67 research outputs found
Anchoring: moving from theory to therapy
No full textBeek, P.J. [Promotor]Kwakkel, G. [Promotor]Lamoth, C.J.C. [Copromotor]Peper, C.E. [Copromotor
Pelvis-thorax coordination in the transverse plane during gait
No full textThe coordination between horizontal pelvic and thoracic rotations during treadmill walking was studied in ten subjects. Previous studies have considered the relative phase using the mean to characterize coordination mode, and the S.D. as an index of its stability. However, to use S.D. of relative phase as a measure for coordinative stability, the underlying oscillations have to be phase-locked at a certain value. Random fluctuations around this value can then be viewed as stochastic perturbations of a stable fixed point, resulting in a unimodal distribution of relative phase. Using methods of circular statistics this study shows that these conditions were not met in pelvis-thorax coordination. Spectral analyses revealed that, as walking velocity increased, a triphasic component emerged in the pelvic rotations, while the thoracic rotations remained harmonic across all walking velocities. These findings refute the use of standard relative phase measures to capture pelvis-thorax coordination. An alternative measure is introduced, namely the difference between the continuous Fourier phases of the component oscillations as determined for the main frequency of the thorax oscillation. With this measure, pelvis-thorax coordination was found to evolve from in-phase coordination towards antiphase coordination as walking velocity increased. This method may be used to assess reliably the properties of pelvis-thorax coordination in both healthy and pathological gait patterns in the future. © 2002 Elsevier Science B.V. All rights reserved
P270: Factors associated with fall rate in psychogeriatric residents
No full textIntroduction: Falls in psychogeriatric residents represent a costly but unresolved safety issue. Identifying fall risk factors and their inter-relationship may help to individualize prevention programs and increase the effectiveness. Therefore, we aimed to examine the relationship between patient characteristics and fall rate in psychogeriatric residents. Methods: Twenty nursing home residents with dementia (80±11 years; 60% male) living on a psychogeriatric ward participated. Based on patient records, we identified 66 patient characteristics and extracted the number of falls over 19 months. Patient characteristics represented seven domains: demographics, ADL, mobility, cognition and behaviour, vision and hearing, medical conditions, and drug-use. We evaluated the relationship between patient characteristics and fall rate using multivariate Partial Least Squares regression. Results: A total of 115 falls (5.1±6.7 falls/person year) occurred during the study period. The 66 patient characteristics included in the model explained 96% of the variance in fall rate. Reduced mobility abilities, indicators of disinhibited behavior, diabetes, and use of analgesics, beta blocking agents and psycholeptics were positively associated with fall rate. Whereas immobility, heart failure, and the inability to communicate were negatively associated fall rate. Conclusion: Dementia is often indicated as fall risk factor; however, our results showed that especially cognitive impairment related to disinhibited behaviour was associated with a high fall rate in psychogeriatric residents. Furthermore, immobility and inactivity seemed to decrease fall rate. The analytic approach provided a detailed view of the fall risk factors and their interactions in psychogeriatric residents, enabling more effective fall prevention
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