Klaas Postema - Academia.edu (original) (raw)

Papers by Klaas Postema

Research paper thumbnail of Psychometric properties of the DCDDaily-Q: A new parental questionnaire on children's performance in activities of daily living

Research in Developmental Disabilities, 2014

Difficulties in the performance of activities of daily living (ADL) are a key feature of developm... more Difficulties in the performance of activities of daily living (ADL) are a key feature of developmental coordination disorder (DCD). The DCDDaily-Q was developed to address children's motor performance in a comprehensive range ADL. The aim of this study was to investigate the psychometric properties of this parental questionnaire. Parents of 218 five to eight year-old children (DCD group: N=25; reference group: N=193) completed the research version of the new DCDDaily-Q and the Movement Assessment Battery for Children-2 (MABC2) Checklist and Developmental Coordination Disorder Questionnaire (DCDQ). Children were assessed with the MABC2 and DCDDaily. Item reduction analyses were performed and reliability (internal consistency and factor structure) and concurrent, discriminant, and incremental validity of the DCDDaily-Q were investigated. The final version of the DCDDaily-Q comprises 23 items that cover three underlying factors and shows good internal consistency (Cronbach's α>.80). Moderate correlations were found between the DCDDaily-Q and the other instruments used (p<.001 for the reference group; p>.05 for the DCD group). Discriminant validity of the DCDDaily-Q was good for DCDDaily-Q total scores (p<.001) and all 23 item scores (p<.01), indicating poorer performance in the DCD group. Sensitivity (88%) and specificity (92%) were good. The DCDDaily-Q better predicted DCD than currently used questionnaires (R(2)=.88). In conclusion, the DCDDaily-Q is a valid and reliable questionnaire to address children's ADL performance.

Research paper thumbnail of Repeated Measurements of Arm Joint Passive Range of Motion After Stroke: Interobserver Reliability and Sources of Variation

Physical Therapy, 2012

Background. Goniometric measurements of hemiplegic arm joints must be reliable to draw proper cli... more Background. Goniometric measurements of hemiplegic arm joints must be reliable to draw proper clinical and scientific conclusions. Previous reliability studies were cross-sectional and based on small samples. Knowledge about the contributions of sources of variation to these measurement results is lacking.

Research paper thumbnail of Suitability of Kinect for measuring whole body movement patterns during exergaming

Journal of biomechanics, Jan 22, 2014

Exergames provide a challenging opportunity for home-based training and evaluation of postural co... more Exergames provide a challenging opportunity for home-based training and evaluation of postural control in the elderly population, but affordable sensor technology and algorithms for assessment of whole body movement patterns in the home environment are yet to be developed. The aim of the present study was to evaluate the use of Kinect, a commonly available video game sensor, for capturing and analyzing whole body movement patterns. Healthy adults (n=20) played a weight shifting exergame under five different conditions with varying amplitudes and speed of sway movement, while 3D positions of ten body segments were recorded in the frontal plane using Kinect and a Vicon 3D camera system. Principal Component Analysis (PCA) was used to extract and compare movement patterns and the variance in individual body segment positions explained by these patterns. Using the identified patterns, balance outcome measures based on spatiotemporal sway characteristics were computed. The results showed ...

Research paper thumbnail of Exergaming for balance training of elderly: state of the art and future developments

Journal of NeuroEngineering and Rehabilitation, 2013

Fall injuries are responsible for physical dysfunction, significant disability, and loss of indep... more Fall injuries are responsible for physical dysfunction, significant disability, and loss of independence among elderly. Poor postural control is one of the major risk factors for falling but can be trained in fall prevention programs. These however suffer from low therapy adherence, particularly if prevention is the goal. To provide a fun and motivating training environment for elderly, exercise games, or exergames, have been studied as balance training tools in the past years. The present paper reviews the effects of exergame training programs on postural control of elderly reported so far. Additionally we aim to provide an in-depth discussion of technologies and outcome measures utilized in exergame studies. Thirteen papers were included in the analysis. Most of the reviewed studies reported positive results with respect to improvements in balance ability after a training period, yet few reached significant levels. Outcome measures for quantification of postural control are under continuous dispute and no gold standard is present. Clinical measures used in the studies reviewed are well validated yet only give a global indication of balance ability. Instrumented measures were unable to detect small changes in balance ability as they are mainly based on calculating summary statistics, thereby ignoring the time-varying structure of the signals. Both methods only allow for measuring balance after the exergame intervention program. Current developments in sensor technology allow for accurate registration of movements and rapid analysis of signals. We propose to quantify the time-varying structure of postural control during gameplay using low-cost sensor systems. Continuous monitoring of balance ability leaves the user unaware of the measurements and allows for generating user-specific exergame training programs and feedback, both during one game and in timeframes of weeks or months. This approach is unique and unlocks the as of yet untapped potential of exergames as balance training tools for community dwelling elderly.

