Browsing by Person "van der Linden, Marietta"

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A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components
(British Editorial Society of Bone and Joint Surgery, 2008-01) Nutton, R. W.; van der Linden, Marietta; Rowe, P. J.; Gaston, P.; Wade, F. A.
Modifications in the design of knee replacements have been proposed in order to maximise flexion. We performed a prospective double-blind randomised controlled trial to compare the functional outcome, including maximum knee flexion, in patients receiving either a standard or a high flexion version of the NexGen legacy posterior stabilised total knee replacement. A total of 56 patients, half of whom received each design, were assessed pre-operatively and at one year after operation using knee scores and analysis of range of movement using electrogoniometry. For both implant designs there was a significant improvement in the function component of the knee scores (p < 0.001) and the maximum range of flexion when walking on the level, ascending and descending a slope or stairs (all p < 0.001), squatting (p = 0.020) and stepping into a bath (p = 0.024). There was no significant difference in outcome, including the maximum knee flexion, between patients receiving the standard and high flexion designs of this implant.
Ankle Kinematics and Temporal Gait Characteristics over the Duration of a 6-Minute Walk Test in People with Multiple Sclerosis Who Experience Foot Drop
(Hindawi Publishing Corporation, 2018-07-02) van der Linden, Marietta; Andreopoulou, Georgia; Scopes, Judy; Hooper, Julie; Mercer, Tom
Foot drop is a common gait impairment in people with MS (pwMS) but in some foot drop may only occur after a period of prolonged walking and may be a sign of motor fatigability. The purpose of the study was to explore whether, for pwMS, an adapted six-minute walk test (6minWT) would result in an increase in foot drop as measured using electrogoniometry. Sagittal ankle kinematics were recorded for fifteen participants (10 females and 5 males, aged 37-64) with MS (EDSS 4-6) throughout the 6minWT. Ankle kinematics and temporal stride parameters were compared between the first and last 10 gait cycles of the 6minWT. Peak dorsiflexion in swing was significantly reduced at the end of the 6minWT compared to the start, with six of the fifteen participants having a decrease of two degrees or more. Statistically significant changes in temporal stride parameters suggested a decrease in walking speed. Our results suggest that with the protocol used in this study it is feasible to identify patients who experience increased foot drop as a result of a prolonged exercise task.
Are tactile function and body awareness of the foot related to motor outcomes in children with upper motor neuron lesions?
(Frontiers Media, 2024-03-01) Marsico, Petra; Lea Meier; van der Linden, Marietta; Mercer, Tom; Van Hedel, Hubertus J.
Introduction: Somatosensory function can be reduced in children with Upper Motor Neuron (UMN) lesions. Therefore, we investigated relationships between somatosensory functions of the foot and motor outcomes in children with UMN lesions.In this cross-sectional study, we assessed the Tactile Threshold (TT) with monofilaments and body awareness with Tactile Localisation Tasks for spatial-related action (TLTaction) and structural-related perception (TLTperception) body representation at the foot sole. Furthermore, we assessed four motor outcomes: the Selective Control Assessment of the Lower Extremity (SCALE), the modified Timed Up and Go test (mTUG), the Gillette Functional Assessment Questionnaire (FAQ), and the Functional Mobility Scale (FMS). Spearman's correlations (ρ) were applied to assess relationships between the somatosensory function of the foot sole and the applied motor outcomes.Results: Thirty-five children with UMN lesions, on average 11.7 ± 3.4 years old, participated. TLTperception correlated significantly with all lower limb motor outcomes p<0.05),. TLTperception correlated strongly with the Gross Motor Function Classification System (|ρ|=0.62; p=0.001) in children with cerebral palsy (n=24).Discussion: Assessing structural body representation of the foot sole should be considered when addressing lower limb motor impairments, including gait, in children with upper motor neuron lesions. Our results suggest that the assessment of tactile function and spatial body representation may be less related to lower limb motor function.
Assessing Proprioception in Children with Upper Motor Neuron Lesions: Feasibility, validity, and reliability of the Proprioception Measurement Tool (ProMeTo)
(Frontiers Media, 2024-08-09) Marsico, Petra; Meier, Lea; Buchmann, Anke; Kläy, Andrina; van der Linden, Marietta; Mercer, Tom; Van Hedel, Hubertus J.
