Marjolijn Ketelaar | University Medical Center Utrecht ,The Netherlands (original) (raw)

Papers by Marjolijn Ketelaar

Physical Therapy, 2010

Background The use of knowledge brokers (KBs) has been recommended as a mechanism to facilitate t... more Background The use of knowledge brokers (KBs) has been recommended as a mechanism to facilitate the use of research evidence in clinical practice. However, little has been written regarding the practical implementation of the KB role. Objectives This article (1) describes the brokering activities of 24 pediatric physical therapist KBs (in Ontario, Alberta, and British Columbia, Canada), and (2) reports KBs' perceptions of the utility of their role and their experiences with the brokering process. Design A mixed-methods research design was used in this investigation, which was part of a larger knowledge translation (KT) study that demonstrated the effectiveness of using KBs to implement a group of evidence-based measurement tools into practice. Methods The KBs completed weekly activity logs, which were summarized and described. Semi-structured telephone interviews with KBs were analyzed qualitatively to provide insight into their perceptions of their role and the brokering proces...

BMC Pediatrics, 2011

Background: Children with motor impairments (e.g. difficulties with motor control, muscle tone or... more Background: Children with motor impairments (e.g. difficulties with motor control, muscle tone or balance) experience significant difficulties in participating in physical play and leisure. Current interventions are often poorly defined, lack explicit hypotheses about why or how they might work, and have insufficient evidence about effectiveness. This project will identify (i) the 'key ingredients' of an effective intervention to increase participation in physical play and leisure in children with motor impairments; and (ii) how these ingredients can be combined in a feasible and acceptable intervention. Methods/Design: The project draws on the WHO International Classification of Functioning, Disability and Health and the UK Medical Research Council guidance for developing 'complex interventions'. There will be five steps: 1) identifying biomedical, personal and environmental factors proposed to predict children's participation in physical play and leisure; 2) developing an explicit model of the key predictors; 3) selecting intervention strategies to target the predictors, and specifying the pathways to change; 4) operationalising the strategies in a feasible and acceptable intervention; and 5) modelling the intervention processes and outcomes within single cases. Discussion: The primary output from this project will be a detailed protocol for an intervention. The intervention, if subsequently found to be effective, will support children with motor difficulties to attain lifelong well-being and participation in society. The project will also be an exemplar of methodology for a systematic development of nondrug interventions for children.

Developmental Medicine & Child Neurology, 2015

AIM To examine the efficacy of child-focused, context-focused, and regular care approaches, deliv... more AIM To examine the efficacy of child-focused, context-focused, and regular care approaches, delivered in a rehabilitation setting by physical or occupational therapists to preschool children with cerebral palsy (CP), in optimizing the child's self-care and mobility capabilities. METHOD A multicentre randomized controlled trial clustered at therapist level was conducted in 13 rehabilitation centres. It included 68 children with CP (38 males, 30 females; mean age 3y, SD 6mo, range 1y 11mo-4y), classified as Gross Motor Function Classification System levels I to IV, who were already receiving therapy. Children received a child-focused, contextfocused, or regular care approach during a 6-month period. Self-care and mobility capabilities were assessed with the Functional Skills Scale of the Pediatric Evaluation of Disability Inventory. RESULTS The child-focused, context-focused, and regular care approaches all resulted in significant but similar improvements in self-care (regular: reference; child-focused: b=À0.11, 95% confidence interval [CI] À0.68 to 0.46; context-focused: b=0.13, CI À0.38 to 0.64) and mobility (regular: reference; child-focused: b=À0.09, CI À0.93 to 0.75; and context-focused: b=0.14, CI À0.65 to 0.94) capabilities. INTERPRETATION The results suggest that the three therapy approaches were equally efficacious for preschool children with CP. Depending on a child's individual situation each approach can be selected.

Disability & Rehabilitation, 2009

Little is known about the way parents of children with cerebral palsy (CP) perceive their involve... more Little is known about the way parents of children with cerebral palsy (CP) perceive their involvement in family and personal life situations, also called 'family participation'. To investigate the perception of family participation among parents of preschool children with CP. Semi-structured interviews were used to describe how parents (n=53) of children with CP (aged 18 months) perceive participation with respect to family activities and their personal activities. In addition, using a combined score of family and personal activities, we investigated the changes of parental (n=36) perceived family participation over time (followed from 18 months onwards until 42 months of age). At the child's age of 18 months, a substantial percentage of parents expressed a feeling of being restricted in their family activities (45%) or personal activities (53%). The longitudinal data show that over the 24-month follow-up significant more parents perceived to be restricted in family participation (p = 0.008; Cochran's Q test). A child with CP in a family may lead to parents perceiving restrictions in family participation. These restrictions arise early in the life of a child with CP and may become more prominent as the child grows older.