Research paper thumbnail of Activities of Daily Living in Children With Developmental Coordination Disorder: Performance, Learning, and Participation

Physical Therapy, 2015

Children with developmental coordination disorder (DCD) face evident motor difficulties in daily ... more Children with developmental coordination disorder (DCD) face evident motor difficulties in daily functioning. Little is known, however, about their difficulties in specific activities of daily living (ADL). The purposes of this study were: (1) to investigate differences between children with DCD and their peers with typical development for ADL performance, learning, and participation, and (2) to explore the predictive values of these aspects. This was a cross-sectional study. In both a clinical sample of children diagnosed with DCD (n=25 [21 male, 4 female], age range=5-8 years) and a group of peers with typical development (25 matched controls), the children's parents completed the DCDDaily-Q. Differences in scores between the groups were investigated using t tests for performance and participation and Pearson chi-square analysis for learning. Multiple regression analyses were performed to explore the predictive values of performance, learning, and participation. Compared with their peers, children with DCD showed poor performance of ADL and less frequent participation in some ADL. Children with DCD demonstrated heterogeneous patterns of performance (poor in 10%-80% of the items) and learning (delayed in 0%-100% of the items). In the DCD group, delays in learning of ADL were a predictor for poor performance of ADL, and poor performance of ADL was a predictor for less frequent participation in ADL compared with the control group. A limited number of children with DCD were addressed in this study. This study highlights the impact of DCD on children's daily lives and the need for tailored intervention.

Research paper thumbnail of Psychometric properties of the DCDDaily-Q: A new parental questionnaire on children's performance in activities of daily living

Research in Developmental Disabilities, 2014

Difficulties in the performance of activities of daily living (ADL) are a key feature of developm... more Difficulties in the performance of activities of daily living (ADL) are a key feature of developmental coordination disorder (DCD). The DCDDaily-Q was developed to address children's motor performance in a comprehensive range ADL. The aim of this study was to investigate the psychometric properties of this parental questionnaire. Parents of 218 five to eight year-old children (DCD group: N=25; reference group: N=193) completed the research version of the new DCDDaily-Q and the Movement Assessment Battery for Children-2 (MABC2) Checklist and Developmental Coordination Disorder Questionnaire (DCDQ). Children were assessed with the MABC2 and DCDDaily. Item reduction analyses were performed and reliability (internal consistency and factor structure) and concurrent, discriminant, and incremental validity of the DCDDaily-Q were investigated. The final version of the DCDDaily-Q comprises 23 items that cover three underlying factors and shows good internal consistency (Cronbach's α>.80). Moderate correlations were found between the DCDDaily-Q and the other instruments used (p<.001 for the reference group; p>.05 for the DCD group). Discriminant validity of the DCDDaily-Q was good for DCDDaily-Q total scores (p<.001) and all 23 item scores (p<.01), indicating poorer performance in the DCD group. Sensitivity (88%) and specificity (92%) were good. The DCDDaily-Q better predicted DCD than currently used questionnaires (R(2)=.88). In conclusion, the DCDDaily-Q is a valid and reliable questionnaire to address children's ADL performance.

Research paper thumbnail of A systematic review of instruments for assessment of capacity in activities of daily living in children with developmental co-ordination disorder

Child: Care, Health and Development, 2013

Children with developmental co-ordination disorder (DCD) face evident motor difficulties in activ... more Children with developmental co-ordination disorder (DCD) face evident motor difficulties in activities of daily living (ADL). Assessment of their capacity in ADL is essential for diagnosis and intervention, in order to limit the daily consequences of the disorder. The aim of this study is to systematically review potential instruments for standardized and objective assessment of children's capacity in ADL, suited for children with DCD. As a first step, databases of MEDLINE, EMBASE, CINAHL and PsycINFO were searched to identify studies that described instruments with potential for assessment of capacity in ADL. Second, instruments were included for review when two independent reviewers agreed that the instruments (1) are standardized and objective; (2) assess at activity level and comprise items that reflect ADL; and (3) are applicable to school-aged children that can move independently. Out of 1507 publications, 66 publications were selected, describing 39 instruments. Seven of these instruments were found to fulfil the criteria and were included for review: the Bruininks-Oseretsky Test of Motor Performance-2 (BOT2); the Do-Eat (Do-Eat); the Movement Assessment Battery for Children-2 (MABC2); the school-Assessment of Motor and Process Skills (schoolAMPS); the Tuffts Assessment of Motor Performance (TAMP); the Test of Gross Motor Development (TGMD); and the Functional Independence Measure for Children (WeeFIM). As a third step, for the included instruments, suitability for children with DCD was discussed based on the ADL comprised, ecological validity and other psychometric properties. We concluded that current instruments do not provide comprehensive and ecologically valid assessment of capacity in ADL as required for children with DCD.

Research paper thumbnail of Development of the DCDDaily: an instrument for the assessment of activities of daily living

Background / Purpose: To develop an instrument for objective and systematic assessment of activit... more Background / Purpose: To develop an instrument for objective and systematic assessment of activities of daily living (ADL) in 5 to 8 year old children: the DCDDailyTo confirm the validity and reliability of the DCDDaily Main conclusion: The DCDDaily is the first instrument for objective and systematic assessment of ADL in children with daily living skills (DCD). The DCDDaily differentiates the performance of ADL between children with DCD and controls.