Introduction: To investigate the feasibility, discriminative and convergent validity, and reliability of a lower limb sensor-based proprioception measure in children with upper motor neuron (UMN) lesions. Method: We assessed three proprioception modalities (joint movement, joint position, and dynamic position sense) of the lower limbs in 49 children with UMN lesions and 50 typically developing (TD) peers (5-19y). Forty-three children with UMN lesion had a congenital and six an acquired brain lesion and 82% are able to walk without a walking aid. We evaluated the feasibility, compared the test results between children with UMN lesions and TD peers, and calculated Spearman correlations (rs) between the modalities. We quantified relative reliability with Intra-Class Correlation Coefficients (ICC) and absolute reliability with Smallest Detectable Changes (SDC). Results: Most children with UMN lesions (>88%) found the tests easy to perform. The children with UMN lesions had significantly (p<0.001) lower proprioceptive function than the TD children. The correlation between the three proprioceptive modalities was moderate to high (0.50 ≤ rs ≤ 0.79). The relative reliability for test-retest and the inter-rater reliability was moderate to high (ICCs=0.65-0.97), and SDC between 2° and 15°. Discussion: The three tests are feasible, and discriminative and convergent validity and reliability were confirmed. Further studies should investigate the influence on motor function and performance in children with UMN lesions.
Association of postural balance and falls in adult patients receiving haemodialysis: A prospective cohort study
(Elsevier, 2020-08-30) Zanotto, Tobia; Mercer, Tom; van der Linden, Marietta; Traynor, Jamie P.; Doyle, Arthur; Chalmers, Karen; Allan, Nicola; Shilliday, Ilona; Koufaki, Pelagia; Funder: British Kidney Patient Association–British Renal Society; Grant(s): 16-003
Background Static postural balance performance is often impaired in people receiving haemodialysis (HD) for the treatment of stage-5 chronic kidney disease (CKD-5). However, the question as to whether lower postural balance is associated with adverse clinical outcomes such as falls has not been addressed yet. Research question We conducted a prospective cohort study to explore the association between static postural balance and falls in people receiving HD. We hypothesised that higher postural sway would be associated with increased odds of falling. Methods Seventy-five prevalent CKD-5 patients receiving HD (age: 61.8 ± 13.4 years) from three Renal Units were enrolled in this prospective cohort study. At baseline, postural balance was assessed with a force platform in eyes open (EO) and eyes closed (EC) conditions. Centre of pressure (CoP) measures of range, velocity and area were taken for the analysis. Falls experienced by study participants were prospectively recorded during 12 months of follow-up. Secondary outcomes included timed-up and go, five-repetition sit-to-stand test and the Tinetti falls efficacy scale (FES). Results In multivariable logistic regression analysis, higher CoP range in medial-lateral direction during EC was associated with increased odds of falling (OR: 1.04, 95 %CI: 1.00−1.07, p = 0.036). In ROC curve analysis, CoP velocity in EO exhibited the greatest prognostic accuracy (AUC: 0.69, 95 %CI: 0.55−0.82), however this was not statistically different from CoP measures of area and range. None of the postural balance measures exceeded the prognostic accuracy of the FES (AUC: 0.70, 95 %CI: 0.58−0.83, p = 0.005). Significance This prospective cohort study showed that higher postural sway in medial-lateral direction was associated with increased odds of falling in people receiving HD. CoP measures of range, velocity and area displayed similar prognostic value in discriminating fallers from non-fallers. The overall utility of static posturography to detect future fall-risk may be limited in a clinical setting.
Athlete-perceived impact of frame running on physical fitness, functional mobility and psychosocial outcomes
(2022-03-01) van der Linden, Marietta; Van Schie, Petra E. M.; Hjalmarsson, Emma; Andreopoulou, Georgia; Verheul, Martine H. G.; Von Walden, Ferdinand
Frame Running (RaceRunning) allows people with moderate-to-severe mobility impairments to participate in physical activity using a 3-wheeled frame with a saddle and handlebars. The aim of this study was to investigate athlete-perceived impact of Frame Running on aspects of physical fitness, functional mobility and psychosocial outcomes. Survey. Frame Running athletes aged 5 years and over. A survey was distributed to athletes through their club or sports organization. The survey was completed by 115 athletes (53 females). Median age was 17 years (range 5-62 years) and 64 (57%) used a wheelchair or walker for distances over 50 m. Many felt that Frame Running stretched their muscles (n=93, 87%) and increased their self-confidence (n=63, 93%). Four (4%) reported extreme fatigue or sore muscles after training (n=17, 15%). Of the 110 athletes who had been participating in Frame Running for over 3 months, 46 (47%) reported being less out of breath during mobility tasks and 66 (66%) felt they had improved their functional mobility. However, 7 (7%) reported increased muscle tightness and 4 (4%) reported a Frame Running-related injury lasting more than 4 weeks. Frame Running is a safe physical activity with athlete-perceived benefits on physical fitness, functional mobility and psychosocial outcomes.
