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Biomedical subjects

H Feys

Publications and source records attributed to H Feys.

At least 19 recordsLinked to original sources
PubMed2006

Prediction of driving after stroke: a prospective study.

BACKGROUND: The process of determining whether patients with stroke should drive again often involves off-road evaluations and road tests that usually take about 2 to 3 h to complete. OBJECTIVES: This prospective study sought to identify the combination of tests that best predicts fitness to drive after stroke. The main aim was to develop a short and predictive predriving assessment battery. METHODS: Sixty-eight consecutive stroke patients were studied who performed a mandatory predriving assessment at the Belgian Road Safety Institute, Brussels, within 18 months. Performance in a predriving assessment included medical examination (when needed), visual and neuropsychological evaluations, and an on-road test. Based on these assessments, a physician, psychologist, and the driving safety expert who administered the tests decided if a subject was either "fit to drive,""temporarily unfit to drive," or "unfit to drive." RESULTS: Logistic regression analysis revealed a combination of visual neglect, figure of Rey, and on-road tests as the model that best predicted (R(2) = 0.73) fitness to drive after stroke. Using a discriminant function that included the 3 tests of the logistic model, the fitness to drive judgments of 59 (86.8%) subjects were correctly predicted. The sensitivity and specificity of the predictions were 79.4% and 94.1%, respectively. CONCLUSION: Fitness to drive after stroke can be predicted from performance on a few road-related tests with a high degree of accuracy. However, some individuals require extended assessments and further tests.

Adult↗
PubMed2005

Effect of simulator training on driving after stroke: a randomized controlled trial.

BACKGROUND: Neurologically impaired persons seem to benefit from driving-training programs, but there is no convincing evidence to support this notion. The authors therefore investigated the effect of simulator-based training on driving after stroke. METHODS: Eighty-three first-ever subacute stroke patients entered a 5-week 15-hour training program in which they were randomly allocated to either an experimental (simulator-based training) or control (driving-related cognitive tasks) group. Performance in off-road evaluations and an on-road test were used to assess the driving ability of subjects pre- and post-training. Outcome of an official predriving assessment administered 6 to 9 months poststroke was also considered. RESULTS: Both groups significantly improved in a visual and many neuropsychological evaluations and in the on-road test after training. There were no significant differences between both groups in improvements from pre- to post-training except in the "road sign recognition test" in which the experimental subjects improved more. Significant improvements in the three-class decision ("fit to drive," "temporarily unfit to drive," and "unfit to drive") were found in favor of the experimental group post-training. Academic qualification and overall disability together determined subjects that benefited most from the simulator-based driving training. Significantly more experimental subjects (73%) than control subjects (42%) passed the follow-up official predriving assessment and were legally allowed to resume driving. CONCLUSIONS: Simulator-based driving training improved driving ability, especially for well educated and less disabled stroke patients. However, the findings of the study may have been modified as a result of the large number of dropouts and the possibility of some neurologic recovery unrelated to training.

Accidents, Traffic↗
PubMed2005

Discriminant ability of the Trunk Impairment Scale: A comparison between stroke patients and healthy individuals.

PURPOSE: The Trunk Impairment Scale (TIS) is a standardized scale to evaluate the trunk function in stroke patients. It was the aim of this study to determine the discriminant ability of the TIS by comparing stroke patients with healthy individuals. Further, the variables that had an influence on obtaining a high score on the TIS in healthy subjects were examined. METHOD: Forty stroke patients and 40 age- and sex-matched healthy individuals were included in the study. TIS scores from the stroke patients and healthy individuals were compared using the Wilcoxon ranked sum test. RESULTS: Sub-scale and total TIS scores showed significant differences between stroke patients and healthy individuals (P < 0.0001). Univariate analysis and logistic regression analysis further revealed that younger persons, women and people who are more active in daily life have a higher chance of obtaining a high score on the TIS. CONCLUSIONS: The TIS discriminates between stroke patients and healthy individuals. A submaximal score on the TIS was found in 45% of the healthy subjects suggesting that a lower score on the TIS still indicates normal trunk function and full participation in daily life.

Abdomen↗
PubMed2002

High initial efficacy of full-spectrum therapy for nocturnal enuresis in children and adolescents.

OBJECTIVE: To investigate the initial efficacy and predictive factors of full-spectrum therapy in the treatment of children and young adolescents with nocturnal enuresis (NE). PATIENTS AND METHODS: Combined therapy for NE comprises an enuresis alarm, bladder training, motivational therapy and pelvic floor muscle training, and is more effective than each of the components alone or than medical intervention. A total of 60 children and adolescents (aged 4-20 years) with NE were treated once a week with full-spectrum therapy for a maximum of 6 months. RESULTS: Overall the therapy was successful (14 consecutive dry nights) in 52 of 60 patients. At 30 days the cure rate was 33%, after 60 days 72% and after 98 days, 87%. The remaining 13% did not achieve 14 consecutive dry nights; seven patients improved, having fewer dry nights/week. One patient discontinued the treatment because of lack of motivation. In children with an initial maximum bladder capacity less than normal for age, the capacity increased from 53% of the normal maximum bladder capacity in week 1 to 88% at the end of treatment. Neither age, gender, sleep arousal, bladder capacity, family history and pathophysiological profile had any association with the success rate. CONCLUSION: The short-term success rate of full-spectrum therapy for NE is high. Age, gender, sleep arousal, bladder capacity, family history and pathophysiological profile of enuresis are unrelated to the success of the intervention.