Child: Care, Health and Development, 2010

Objective This study aimed to describe changes in parents' resolution regarding their young child... more Objective This study aimed to describe changes in parents' resolution regarding their young child's diagnosis of cerebral palsy over a period of 1 year, and to describe the changes in strategies of resolution. Methods In this longitudinal study, 38 parents of children with cerebral palsy (mean age 18.4 months, SD = 1.1 at baseline) were followed with the Reaction to Diagnosis Interview, assessing their personal reactions to their child's diagnosis (i.e. resolution status). Changes at main and subclassification level of the Reaction to Diagnosis Interview were investigated using a binominal test. Results Twenty-nine parents (76%) were found to be stable with respect to their main resolution status (i.e.'resolved' or 'unresolved'), while 24% of the parents either had changed from 'unresolved' to 'resolved' or in the opposite way. Furthermore, of the 28 parents who were classified as 'resolved' at both times, 15 (54%) had changed at subclassification level with respect to the specific strategies used. Conclusion Resolution at a main level of parental reactions to their child's diagnosis was predominantly stable. Most parents were classified as 'resolved' at both baseline and follow-up assessment. However, more detailed analyses at subclassification level showed that most parents with a 'resolved' main status showed changing patterns of resolution strategies to their child's diagnosis, suggesting that resolution is an ongoing process.

The purpose of this study was to examine the reliability and validity of data obtained with 2 new... more The purpose of this study was to examine the reliability and validity of data obtained with 2 newly developed shuttle run tests (SRT-I and SRT-II) to measure aerobic power in children with cerebral palsy (CP) who were classified at level I or II on the Gross Motor Function Classification System (GMFCS). The SRT-I was developed for children at GMFCS level I, and the SRT-II was developed for children at GMFCS level II. Twenty-five children and adolescents with CP (10 female, 15 male; mean age = 11.9 years, SD = 2.9), classified at GMFCS level I (n = 14) or level II (n = 11), participated in the study. To assess test-retest reliability of data for the 10-m shuttle run tests, the subjects performed the same test within 2 weeks. To examine validity, the shuttle run tests were compared with a GMFCS level-based treadmill test designed to measure peak oxygen uptake. Statistical analyses revealed test-retest reliability for exercise time (number of levels completed) (intraclass correlation coefficients of .97 for the SRT-I and .99 for the SRT-II) and reliability for peak heart rate attained during the final level (intraclass correlation coefficients of .87 for the SRT-I and .94 for the SRT-II). High correlations were found for the relationship between data for both shuttle run tests and data for the treadmill test (r = .96 for both). The results suggest that both 10-m shuttle run tests yield reliable and valid data. Moreover, the shuttle run tests have advantages over a treadmill test for children with CP who are able to walk and run (GMFCS level I or II).

Brain & Development, 2001

Archives of physical medicine and rehabilitation, 2014

To investigate the relations between changes in motor capacity (can do, in standardized environme... more To investigate the relations between changes in motor capacity (can do, in standardized environment), motor capability (can do, in daily environment), and motor performance (does do, in daily environment) among children with cerebral palsy (CP). Prospective longitudinal study. After baseline measurements (at the age of 18 mo, 30 mo, 5 y, 7 y, 9 y, 11 y, or 13 y), 2-year follow-up measurements were performed. Change scores were calculated, and Pearson correlations were used for change score relations. Outpatient clinic. Toddlers, school-age children, and adolescents with CP (N=321; 200 boys, 121 girls). Levels of severity according to the Gross Motor Function Classification System included level I (42%), level II (15%), level III (17%), level IV (13%), and level V (13%). Not applicable. Change in motor capacity was assessed with the Gross Motor Function Measure-66. Changes in motor capability and motor performance were assessed with the Pediatric Evaluation of Disability Inventory us...