Research paper thumbnail of Development and psychometric properties of the DCDDaily: a new test for clinical assessment of capacity in activities of daily living in children with developmental coordination disorder

Clinical Rehabilitation, 2013

To develop the DCDDaily, an instrument for objective and standardized clinical assessment of capa... more To develop the DCDDaily, an instrument for objective and standardized clinical assessment of capacity in activities of daily living (ADL) in children with developmental coordination disorder (DCD), and to investigate its usability, reliability, and validity. Five to eight-year-old children with and without DCD. The DCDDaily was developed based on thorough review of the literature and extensive expert involvement. To investigate the usability (assessment time and feasibility), reliability (internal consistency and repeatability), and validity (concurrent and discriminant validity) of the DCDDaily, children were assessed with the DCDDaily and the Movement Assessment Battery for Children-2 Test, and their parents filled in the Movement Assessment Battery for Children-2 Checklist and Developmental Coordination Disorder Questionnaire. 459 children were assessed (DCD group, n = 55; normative reference group, n = 404). Assessment was possible within 30 minutes and in any clinical setting. For internal consistency, Cronbach's α = 0.83. Intraclass correlation = 0.87 for test-retest reliability and 0.89 for inter-rater reliability. Concurrent correlations with Movement Assessment Battery for Children-2 Test and questionnaires were ρ = -0.494, 0.239, and -0.284, p < 0.001. Discriminant validity measures showed significantly worse performance in the DCD group than in the control group (mean (SD) score 33 (5.6) versus 26 (4.3), p < 0.001). The area under curve characteristic = 0.872, sensitivity and specificity were 80%. The DCDDaily is a valid and reliable instrument for clinical assessment of capacity in ADL, that is feasible for use in clinical practice.

Research paper thumbnail of Activities of Daily Living in Children With Developmental Coordination Disorder: Performance, Learning, and Participation

Physical therapy, Jan 4, 2015

Children with developmental coordination disorder (DCD) face evident motor difficulties in daily ... more Children with developmental coordination disorder (DCD) face evident motor difficulties in daily functioning. Little is known, however, about their difficulties in specific activities of daily living (ADL). The purposes of this study were: (1) to investigate differences between children with DCD and their peers with typical development for ADL performance, learning, and participation, and (2) to explore the predictive values of these aspects. This was a cross-sectional study. In both a clinical sample of children diagnosed with DCD (n=25 [21 male, 4 female], age range=5-8 years) and a group of peers with typical development (25 matched controls), the children's parents completed the DCDDaily-Q. Differences in scores between the groups were investigated using t tests for performance and participation and Pearson chi-square analysis for learning. Multiple regression analyses were performed to explore the predictive values of performance, learning, and participation. Compared with ...

Research paper thumbnail of Cancer-Related Fatigue: Predictors and Effects of Rehabilitation

The Oncologist, 2006

The aims of the study were to examine the effects of a multidimensional rehabilitation program on... more The aims of the study were to examine the effects of a multidimensional rehabilitation program on cancer-related fatigue, to examine concurrent predictors of fatigue, and to investigate whether change in fatigue over time was associated with change in predictors. 72 cancer survivors with different diagnoses. rehabilitation center. 15-week rehabilitation program. Fatigue (Multidimensional Fatigue Inventory), demographic and disease/treatment-related variables, body composition (bioelectrical impedance), exercise capacity (symptom-limited bicycle ergometry), muscle force (handheld dynamometry), physical and psychological symptom distress (Rotterdam Symptom Check List), experienced physical and psychological functioning (RAND-36), and self-efficacy (General-Self-Efficacy Scale, Dutch version). Measurements were performed before (T0) and after rehabilitation (T1). At T1 (n = 56), significant improvements in fatigue were found, with effect sizes varying from -0.35 to -0.78. At T0, the different dimensions of fatigue were predicted by different physical and psychological variables. Explained variance of change in fatigue varied from 42%-58% and was associated with pre-existing fatigue and with change in physical functioning, role functioning due to physical problems, psychological functioning, and physical symptoms distress. Within this selected group of patients we found that (a) rehabilitation is effective in reducing fatigue, (b) both physical and psychological parameters predicted different dimensions of fatigue at baseline, and (c) change in fatigue was mainly associated with change in physical parameters.