Baroreflex function, haemodynamic responses to an orthostatic challenge, and falls in haemodialysis patients
(PLoS, 2018-12-06) Zanotto, Tobia; Mercer, Tom; van der Linden, Marietta; Traynor, Jamie P.; Petrie, Colin J.; Doyle, Arthur; Chalmers, Karen; Allan, Nicola; Price, Jonathan; Oun, Hadi; Shilliday, Ilona; Koufaki, Pelagia; Joles, Jaap A.
Background: Stage 5 chronic kidney disease patients on haemodialysis (HD) often present with dizziness and pre-syncopal events as a result of the combined effect of HD therapy and cardiovascular disease. The dysregulation of blood pressure (BP) during orthostasis may be implicated in the aetiology of falls in these patients. Therefore, we explored the relationship between baroreflex function, the haemodynamic responses to a passive orthostatic challenge, and falls in HD patients.
Baroreflex function, haemodynamic responses to an orthostatic challenge, and falls in haemodialysis patients [SP400] (Abstract)
(Oxford University Press, 2018-05-18) Zanotto, Tobia; Koufaki, Pelagia; Mercer, Tom; van der Linden, Marietta; Traynor, Jamie; Petrie, Colin; Price, Jonathan; Oun, Hadi; Shilliday, Ilona
Background: The prevalence of falls among Stage 5 chronic kidney disease (CKD-5) patients undergoing haemodialysis (HD) therapy ranges from 26.3% to 47%, and is considerably higher than in the general healthy population. In addition to traditional risk factors such as older age, frailty, comorbidity, and polypharmacy, these patients often present with dizziness and pre-syncopal events as a result of the combined effect of HD therapy and cardiovascular disease, which may contribute to an increased risk of falling. Particularly, it has been suggested that the dysregulation of blood pressure during orthostasis may play a role in the aetiology of falls in these patients. Purpose of the study: To compare the haemodynamic responses to a passive orthostatic challenge, as well as the baroreflex function, in HD patients with and without history of falls.
Between-day repeatability of knee kinematics during functional tasks recorded using flexible electrogoniometry
(Elsevier, 2008-08) van der Linden, Marietta; Rowe, P. J.; Nutton, R. W.
The objective of this study was to assess the between-day repeatability of knee kinematics during activities of daily living recorded by electrogoniometry. One rater assessed the peak knee angles and knee excursion of 15 subjects during 13 activities twice with an average of 22 days (range 5-31) between the two assessments. The 15 subjects included four patients one year after total knee replacement (TKR) surgery, five patients before TKR surgery and six age-matched controls. Intra-class correlation coefficients and Bland and Altman coefficient of repeatability were derived to analyse the results. Only the most affected leg of the patients and the right leg of the controls were used for analysis. Different measures of repeatability showed different results. Intra-class correlation coefficients were higher than 0.75 for peak values of all functions except sitting down and rising from a standard chair. However, coefficients of repeatability ranged from 5.6 for the loading response in level walking to 39.8 for stepping out of a bath. Both of these values are higher than clinically significant changes seen after total knee surgery. It was concluded that for a single assessment on individual patients, the functional knee motion as performed in this study did not have sufficient repeatability. However, if the measurements are used to assess the average changes before and after surgery in a group of patients, the assessment of knee motion during activities such as level walking, and slope and stair ascending and descending were found to be sufficiently repeatable.