Archives of Physical Medicine and Rehabilitation, 2014

To (1) determine the long-term trajectory of health-related quality of life (HRQOL) for the dimen... more To (1) determine the long-term trajectory of health-related quality of life (HRQOL) for the dimensions of physical complaints and motor, psychological, and social functioning for groups of individuals with cerebral palsy (CP) aged 1 to 24 years; (2) assess the variability in HRQOL within individuals with CP over time; (3) assess the variability in HRQOL between individuals with CP; and (4) compare the HRQOL in individuals with CP to reference data of typically developing individuals. Multicenter prospective longitudinal study. Rehabilitation departments of 3 university medical centers and various rehabilitation centers in The Netherlands. Dutch individuals with CP (N=424; age, 1-24y). Not applicable. The HRQOL dimensions of physical complaints and motor, psychological, and social functioning. Each individual visited the rehabilitation department for 3 or 4 measurements. The time between measurements was 1 or 2 years. Individuals with CP experience an HRQOL that, on average, remains fairly stable over time. Variability in HRQOL within individuals with CP was similar to that within typically developing individuals. Variability between individuals with CP could be explained by type of CP (motor functioning), Gross Motor Function Classification System level (physical complaints and motor and social functioning), and intellectual disability (physical complaints and social functioning). Finally, individuals with CP experienced a lower HRQOL than did typically developing individuals, especially for the dimensions of motor and social functioning. Many changes take place in the psychosocial development of the individual with CP, which accordingly change their expectations and those of their caregivers, peers, and professionals. As a result, perceived physical complaints and motor, psychological, and social functioning remain fairly stable over many years.

Research in Developmental Disabilities, 2011

Quality of Life Research, 2008

Objective Our objective was to review measures of health-related quality of life (HRQL) for long-... more Objective Our objective was to review measures of health-related quality of life (HRQL) for long-term follow up in children after major trauma and to determine the measures that are suitable for a large age range, reliable and valid, and cover a substantial amount of the domains of functioning using the International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization (WHO). Methods The Medline and EMBASE databases were searched in all years up to October 2007 for generic HRQL measures suitable for children aged 5-18 years old and validated in English or Dutch. Measures were reviewed with respect to the age range for which the measure was suitable and reliability, validity, and content related to the ICF. Measures that were suitable for a large age range were CHQ-PF50/PF28, DISABKIDS, FS II(R), HUI 2, KIDSCREEN, PedsQL, and TACQOL. All measures had moderate to good psychometric properties, except for CHQ-PF50/PF28, KINDL, and TACQOL, which had either low internal consistency or bad test-retest reliability. The measures that covered more than six chapters of the ICF domains were CHIP-AE/CE, CHQ-CF87/PF50, DI-SABKIDS, KIDSCREEN-52, PedsQL, and TACQOL. Conclusions DISABKIDS, KIDSCREEN 52, and Peds-QL are suitable for long-term follow-up measurement of HRQL in children after major trauma. They cover a large age range, have good psychometric properties, and cover the ICF substantially. Keywords Health-related quality of life Á Children Á Major trauma Á Long term Á International classification of functioning Á Disability and health Abbreviations

Physical & Occupational Therapy in Pediatrics, 2011

The purpose of this study was to examine professionals' perceptions on classifying learning style... more The purpose of this study was to examine professionals' perceptions on classifying learning styles in the context of teaching motor activities to children and adolescents with cerebral palsy (CP). The participants were 21 pediatric physical therapists (PPTs) and seven physical educators (PEs) in three schools for special education in The Netherlands. All participants were introduced to the key descriptions of two existing learning style instruments (Kolb's Learning Style Inventory and Myers-Briggs Type Indicator), applied them to children and adolescents with CP, and reported their perceptions in written surveys. This study had a mixed-methods design. Quantitative and qualitative data analyses showed that PPTs and PEs are mostly positive about the idea of classifying learning styles in the context of teaching motor activities to children and adolescents with CP, giving three main reasons: individual approach, professional communication, and treatment awareness. Additionally, qualitative data analysis showed that the key descriptions of the two learning style instruments were not feasible as classifications for children and adolescents with CP. It is therefore recommended that other learning style classification instruments should be explored and that possibly a new learning style classification instrument should be developed in the context of teaching motor activities to children and adolescents with CP.