Research paper thumbnail of A multidimensional cancer rehabilitation program for cancer survivors

Journal of Psychosomatic Research, 2005

Objective: A multidimensional rehabilitation program for cancer survivors was developed to overco... more Objective: A multidimensional rehabilitation program for cancer survivors was developed to overcome cancer-related problems and to improve quality of life. The two purposes of the study were to describe the effectiveness of the program and to obtain information about patient preferences for multi or mono dimensional rehabilitation programs. Methods: Subjects: cancer survivors with different diagnoses, and cancer-related physical and psychosocial problems. Intervention: a 15-week rehabilitation program including individual exercise, sports, psycho-education, and information. Group-wise randomization was implemented by assigning one half of the patients to the complete program while the other half were allowed to choose which program components they considered relevant. Measures: Health-Related Quality of Life [RAND-36 and Rotterdam Symptom Check List (RSCL)], exercise capacity (symptom limited bicycle ergometry), muscle force (hand-held dynamometry), and patient preferences. Measurements were performed before (T0) and after the rehabilitation program (T1), and at a 3-month follow-up (T2). Results: After the rehabilitation program, cancer survivors (n=63) displayed statistically significant improvements on health-related quality of life with effect sizes (ES) varying from 0.38 to 0.99 (RAND-36) and from À0.34 to À0.57 (RSCL), most persistent at 3-month follow-up. Furthermore, statistically significant improvements in exercise capacity and muscle force of upper and lower extremities were displayed after rehabilitation. If offered a choice, 80% of the patients prior to start and 58% of the patients after completion of the program indicated that they preferred the entire multidimensional program. Conclusion: A multidimensional rehabilitation program has statistically and clinically relevant beneficial effects on health-related quality of life, exercise capacity, and muscle force in cancer patients with different diagnoses. Furthermore, if offered the choice, the majority of cancer survivors seem to prefer multidimensional programs to programs with only one component. D

Research paper thumbnail of Happiness to be gained in paediatric asthma care

European Respiratory Journal, 2008

The aim of the present study was to establish the efficacy in terms of morbidity and health-relat... more The aim of the present study was to establish the efficacy in terms of morbidity and health-related quality of life (HRQoL) of a group asthma education-exercise programme to children with low (below 10th percentile value) quality-of-life scores. A controlled, randomised, open, clinical trial was conducted. In total, 36 out of 53 unhappy children, among 204 (68%) respondents, treated in four paediatric practices, enrolled (mean age 10 yrs; range: 8-12 yrs), after random allocation in control and intervention groups (child, parent, teacher). Measurements were taken at baseline (T0) and after 3, 6 (T6) and 9 months (T9; intervention group only at 9 months). All but four controls completed the study. From T0-T6, changes (Delta) in HRQoL were clinically important and significantly greater in the intervention group than in the control group, both for generic HRQoL (effect size (ES) 0.95; Delta 16%+/-12% versus -1+/-4%) and for asthma-specific HRQoL (ES 0.58; Delta 15%+/-17% versus 1.5+/-14%). T9 measurements were consistent with T6 findings. Changes in sick days (ES 0.78), oral prednisone courses (ES 0.71) and doctor visits (ES 0.74) over a 6-month period were greater in the intervention group than in the control group. Changes could not be ascribed to change in lung function or medication. In unhappy children, quality of life and morbidity may improve with a low intensity asthma education-exercise programme, even without gains in pulmonary function or exercise tolerance.

Research paper thumbnail of Proprioceptive deficits after ACL injury: are they clinically relevant?

British Journal of Sports Medicine, 2012

Objective To establish the clinical relevance of proprioceptive defi cits reported after anterior... more Objective To establish the clinical relevance of proprioceptive defi cits reported after anterior cruciate ligament (ACL) injury. Material and methods A literature search was done in electronic databases from

Research paper thumbnail of Differences between Young and Older Adults in the Control of Weight Shifting within the Surface of Support

PLoS ONE, 2014

An important reason for falling in elderly is incorrect weight-shifting. In many daily life activ... more An important reason for falling in elderly is incorrect weight-shifting. In many daily life activities quick and accurate weightshifting is needed to maintain balance and to prevent from falling. The present study aims to gain more insight in agerelated differences in the control of weight-shifting. Nine healthy older adults (70.366.9 years) and twelve young adults (20.960.5 years) participated in the study. They performed a weight shifting task by moving the body's center of pressure, represented by a red dot on a screen, in different directions, towards targets of different sizes and at different distances projected on a screen. Movement time, fluency and accuracy of the movement were determined. Accuracy was quantified by the number of times the cursor hit the goal target before a target switch was realized (counts on goal) and by the time required to realize a target switch after the goal target was hit by the cursor for the first time (dwelling time). Fluency was expressed by the maximal deviation of the performed path with respect to the ideal path and the number of peaks, or inflections in the performed path. Significant main effects of target size, target distance and age on all outcome measures were found. With decreasing target size, increasing target distance and increasing age, movement time significantly increased and fluency and accuracy significantly decreased (i.e. increased number of peaks, maximal deviation, number of times on the goal target and longer dwelling time around the goal target). In addition, significant interaction effects of size*age and distance*age were found. Older adults needed more time to perform the weight-shifting task and their movements were less fluent and accurate compared to younger adults, especially with increasing task difficulty. This indicates that elderly might have difficulties with executing an adequate adaptation to a perturbation in daily life. Citation: de Vries EA, Caljouw SR, Coppens MJM, Postema K, Verkerke GJ, et al. (2014) Differences between Young and Older Adults in the Control of Weight Shifting within the Surface of Support. PLoS ONE 9(6): e98494.