Blood pressure variability and frailty in end-stage kidney disease
(Springer, 2024-08-10) Zanotto, Tobia; Mercer, Tom; van der Linden, Marietta; Koufaki, Pelagia
Background High blood pressure variability (BPV) is a predictor of cardiovascular events and all-cause mortality in people with end-stage kidney disease (ESKD) and a marker of aging in geriatric populations. Nevertheless, the relationship between BPV and geriatric syndromes, such as frailty, in people with ESKD is not well understood. Objective To examine the association between very short-term BPV and frailty in people with ESKD and receiving hemodialysis. Design Cross-sectional study. Setting Three dialysis units in the United Kingdom. Participants Sixty-nine people receiving hemodialysis (median age=62.0 years, interquartile range [IQR]=19.0; 52.2% male; median dialysis vintage=1.1 years, IQR=2.4). Measurements Systolic and diastolic BPV were recorded using continuous, non-invasive BP monitoring (Task Force Monitor). The very low, low, and high frequency components of BPV (VLF-BPV, LF-BPV, and HF-BPV), as well as the power spectral density (PSD-BPV) and low frequency/high frequency ratio of BPV (LF/HF-BPV) were analyzed. Frailty was evaluated using the Fried frailty phenotype. Results Twenty-six (37.7%) participants were classified as frail and 43 (62.3%) as non-frail. Frail participants had higher median systolic (2.1, IQR=5.2 mmHg2 vs. 1.1, IQR=1.6 mmHg2, p=0.002) and diastolic HF-BPV (0.9, IQR=2.3 mmHg2 vs. 0.5, IQR=1.0 mmHg2, p=0.048) compared to their non-frail counterparts. In addition, frail participants had higher median systolic VLF-BPV (3.2, IQR=12.5 mmHg2 vs. 2.0, IQR=2.4 mmHg2, p=0.012), LF-BPV (2.0, IQR=3.8 mmHg2 vs. 1.1, IQR=2.0 mmHg2, p=0.016), and PSD-BPV (6.6, IQR=27.6 mmHg2 vs. 4.5, IQR=5.9 mmHg2, p=0.005) compared to the non-frail participants. In age- and sex-adjusted logistic regression analyses, only systolic VLF-BPV (odds ratio [OR]=1.13, 95% confidence interval [CI]:1.01–1.26, p=0.035), HF-BPV (OR=1.26, 95%CI:1.01–1.57, p=0.044), and PSD-BPV (OR=1.06, 95%CI:1.01–1.12, p=0.029) were associated with increased odds of being frail. Conclusion Higher systolic BPV is associated with frailty in people receiving hemodialysis. Beat-to-beat assessments of BPV through continuous, non-invasive BP monitoring may be useful in evaluating frailty in ESKD populations.
Changes in physical activity participation during the COVID-19 pandemic in people with Multiple Sclerosis: an international survey study [Letter to the editor]
(Elsevier, 2023-11-14) van der Linden, Marietta; Kos, Daphne; Moumdjian, Lousin; Kalron, Alon; Coote, Susan; Smedal, Tori; Arntzen, Ellen Christin; Tayfur, Sümeyra N; Pedullà, Ludovico; Tacchino, Andrea; Jonsdottir, Johanna; Santoyo-Medina, Carme; Novotna, Klara; Yazgan, Yonca Zenginler; Nedeljkovic, Una; Learmonth, Yvonne
Cluster analysis of impairment measures to inform an evidence-based classification structure in RaceRunning, a new World Para Athletic event for athletes with hypertonia, ataxia or athetosis
(Taylor & Francis, 2020-12-18) van der Linden, Marietta; Corrigan, Orla; Tennant, Nicola; Verheul, Martine H. G.
RaceRunning enables athletes with limited or no walking ability to propel themselves independently using a three-wheeled frame that has a saddle, handle bars and a chest plate. For RaceRunning to be included as a para athletics event, an evidence-based classification system is required. This study assessed the impact of trunk control and lower limb impairment measures on RaceRunning performance and evaluated whether clusters analysis of these impairment measures produce a valid classification structure for RaceRunning. The Trunk Control Measurement Scale (TCMS), Selective Control Assessment of the Lower Extremity (SCALE), the Australian Spasticity Assessment Scale (ASAS), and knee extension were recorded for 26 RaceRunning athletes. Thirteen male and 13 female athletes aged 24 (SD=7) years participated. All impairment measures were significantly correlated with performance (rho=0.55-0.74). Using ASAS, SCALE, TCMS and knee extension as cluster variables in a two-step cluster analysis resulted in two clusters of athlete. Race speed and the impairment measures were significantly different between the clusters (p<0.001). The findings of this study provide evidence for the utility of the selected impairment measures in an evidence-based classification system for RaceRunning athletes.
