaluate interrater and intrarater reliability (intraclass correlation coefficients), patients admitted to the ICU were assessed with the DEMMI during and after ICU stay. Validity was evaluated by correlating the DEMMI with the Barthel Index (BI), the Katz Index of Independence in Activities of Daily Living (Katz ADL), and manual muscle testing (MMT). Feasibility was evaluated based on the percentage of participants in which the DEMMI could be assessed, the floor and ceiling effects, and the number of adverse events. Results. One hundred fifteen participants were included (Acute Physiology and Chronic Health Evaluation II [APACHE II] mean score=15.2 and Sepsis-related Organ Failure Assessment [SOFA] mean score=7). Interrater reliability was .93 in the ICU and .97 on the wards, whereas intrarater reliability during the ICU stay was .68. Validity (Spearman rho coefficient) during the ICU stay was .56, -.45, and .57 for the BI, Katz ADL, and MMT, respectively. The DEMMI showed low floor and ceiling effects (2.6%) during and after ICU discharge. There were no major adverse events. Limitations. Rapid changes in participants' health status may have led to underestimation of intrarater reliability. Conclusion. The DEMMI was found to be clinically feasible, reliable, and valid for measuring mobility in an ICU population. Therefore, the DEMMI should be considered a preferred instrument for measuring mobility in patients during and after their ICU stay., Due to critical illness and prolonged inactivity, survivors of the intensive care unit (ICU) often show decreased physical functioning and mobility, limiting their daily activities and quality of life. (1-3) [...]

Published
2016
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