Research paper thumbnail of Psychometric properties of the DCDDaily-Q: A new parental questionnaire on children's performance in activities of daily living

Research in Developmental Disabilities, 2014

Difficulties in the performance of activities of daily living (ADL) are a key feature of developm... more Difficulties in the performance of activities of daily living (ADL) are a key feature of developmental coordination disorder (DCD). The DCDDaily-Q was developed to address children's motor performance in a comprehensive range ADL. The aim of this study was to investigate the psychometric properties of this parental questionnaire. Parents of 218 five to eight year-old children (DCD group: N=25; reference group: N=193) completed the research version of the new DCDDaily-Q and the Movement Assessment Battery for Children-2 (MABC2) Checklist and Developmental Coordination Disorder Questionnaire (DCDQ). Children were assessed with the MABC2 and DCDDaily. Item reduction analyses were performed and reliability (internal consistency and factor structure) and concurrent, discriminant, and incremental validity of the DCDDaily-Q were investigated. The final version of the DCDDaily-Q comprises 23 items that cover three underlying factors and shows good internal consistency (Cronbach's α>.80). Moderate correlations were found between the DCDDaily-Q and the other instruments used (p<.001 for the reference group; p>.05 for the DCD group). Discriminant validity of the DCDDaily-Q was good for DCDDaily-Q total scores (p<.001) and all 23 item scores (p<.01), indicating poorer performance in the DCD group. Sensitivity (88%) and specificity (92%) were good. The DCDDaily-Q better predicted DCD than currently used questionnaires (R(2)=.88). In conclusion, the DCDDaily-Q is a valid and reliable questionnaire to address children's ADL performance.

Research paper thumbnail of Repeated Measurements of Arm Joint Passive Range of Motion After Stroke: Interobserver Reliability and Sources of Variation

Physical Therapy, 2012

Background. Goniometric measurements of hemiplegic arm joints must be reliable to draw proper cli... more Background. Goniometric measurements of hemiplegic arm joints must be reliable to draw proper clinical and scientific conclusions. Previous reliability studies were cross-sectional and based on small samples. Knowledge about the contributions of sources of variation to these measurement results is lacking.

Research paper thumbnail of Suitability of Kinect for measuring whole body movement patterns during exergaming

Journal of biomechanics, Jan 22, 2014

Exergames provide a challenging opportunity for home-based training and evaluation of postural co... more Exergames provide a challenging opportunity for home-based training and evaluation of postural control in the elderly population, but affordable sensor technology and algorithms for assessment of whole body movement patterns in the home environment are yet to be developed. The aim of the present study was to evaluate the use of Kinect, a commonly available video game sensor, for capturing and analyzing whole body movement patterns. Healthy adults (n=20) played a weight shifting exergame under five different conditions with varying amplitudes and speed of sway movement, while 3D positions of ten body segments were recorded in the frontal plane using Kinect and a Vicon 3D camera system. Principal Component Analysis (PCA) was used to extract and compare movement patterns and the variance in individual body segment positions explained by these patterns. Using the identified patterns, balance outcome measures based on spatiotemporal sway characteristics were computed. The results showed ...

Research paper thumbnail of Exergaming for balance training of elderly: state of the art and future developments

Journal of NeuroEngineering and Rehabilitation, 2013

Fall injuries are responsible for physical dysfunction, significant disability, and loss of indep... more Fall injuries are responsible for physical dysfunction, significant disability, and loss of independence among elderly. Poor postural control is one of the major risk factors for falling but can be trained in fall prevention programs. These however suffer from low therapy adherence, particularly if prevention is the goal. To provide a fun and motivating training environment for elderly, exercise games, or exergames, have been studied as balance training tools in the past years. The present paper reviews the effects of exergame training programs on postural control of elderly reported so far. Additionally we aim to provide an in-depth discussion of technologies and outcome measures utilized in exergame studies. Thirteen papers were included in the analysis. Most of the reviewed studies reported positive results with respect to improvements in balance ability after a training period, yet few reached significant levels. Outcome measures for quantification of postural control are under continuous dispute and no gold standard is present. Clinical measures used in the studies reviewed are well validated yet only give a global indication of balance ability. Instrumented measures were unable to detect small changes in balance ability as they are mainly based on calculating summary statistics, thereby ignoring the time-varying structure of the signals. Both methods only allow for measuring balance after the exergame intervention program. Current developments in sensor technology allow for accurate registration of movements and rapid analysis of signals. We propose to quantify the time-varying structure of postural control during gameplay using low-cost sensor systems. Continuous monitoring of balance ability leaves the user unaware of the measurements and allows for generating user-specific exergame training programs and feedback, both during one game and in timeframes of weeks or months. This approach is unique and unlocks the as of yet untapped potential of exergames as balance training tools for community dwelling elderly.