A community-based exercise program for ambulant adolescents and young adults with cerebral palsy, a feasibility study
(European Federation of Adapted Physical Activity, 2021-11-22) Zanudin, Asfarina; Mercer, Tom; Samaan, Cynthia; Jagadamma, Kavi; McKelvie, Gillian; van der Linden, Marietta
The aim of this study was to investigate the feasibility of an 18-week exercise program for adolescents and young adults with cerebral palsy (CP). Fourteen individuals aged 16-25 (GMFCS I-III) performed aerobic and strength exercises at their community leisure center up to three times a week. A physiotherapist provided instruction at the first session and between 2-4 times thereafter. The fitness instructor on duty provided supervision when required. Feasibility of the exercise program was explored through an exercise logbook and participant feedback survey. Gross motor function, muscle strength, aerobic capacity and Timed Up and Go test were assessed at baseline, 6, 12 and 18 weeks and quality of life and self-esteem at baseline and 12 weeks. Participants completed on average 14.8 (range 5-23) weeks of the exercise program and an average of 31 (range 10-52) sessions. The feedback survey indicated that the exercise program was mostly well accepted, adverse effects were reported by three participants. Moderate effects (d=0.57-0.64) were found for leg muscle strength increase at week 12. Other measures showed small or negligible effects. This study indicated the feasibility of a community exercise program for young people with CP and provides recommendations for sustainable exercise programs for this group.
Construct validity and reliability of the Selective Control Assessment of the Lower Extremity in children with cerebral palsy
(Blackwell, 2016-02) Balzer, Julia; Marsico, P.; Mitteregger, E.; van der Linden, Marietta; Mercer, Tom; van Hedel, H.
AIM: Assessing impaired selective voluntary movement control in children with cerebral palsy (CP) has gained increasing interest. We investigated construct validity and intra- and interrater reliability of the Selective Control Assessment of the Lower Extremity (SCALE). METHOD: Thirty-nine children (21 males, 18 females) with spastic CP, mean age 12 years 6 months [range 6y 11mo-19y 9mo], Gross Motor Function Classification System (GMFCS) levels I to IV, participated. Differences in SCALE scores were determined on joint levels and between patients categorized according to their limb distribution and GMFCS levels. SCALE scores were correlated with the Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale. To determine reliability, the SCALE was applied once and recorded on video. RESULTS: SCALE scores differed significantly between the less and more affected leg (p<0.001) and between most leg joints. Total SCALE scores differed significantly between GMFCS levels I and II. Correlations with Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale were 0.88, 0.88, and -0.55 respectively. Intraclass correlation coefficients were all above 0.9, with the minimal detectable change below 2 points. INTERPRETATION: The SCALE appears to be a valid and reliable tool to assess selective voluntary movement control of the legs in children with spastic CP.
Correlation of the Edinburgh Gait Score With the Gillette Gait Index, the Gillette Functional Assessment Questionnaire, and Dimensionless Speed
(Wolters Kluwer, 2007-01) Hillman, S.; Hazlewood, M.; Schwarz, M.; van der Linden, Marietta; Robb, J.
This study examines the correlation of the Edinburgh Gait Score (EGS) with the Gillette Gait Index (GGI; formerly the Normalcy Index), the Gillette Functional Assessment Questionnaire, and speed, all of which are used as measures of gait quality or function. Scores were computed for 58 subjects, all with a diagnosis of cerebral palsy. The correlation of the EGS with all of the other scores was found to be significant, with r2 ranging from 0.26 to 0.79. The strongest correlation was found with the GGI, which may reflect common features in the derivation of both of these scores, although the EGS was derived from observational gait analysis and the GGI from principal component analysis of variables from computerized 3-dimensional gait data. We conclude that the EGS shows good concurrent validity with alternative gait assessment scores.
