39 research outputs found
The prevalence of scoliosis in spina bifida subpopulations: a systematic review
No full textPrevalence of scoliosis within spina bifida subpopulations is important for diagnostics and therapeutic purposes. This review determined the prevalence of scoliosis within spina bifida subpopulations by means of a systematic literature review by using the following databases: Medline-Pubmed, Embase, Cochrane and Pedro. All Dutch- and English-written literature using the MESH-terms: "Spinal Dysraphism", "Neural Tube Defects", "Scoliosis" was analysed using the exclusion criteria: animal studies, case reports, studies regarding the prevalence of spina bifida among patients with scoliosis, studies with inclusion of patients with scoliosis 10°, studies without an own study group, articles comprising the same patient group as another article, neural tube defects besides spina bifida and articles without specification of spina bifida subtype. It resulted in six articles, two concerning diastematomyelia (103 patients, 82 females and 21 males), four about myelomeningocele (479 patients, 283 females and 196 males) with an overall weighted prevalence of scoliosis (20° Cobb angle cut off) of 44.4% and 52.5% respectively. It can be concluded that most studies have a lot of methodological flaws so there is a need for further research with standardisation of data collection to allow comparison of different data
Patient perspective vs expert opinion: Optimal rehabilitation practices for management of single-and double level lumbar fusion surgery
No full textBest practices in the rehabilitation of single- and double level lumbar fusion surgery: results of a modified delphi process
No full textThe Infinity Loop of Healthcare Innovation: Development of an Integrated Rehabilitation Pathway for Lumbar Fusion Surgery Through Design Thinking
No full textIntroduction: Integrated care pathways may help to bridge evidence-practice gaps. To overcome the limitations of traditional researcher-centred and linear pathway development frameworks, a more user-centred approach is needed. In this study, we propose design thinking as a framework for developing integrated care pathways, specifically targeting rehabilitation of patients undergoing lumbar fusion surgery. Description: From 2017 to 2022, we utilized the design thinking infinity loop to create an evidence-based rehabilitation pathway for patients undergoing lumbar fusion surgery. This approach consisted of five phases: (1) empathizing with user needs, (2) defining problem statements, (3) ideating through meta-analysis, expert consensus, and brainstorming, (4) prototyping the pathway, and (5) testing its effectiveness and implementability. Discussion: Through the proposed design thinking phases, innovative elements such as prehabilitation, early mobilization, and consistent communication emerged as the building blocks of the new rehabilitation pathway, addressing the needs of both patients and healthcare providers. These results serve as a practical guide for applying design thinking in developing integrated care pathways. Conclusion: Design thinking, represented by the infinity loop, presents a user-centred framework for developing integrated care pathways, and has the potential to effectively bridge the gap between evidence and clinical practice
The prevalence of scoliosis within Belgian myelomeningocele population and the correlation with ambulatory status and neurological comorbidities: a chart audit
No full textSTUDY DESIGN: Retrospective chart audit. OBJECTIVES: Firstly determining the prevalence of scoliosis in myelomeningocele (MMC) patients of the University Hospitals Leuven. Secondly analyzing whether there are differences concerning distribution of radiological level, ambulatory status, hydrocephalus, tethered cord, and syringomyelia in MMC patients with/without scoliosis. SETTING: University Hospitals Leuven, spina bifida convention. METHODS: The following data were collected: age, gender, radiograph type, age at the time of the radiograph, position during radiograph, presence of fusion, age at the time of fusion, diagnosis of hydrocephalus, tethered cord, or syringomyelia, radiological level of MMC, ambulatory status, main Cobb angle, main curve convexity, and main curve location. Correlation between prevalence of scoliosis and ambulatory status, neurological comorbidities, and radiological level were investigated. RESULTS: There were 116 patients remaining, after excluding patients without MMC or useful images. The scoliosis prevalence in MMC patients was 78.4% (95% CI, 71.0-85.8) for Cobb angle ≥10°; 60.3% (95% CI, 51.4-69.2) for ≥20°, 52.6% (95% CI, 43.5-61.7) for ≥30°, and 36.6% (95% CI, 27.7-45.5) for an angle ≥40°. Wheelchair users had 4 to 8 times more chance of having scoliosis than patients able to walk on all surfaces without aid. Thoracolumbar and lumbar radiological levels had a slightly higher prevalence of scoliosis than sacral levels. CONCLUSIONS: The high prevalence of scoliosis warrants a thorough screening and follow-up for MMC. There was no statistically significant difference between hydrocephalus, tethered cord, or syringomyelia regarding scoliosis. Future studies should focus on the interactions of the neurological comorbidities associated with MMC and scoliosis.status: Publishe
Best practices in the rehabilitation of single- and double level lumbar fusion surgery: results of a modified delphi process
No full textBest practices in the rehabilitation of single- and double level lumbar fusion surgery: results of a modified delphi process
No full textFunctionality, Pain and Return to Work After Lumbar Fusion Surgery: a Preliminary Study.
No full textBest practices in the rehabilitation of single- and double level lumbar fusion surgery: Results of a modified Delphi process
No full textBest practice rehabilitation pathway for the management of single and double-level lumbar fusion surgery: a modified Delphi Study
No full textBACKGROUND: There is limited evidence to guide the rehabilitation of patients following single or double-level lumbar fusion surgery (LFS). This is reflected in extensive variability in current rehabilitation regimes and subsequent low clinical success rates, which urges a call for a consensus rehabilitation pathway. AIM: To establish consensus on the optimal pre-, peri- and postoperative rehabilitation of LFS. DESIGN: A modified Delphi Study. SETTING: Belgium and the Netherlands. POPULATION: A multidisciplinary panel of 31 experts in the field of LFS and rehabilitation participated. Nine patients validated the consensus pathway. METHODS: A three-round online Delphi questionnaire was followed by an in-person consensus meeting. In each round, experts could suggest new statements, and received group summary statistics and feedback for reconsidered statements. Consensus threshold was set at ≥75% agreement. The resulting rehabilitation pathway was validated by patients through an online questionnaire and subsequent in-person focus group. RESULTS: A total of 31 experts participated in the first online round, with 27 (87%) completing all online rounds, and 17 (55%) attending the in-person consensus meeting. Consensus was reached on 122 statements relating to pre-, peri- and postoperative rehabilitation of LFS, and validated by patients. Key components of the rehabilitation pathway included prehabilitation, education, physiotherapy in every phase, early postoperative mobilization, and little movement restrictions. Patients emphasized the need for support during the return-to-work process. CONCLUSIONS: This process resulted in 122 expert-consensus statements on best practice rehabilitation for managing LFS, validated by patients. CLINICAL REHABILITATION IMPACT: The proposed rehabilitation pathway can serve as guidance to support clinicians, reduce practice variability, and subsequently improve clinical outcomes after LFS.sponsorship: This research was funded by a grant from Research Foundation - Flanders (FWO, 1181521N). (Research Foundation - Flanders (FWO)|1181521N)status: Publishe