Research paper thumbnail of Activities of Daily Living in Children With Developmental Coordination Disorder: Performance, Learning, and Participation

Physical Therapy, 2015

Children with developmental coordination disorder (DCD) face evident motor difficulties in daily ... more Children with developmental coordination disorder (DCD) face evident motor difficulties in daily functioning. Little is known, however, about their difficulties in specific activities of daily living (ADL). The purposes of this study were: (1) to investigate differences between children with DCD and their peers with typical development for ADL performance, learning, and participation, and (2) to explore the predictive values of these aspects. This was a cross-sectional study. In both a clinical sample of children diagnosed with DCD (n=25 [21 male, 4 female], age range=5-8 years) and a group of peers with typical development (25 matched controls), the children's parents completed the DCDDaily-Q. Differences in scores between the groups were investigated using t tests for performance and participation and Pearson chi-square analysis for learning. Multiple regression analyses were performed to explore the predictive values of performance, learning, and participation. Compared with their peers, children with DCD showed poor performance of ADL and less frequent participation in some ADL. Children with DCD demonstrated heterogeneous patterns of performance (poor in 10%-80% of the items) and learning (delayed in 0%-100% of the items). In the DCD group, delays in learning of ADL were a predictor for poor performance of ADL, and poor performance of ADL was a predictor for less frequent participation in ADL compared with the control group. A limited number of children with DCD were addressed in this study. This study highlights the impact of DCD on children's daily lives and the need for tailored intervention.

Research paper thumbnail of Psychometric properties of the DCDDaily-Q: A new parental questionnaire on children's performance in activities of daily living

Research in Developmental Disabilities, 2014

Difficulties in the performance of activities of daily living (ADL) are a key feature of developm... more Difficulties in the performance of activities of daily living (ADL) are a key feature of developmental coordination disorder (DCD). The DCDDaily-Q was developed to address children's motor performance in a comprehensive range ADL. The aim of this study was to investigate the psychometric properties of this parental questionnaire. Parents of 218 five to eight year-old children (DCD group: N=25; reference group: N=193) completed the research version of the new DCDDaily-Q and the Movement Assessment Battery for Children-2 (MABC2) Checklist and Developmental Coordination Disorder Questionnaire (DCDQ). Children were assessed with the MABC2 and DCDDaily. Item reduction analyses were performed and reliability (internal consistency and factor structure) and concurrent, discriminant, and incremental validity of the DCDDaily-Q were investigated. The final version of the DCDDaily-Q comprises 23 items that cover three underlying factors and shows good internal consistency (Cronbach's α>.80). Moderate correlations were found between the DCDDaily-Q and the other instruments used (p<.001 for the reference group; p>.05 for the DCD group). Discriminant validity of the DCDDaily-Q was good for DCDDaily-Q total scores (p<.001) and all 23 item scores (p<.01), indicating poorer performance in the DCD group. Sensitivity (88%) and specificity (92%) were good. The DCDDaily-Q better predicted DCD than currently used questionnaires (R(2)=.88). In conclusion, the DCDDaily-Q is a valid and reliable questionnaire to address children's ADL performance.

Research paper thumbnail of A systematic review of instruments for assessment of capacity in activities of daily living in children with developmental co-ordination disorder

Child: Care, Health and Development, 2013

Children with developmental co-ordination disorder (DCD) face evident motor difficulties in activ... more Children with developmental co-ordination disorder (DCD) face evident motor difficulties in activities of daily living (ADL). Assessment of their capacity in ADL is essential for diagnosis and intervention, in order to limit the daily consequences of the disorder. The aim of this study is to systematically review potential instruments for standardized and objective assessment of children's capacity in ADL, suited for children with DCD. As a first step, databases of MEDLINE, EMBASE, CINAHL and PsycINFO were searched to identify studies that described instruments with potential for assessment of capacity in ADL. Second, instruments were included for review when two independent reviewers agreed that the instruments (1) are standardized and objective; (2) assess at activity level and comprise items that reflect ADL; and (3) are applicable to school-aged children that can move independently. Out of 1507 publications, 66 publications were selected, describing 39 instruments. Seven of these instruments were found to fulfil the criteria and were included for review: the Bruininks-Oseretsky Test of Motor Performance-2 (BOT2); the Do-Eat (Do-Eat); the Movement Assessment Battery for Children-2 (MABC2); the school-Assessment of Motor and Process Skills (schoolAMPS); the Tuffts Assessment of Motor Performance (TAMP); the Test of Gross Motor Development (TGMD); and the Functional Independence Measure for Children (WeeFIM). As a third step, for the included instruments, suitability for children with DCD was discussed based on the ADL comprised, ecological validity and other psychometric properties. We concluded that current instruments do not provide comprehensive and ecologically valid assessment of capacity in ADL as required for children with DCD.

Research paper thumbnail of Development of the DCDDaily: an instrument for the assessment of activities of daily living

Background / Purpose: To develop an instrument for objective and systematic assessment of activit... more Background / Purpose: To develop an instrument for objective and systematic assessment of activities of daily living (ADL) in 5 to 8 year old children: the DCDDailyTo confirm the validity and reliability of the DCDDaily Main conclusion: The DCDDaily is the first instrument for objective and systematic assessment of ADL in children with daily living skills (DCD). The DCDDaily differentiates the performance of ADL between children with DCD and controls.