Delphi Consensus Study and Clinical Practice Guideline Development for Functional Electrical Stimulation to support upright mobility in people with an upper motor neuron lesion
(Wiley, 2023-07-11) Bulley, Catherine; Burridge, Jane; Adonis, Adine; Joiner, Sarah; Curnow, Eleanor; van der Linden, Marietta; Street, Tamsyn
Purpose A Clinical Practice Guideline (CPG) is required to provide guidance on optimal service delivery for Functional Electrical Stimulation (FES) to support upright mobility in people living with mobility difficulties due to an upper motor neuron lesion, such as stroke or multiple sclerosis. A modified Delphi consensus study was used to provide expert consensus on best practice. Methods A Steering Group supported recruitment of an Expert Panel which included a range of stakeholders who participated in up to three survey rounds. In each round panellists were asked to rate their agreement of draft statements about best practice using a 6-point Likert scale and add free text to explain their answer. Statements that achieved over 75% agree/strongly agree on the Likert scale were included in the CPG. Those that did not were revised based on free text comments and proposed in the next survey round. Results The first round included 82 statements with seven sub-statements. 65 people (84% response rate) completed survey round 1 leading to 62 statements and four sub-statements being accepted. Fifty-six people responded to survey round 2, and consensus was achieved for all remaining statements. Conclusion The accepted statements are included within the CPG and provide recommendations about who can benefit from FES and how they can be optimally supported through FES service provision. As such the CPG will support advocacy for, and optimal design of, FES services.
Does a mobile-bearing, high-flexion design increase knee flexion after total knee replacement?
(British Editorial Society of Bone and Joint Surgery, 2012-08) Nutton, R. W.; Wade, F. A.; Coutts, Fiona; van der Linden, Marietta
This prospective randomised controlled double-blind trial compared two types of PFC Sigma total knee replacement (TKR), differing in three design features aimed at improving flexion. The outcome of a standard fixed-bearing posterior cruciate ligament-preserving design (FB-S) was compared with that of a high-flexion rotating-platform posteriorstabilised design (RP-F) at one year after TKR. The study group of 77 patients with osteoarthritis of the knee comprised 37 men and 40 women, with a mean age of 69 years (44.9 to 84.9). The patients were randomly allocated either to the FB-S or the RP-F group and assessed pre-operatively and at one year postoperatively. The mean post-operative non-weight-bearing flexion was 107 (95% confidence interval (CI) 104 to 110)) for the FB-S group and 113 (95% CI 109 to 117) for the RP-F group, and this difference was statistically significant (p = 0.032). However, weight-bearing range of movement during both level walking and ascending a slope as measured during flexible electrogoniometry was a mean of 4 lower in the RP-F group than in the FB-S group, with 58 (95% CI 56 to 60) versus 54 (95% CI 51 to 57) for level walking (p = 0.019) and 56 (95% CI 54 to 58) versus 52 (95% CI 48 to 56) for ascending a slope (p = 0.044). Further, the mean post-operative pain score of the Western Ontario and McMaster Universities Osteoarthritis Index was significantly higher in the RP-F group (2.5 (95% CI 1.5 to 3.5) versus 4.2 (95% CI 2.9 to 5.5), p = 0.043). Although the RP-F group achieved higher non-weight-bearing knee flexion, patients in this group did not use this during activities of daily living and reported more pain one year after surgery. 2012 British Editorial Society of Bone and Joint Surgery.
Effect of exercise interventions on perceived fatigue in people with multiple sclerosis: synthesis of meta-analytic reviews
(Future Science, 2017-06-20) Safari, Reza; van der Linden, Marietta; Mercer, Tom
Although exercise training has been advocated as a nonpharmacological treatment for multiple sclerosis (MS) related fatigue, no consensus exists regarding its effectiveness. To address this, we collated meta-analytic reviews that explored the effectiveness of exercise training for the treatment of MS-related fatigue. We searched five online databases for relevant reviews, published since 2005, and identified 172 records. Five reviews were retained for systematic extraction of information and evidence quality analysis. Although our review synthesis indicated that exercise training interventions have a moderate effect on fatigue reduction in people with MS, no clear insight was obtained regarding the relative effectiveness of specific types or modes of exercise intervention. Moreover, Grading of Recommendation Assessment, Development and Evaluation revealed that the overall quality of evidence emanating from these five reviews was 'very low'.