Pediatric Physical Therapy, 2007

We investigated reliability, construct validity, and feasibility of two sprint tests for children... more We investigated reliability, construct validity, and feasibility of two sprint tests for children with cerebral palsy (CP). Methods: Twenty-six children with CP participated (7-18 years of age; Gross Motor Function Classification System [GMFCS] level I or II). On different occasions, the 10 ϫ 5-Meter Sprint Test and the Muscle Power Sprint Test were scored by different assessors. Results: Excellent interobserver reliability (intraclass correlation [ICC] ϭ 1.0 and ICC Ն 0.97) and testϪretest reliability (ICC ϭ 0.97 and ICC Ն 0.97) were obtained. Scores differed significantly on both sprint tests for children classified at GMFCS level I and level II. Mean scores for feasibility ranged from 8.8 to 9.2 on a 10-cm visual analog scale (10 ϭ the best). Conclusions: Both exercise tests are reliable and have good feasibility for children and adolescents with CP (GMFCS level I or II). Construct validity is supported for both sprint tests in children classified at GMFCS level I and level II. (Pediatr Phys Ther 2007;19:108 -115)

Journal of Rehabilitation Medicine, 2008

Journal of Rehabilitation Medicine, 2010

A major focus of rehabilitation is that of optimizing patients&amp;amp;amp;amp;amp;amp;am... more A major focus of rehabilitation is that of optimizing patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; activities. Learning and teaching are key elements in this respect, but raise important questions: what do rehabilitation professionals know with respect to learning and teaching, what do they do, and what do they need? This paper discusses the issue of learning and teaching in rehabilitation practice, and introduces the concept of learning styles. This concept, new in the field of rehabilitation, but well-known in other areas, is presumed to benefit both patients and professionals, as it allows teaching strategies to be matched to individual patients. As a consequence, the process of learning may be more efficient and optimizing activities may be more effective.

Journal of Rehabilitation Medicine, 2005

Objective: To investigate the support given to young children of patients with stroke by rehabili... more Objective: To investigate the support given to young children of patients with stroke by rehabilitation teams and to identify characteristics of the patients, spouses and children that relate to children's adjustment 2 months after the patient's discharge. Subjects and methods: Seventy-seven children (£18 years of age) of patients with stroke consecutively admitted to inpatient rehabilitation were included. Adjustment was measured with the Child Behaviour Check List, Child Depression Inventory and Functional Status II. Multilevel regression analyses were conducted to identify determinants of adjustment. Results: Half of the children received some form of support from a rehabilitation team. Receiving more support was related to more severe disability of the parent with stroke, but not to the child's health or behavioural problems at the start of the stroke victim's inpatient stay. At the start of rehabilitation, 54% of the children had subclinical or clinical problems. Children's adjustment 2 months after their parent's discharge was related to the strain on spouses and not to the patients' characteristics or those of the support. Conclusion: The children's adjustment was related to the strain perceived by the healthy parent. There is a need for support that focuses on the experience of children of patients with stroke, regardless of stroke severity.

Journal of Pediatric Surgery, 2009

Purpose: Major trauma is the leading cause of death in children of developed countries. However, ... more Purpose: Major trauma is the leading cause of death in children of developed countries. However, little is known about its long-term health consequences in survivors. Our aim was to describe the health condition in children at long-term after major trauma. Methods: Prospective cohort study of severely injured children (Injury Severity Score ≥16, age b16) admitted to a Dutch level I trauma center in 1999 to 2000 (N = 40). About 7 years after trauma (median, 7.3; range, 6.3-8.2 years), survivors' health condition was assessed with the following: guides to the evaluation of permanent impairment of the American Medical Association (AMA-guides), Glasgow Outcome Scales (GOS/GOSE), Vineland Adaptive Behavior Scales (VABS), Child Behavior Checklist (CBCL), and Strengths and Difficulties Questionnaire (SDQ). Results: Of 40 children, 28 were followed up. Most (n = 16; 57%) had no impairments (AMA guides); minor to severe impairments were found in 12 of the respondents. About 80% (n = 22) had good recovery (GOS 5 and GOSE 7/8); the remaining had moderately disability (GOS 4 or GOSE 5/6). The mean scores on the VABS and the frequency of behavioral problems on the CBCL (24%) and the SDQ (20%) were comparable to healthy peers. Conclusions: This long-term follow-up study after major trauma revealed that most children had a health condition comparable to healthy peers; about 40% of the respondents was physically impaired or ☆ There are no financial relationships relevant to this article to disclose.