Research paper thumbnail of Development and psychometric properties of the DCDDaily: a new test for clinical assessment of capacity in activities of daily living in children with developmental coordination disorder

Clinical Rehabilitation, 2013

To develop the DCDDaily, an instrument for objective and standardized clinical assessment of capa... more To develop the DCDDaily, an instrument for objective and standardized clinical assessment of capacity in activities of daily living (ADL) in children with developmental coordination disorder (DCD), and to investigate its usability, reliability, and validity. Five to eight-year-old children with and without DCD. The DCDDaily was developed based on thorough review of the literature and extensive expert involvement. To investigate the usability (assessment time and feasibility), reliability (internal consistency and repeatability), and validity (concurrent and discriminant validity) of the DCDDaily, children were assessed with the DCDDaily and the Movement Assessment Battery for Children-2 Test, and their parents filled in the Movement Assessment Battery for Children-2 Checklist and Developmental Coordination Disorder Questionnaire. 459 children were assessed (DCD group, n = 55; normative reference group, n = 404). Assessment was possible within 30 minutes and in any clinical setting. For internal consistency, Cronbach's α = 0.83. Intraclass correlation = 0.87 for test-retest reliability and 0.89 for inter-rater reliability. Concurrent correlations with Movement Assessment Battery for Children-2 Test and questionnaires were ρ = -0.494, 0.239, and -0.284, p < 0.001. Discriminant validity measures showed significantly worse performance in the DCD group than in the control group (mean (SD) score 33 (5.6) versus 26 (4.3), p < 0.001). The area under curve characteristic = 0.872, sensitivity and specificity were 80%. The DCDDaily is a valid and reliable instrument for clinical assessment of capacity in ADL, that is feasible for use in clinical practice.

Research paper thumbnail of Activities of Daily Living in Children With Developmental Coordination Disorder: Performance, Learning, and Participation

Physical therapy, Jan 4, 2015

Children with developmental coordination disorder (DCD) face evident motor difficulties in daily ... more Children with developmental coordination disorder (DCD) face evident motor difficulties in daily functioning. Little is known, however, about their difficulties in specific activities of daily living (ADL). The purposes of this study were: (1) to investigate differences between children with DCD and their peers with typical development for ADL performance, learning, and participation, and (2) to explore the predictive values of these aspects. This was a cross-sectional study. In both a clinical sample of children diagnosed with DCD (n=25 [21 male, 4 female], age range=5-8 years) and a group of peers with typical development (25 matched controls), the children's parents completed the DCDDaily-Q. Differences in scores between the groups were investigated using t tests for performance and participation and Pearson chi-square analysis for learning. Multiple regression analyses were performed to explore the predictive values of performance, learning, and participation. Compared with ...

Research paper thumbnail of Cancer-Related Fatigue: Predictors and Effects of Rehabilitation

The Oncologist, 2006

The aims of the study were to examine the effects of a multidimensional rehabilitation program on... more The aims of the study were to examine the effects of a multidimensional rehabilitation program on cancer-related fatigue, to examine concurrent predictors of fatigue, and to investigate whether change in fatigue over time was associated with change in predictors. 72 cancer survivors with different diagnoses. rehabilitation center. 15-week rehabilitation program. Fatigue (Multidimensional Fatigue Inventory), demographic and disease/treatment-related variables, body composition (bioelectrical impedance), exercise capacity (symptom-limited bicycle ergometry), muscle force (handheld dynamometry), physical and psychological symptom distress (Rotterdam Symptom Check List), experienced physical and psychological functioning (RAND-36), and self-efficacy (General-Self-Efficacy Scale, Dutch version). Measurements were performed before (T0) and after rehabilitation (T1). At T1 (n = 56), significant improvements in fatigue were found, with effect sizes varying from -0.35 to -0.78. At T0, the different dimensions of fatigue were predicted by different physical and psychological variables. Explained variance of change in fatigue varied from 42%-58% and was associated with pre-existing fatigue and with change in physical functioning, role functioning due to physical problems, psychological functioning, and physical symptoms distress. Within this selected group of patients we found that (a) rehabilitation is effective in reducing fatigue, (b) both physical and psychological parameters predicted different dimensions of fatigue at baseline, and (c) change in fatigue was mainly associated with change in physical parameters.