Effect of RaceRunning on cardiometabolic disease risk factors and functional mobility in young people with moderate-to-severe cerebral palsy: Protocol for a feasibility study
(BMJ Publishing Group, 2020-07-01) Ryan, Jennifer; Theis, Nicola; Koufaki, Pelagia; Phillips, Shaun; Anokye, Nana; Andreopoulou, Georgia; Kennedy, Fiona; Jagadamma, Kavi; vanSchie, Petra; Dines, Hannah; van der Linden, Marietta; Funder: Chartered Society of Physiotherapy Charitable Trust; FundRef: http://dx.doi.org/10.13039/100011698; Grant(s): GN2767; Funder: Action Medical Research; FundRef: http://dx.doi.org/10.13039/501100000317; Grant(s): GN2767
Introduction: There is consistent evidence that people with cerebral palsy (CP) do not engage in the recommended physical activity guidelines for the general population from a young age. Participation in moderate-to-vigorous physical activity is particularly reduced in people with CP who have a moderate-to-severe disability. RaceRunning is a growing disability sport that provides an opportunity for people with moderate-to-severe disability to participate in physical activity in the community. It allows those who are unable to walk independently to propel themselves using a RaceRunning bike, which has a breastplate for support but no pedals. The aim of this study is to examine the feasibility and acceptability of RaceRunning for young people with moderate-to-severe CP and the feasibility of conducting a definitive study of the effect of RaceRunning on cardiometabolic disease risk factors and functional mobility. Methods and analysis: Twenty-five young people (age 5–21 years) with CP or acquired brain injury affecting coordination will be included in this single-arm intervention study. Participants will take part in one RaceRunning session each week for 24 weeks. Outcomes assessed at baseline, 12 and 24 weeks include body mass index, waist circumference, blood pressure, muscle strength, cardiorespiratory fitness, physical activity and sedentary behaviour, functional mobility, activity competence and psychosocial impact. Adverse events will be systematically recorded throughout the 24 weeks. Focus groups will be conducted with participants and/or parents to explore their views and experiences of taking part in RaceRunning. Ethics and dissemination: Approval has been granted by Queen Margaret University Research Ethics Committee (REC) and the South East of Scotland REC. Results will be disseminated through peer-reviewed journals and distributed to people with CP and their families through RaceRunning and Athletic Clubs, National Health Service trusts and organisations for people with disabilities. Trial registration number: NCT04034342; pre-results.
Effects of hybrid custom foot orthoses on running economy, running mechanics and comfort: a double-blinded randomized crossover study
(Elsevier, 2025-02-01) Van Alsenoy, Ken K.; van der Linden, Marietta; Santos, Derek; Girard, Olivier
Objective: This study examined the effects of orthotic materials on running economy, running mechanics, and footwear comfort. Design: A double-blinded randomized crossover study design was used. Method: Eighteen athletes ran on an instrumented treadmill for six minutes at speeds corresponding to 10% below their first ventilatory threshold (average: 9.9 ± 1.3 km/h) in four footwear conditions [control (CON), Ethyl vinyl acetate (EVA), Thermoplastic Polyurethane (TPU), and a combination of EVA and TPU (HYB)]. Results: No differences were found in running economy between conditions (p=0.099). All custom foot orthoses materials reduced peak heel impact force vs CON (p<0.001). TPU reduced hysteresis at heel impact vs CON (-47.8%, p=0.016). Shorter flight time (-3.8%, p=0.016; -3.1%, p=0.021) and lower mean vertical loading rate (-4.0%, p=0.003; -7.1%, p<0.001) occurred for HYB vs TPU and CON, respectively. Higher peak vertical loading rates (+7.4%, p=0.002) and earlier impact peaks (-5.7%, p<0.001) were found for HYB vs TPU. HYB exhibited longer propulsive phase duration (+2.0%, p=0.003) but lower peak propulsive force (-3.3%, p=0.009) vs CON. Reduced ‘overall comfort’ (-26.4%, p=0.004), ‘comfort of heel cushioning’ (-43.3%, p<0.001), and ‘comfort of forefoot cushioning’ (-18.3%, p=0.048) was found for HYB vs TPU, but ‘comfort of forefoot cushioning’ (+48.0%, p=0.032) showed an increase vs EVA. Conclusions: Combining materials could enhance comfort during running causing subtle changes in running mechanics. Overall, neither EVA, TPU nor their combination significantly improved running economy compared to CON.