Research paper thumbnail of A multidimensional cancer rehabilitation program for cancer survivors

Journal of Psychosomatic Research, 2005

Objective: A multidimensional rehabilitation program for cancer survivors was developed to overco... more Objective: A multidimensional rehabilitation program for cancer survivors was developed to overcome cancer-related problems and to improve quality of life. The two purposes of the study were to describe the effectiveness of the program and to obtain information about patient preferences for multi or mono dimensional rehabilitation programs. Methods: Subjects: cancer survivors with different diagnoses, and cancer-related physical and psychosocial problems. Intervention: a 15-week rehabilitation program including individual exercise, sports, psycho-education, and information. Group-wise randomization was implemented by assigning one half of the patients to the complete program while the other half were allowed to choose which program components they considered relevant. Measures: Health-Related Quality of Life [RAND-36 and Rotterdam Symptom Check List (RSCL)], exercise capacity (symptom limited bicycle ergometry), muscle force (hand-held dynamometry), and patient preferences. Measurements were performed before (T0) and after the rehabilitation program (T1), and at a 3-month follow-up (T2). Results: After the rehabilitation program, cancer survivors (n=63) displayed statistically significant improvements on health-related quality of life with effect sizes (ES) varying from 0.38 to 0.99 (RAND-36) and from À0.34 to À0.57 (RSCL), most persistent at 3-month follow-up. Furthermore, statistically significant improvements in exercise capacity and muscle force of upper and lower extremities were displayed after rehabilitation. If offered a choice, 80% of the patients prior to start and 58% of the patients after completion of the program indicated that they preferred the entire multidimensional program. Conclusion: A multidimensional rehabilitation program has statistically and clinically relevant beneficial effects on health-related quality of life, exercise capacity, and muscle force in cancer patients with different diagnoses. Furthermore, if offered the choice, the majority of cancer survivors seem to prefer multidimensional programs to programs with only one component. D

Research paper thumbnail of Happiness to be gained in paediatric asthma care

European Respiratory Journal, 2008

The aim of the present study was to establish the efficacy in terms of morbidity and health-relat... more The aim of the present study was to establish the efficacy in terms of morbidity and health-related quality of life (HRQoL) of a group asthma education-exercise programme to children with low (below 10th percentile value) quality-of-life scores. A controlled, randomised, open, clinical trial was conducted. In total, 36 out of 53 unhappy children, among 204 (68%) respondents, treated in four paediatric practices, enrolled (mean age 10 yrs; range: 8-12 yrs), after random allocation in control and intervention groups (child, parent, teacher). Measurements were taken at baseline (T0) and after 3, 6 (T6) and 9 months (T9; intervention group only at 9 months). All but four controls completed the study. From T0-T6, changes (Delta) in HRQoL were clinically important and significantly greater in the intervention group than in the control group, both for generic HRQoL (effect size (ES) 0.95; Delta 16%+/-12% versus -1+/-4%) and for asthma-specific HRQoL (ES 0.58; Delta 15%+/-17% versus 1.5+/-14%). T9 measurements were consistent with T6 findings. Changes in sick days (ES 0.78), oral prednisone courses (ES 0.71) and doctor visits (ES 0.74) over a 6-month period were greater in the intervention group than in the control group. Changes could not be ascribed to change in lung function or medication. In unhappy children, quality of life and morbidity may improve with a low intensity asthma education-exercise programme, even without gains in pulmonary function or exercise tolerance.

Research paper thumbnail of Proprioceptive deficits after ACL injury: are they clinically relevant?

British Journal of Sports Medicine, 2012

Objective To establish the clinical relevance of proprioceptive defi cits reported after anterior... more Objective To establish the clinical relevance of proprioceptive defi cits reported after anterior cruciate ligament (ACL) injury. Material and methods A literature search was done in electronic databases from

Research paper thumbnail of Differences between Young and Older Adults in the Control of Weight Shifting within the Surface of Support

PLoS ONE, 2014

An important reason for falling in elderly is incorrect weight-shifting. In many daily life activ... more An important reason for falling in elderly is incorrect weight-shifting. In many daily life activities quick and accurate weightshifting is needed to maintain balance and to prevent from falling. The present study aims to gain more insight in agerelated differences in the control of weight-shifting. Nine healthy older adults (70.366.9 years) and twelve young adults (20.960.5 years) participated in the study. They performed a weight shifting task by moving the body's center of pressure, represented by a red dot on a screen, in different directions, towards targets of different sizes and at different distances projected on a screen. Movement time, fluency and accuracy of the movement were determined. Accuracy was quantified by the number of times the cursor hit the goal target before a target switch was realized (counts on goal) and by the time required to realize a target switch after the goal target was hit by the cursor for the first time (dwelling time). Fluency was expressed by the maximal deviation of the performed path with respect to the ideal path and the number of peaks, or inflections in the performed path. Significant main effects of target size, target distance and age on all outcome measures were found. With decreasing target size, increasing target distance and increasing age, movement time significantly increased and fluency and accuracy significantly decreased (i.e. increased number of peaks, maximal deviation, number of times on the goal target and longer dwelling time around the goal target). In addition, significant interaction effects of size*age and distance*age were found. Older adults needed more time to perform the weight-shifting task and their movements were less fluent and accurate compared to younger adults, especially with increasing task difficulty. This indicates that elderly might have difficulties with executing an adequate adaptation to a perturbation in daily life. Citation: de Vries EA, Caljouw SR, Coppens MJM, Postema K, Verkerke GJ, et al. (2014) Differences between Young and Older Adults in the Control of Weight Shifting within the Surface of Support. PLoS ONE 9(6): e98494.