Adolescent↗
PubMed2001

Group physiotherapy improves time use by patients with stroke in rehabilitation.

Does feedback about the time use of patients with stroke influence the organisation of services in rehabilitation? An observation was made of the time use by 22 patients with stroke in a specialised rehabilitation unit, feedback was given to the staff, and another observation on 16 patients was made one year later. As a result of the first observation, the physiotherapy staff were urged to organise group sessions for patients with similar levels of disability, allowing practice with a higher patient to staff ratio. During the second observation, patients spent significantly more time on therapy (8%) and with their peers (25%). These results indicate that feedback about patients' time use can substantially influence management and consequently patients' behaviour in rehabilitation.

Adult↗
PubMed2001

Effect of the serotonin agonist 8-OH-DPAT on the sensorimotor system of the rat.

8-Hydroxy-2-(di-n-propylamino)-tetralin hydrobromide (8-OH-DPAT, 2 mg/kg) is used to induce perseverative behavior in rats in a T-maze as a model for obsessive-compulsive disorder (OCD). Using the open-field test, radiant heat test, and the test with von Frey filaments, we examined whether alterations in sensorimotor functioning could contribute to the perseverative tendencies in this model by measuring differences in left versus right hind paw reactions after 8-OH-DPAT administration (2 mg/kg, sc). Also, the effect of repeated 8-OH-DPAT administration on sensorimotor functioning was tested every third day. 8-OH-DPAT administration induced a significantly decreased sensorimotor performance in the open-field test, an increased threshold for noxious thermal stimulation (increased withdrawal latency, WL, and decreased elevation time, ET) in the radiant heat test, and a decreased nociceptive threshold for mechanical stimulation in the test with von Frey filaments. All changes in sensorimotor functioning were similar for left and right hind paws suggesting that, these changes as measured with the tests in the present study, are not likely to contribute to the perseverative behavior of rats in a T-maze. Further, repeated administration of 8-OH-DPAT had no effect in the radiant heat test and the test with the Frey filaments, but produced a tolerance effect in the open-field test.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed2001

Effect of a physical therapeutic intervention for balance problems in the elderly: a single-blind, randomized, controlled multicentre trial.

OBJECTIVE: To establish the effect of a short, individualized exercise programme on balance dysfunction in the elderly. DESIGN: A single-blind, randomized, controlled, multicentre trial. SETTING: Physical and recreational therapy departments from two rehabilitation centres. PARTICIPANTS: Ninety-four subjects of >75 years with functional balance problems living independently or in a residential care facility. Seventy-seven subjects completed the intervention period and four-week follow-up. At a one-year follow-up 49 subjects were evaluated on balance functioning. INTERVENTIONS: Twelve sessions of an individualized balance training programme (experimental group) or 12 sessions of an individualized extra attention programme (control group) given in 4-6 weeks. MAIN OUTCOME MEASURES: Berg Balance Scale and the Dynamic Gait Index to establish balance functioning, a visual analogue scale to establish fear of falling in daily life and the Hospital Anxiety Depression Scale to verify feelings of anxiety and depression. RESULTS: Subjects in the experimental group improved significantly more on the Berg Balance Scale and the Dynamic Gait Index than those in the control group (p f 0.001, p f 0.001, respectively). However the effect disappeared at a one-year follow-up on the Berg Balance Scale. No prognostic factors could be identified to determine who would benefit most from the individualized exercise programme. Results on the other response variables revealed no effect of the intervention. CONCLUSION: A short individualized exercise programme can improve functional balance in people aged 75 years and older. This improvement was maintained at least for one month but had worn off by one year.

Activities of Daily Living↗
PubMed2000

Time use of stroke patients in an intensive rehabilitation unit: a comparison between a Belgian and a Swiss setting.

PURPOSE: Functional improvement after stroke has been related to the intensity of treatment. The present study was set up to observe how stroke patients spend their time in a rehabilitation unit. METHOD: Behavioural mapping was performed throughout a full working day in a Belgian and Swiss stroke unit. RESULTS: Patients were most frequently involved in therapeutic activities, 28% of the day in Belgium and 45% in Switzerland. Physiotherapy accounted for the majority of the therapy time. The Belgian patients spent 27% of the day in their own room and Swiss patients 49% of the day. The most striking finding was that the Swiss patients spent nearly 1.5 hours per day more in therapy. CONCLUSIONS: Differences between the two settings could only partially be explained by more favourable patient-staff ratios in the Swiss setting. Autonomous practice, group therapy sessions and family involvement have to also be considered.

Activities of Daily Living↗
PubMed2000

Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: a randomised controlled trial.

BACKGROUND: Urinary incontinence is a common long-term complication after radical prostatectomy. Spontaneous recovery of normal urinary control after surgery can take 1-2 years. We aimed to investigate whether there was any beneficial effect of pelvic-floor re-education for patients with urinary incontinence as a result of radical prostatectomy. METHODS: 102 consecutive incontinent patients who had had radical retropubic prostatectomy for clinically localised prostate cancer and who could comply with the ambulatory treatment schedule in our hospital were randomised, after catheter removal, into a treatment group (n=50) and a control group (n=52). Patients in the treatment group took part in a pelvic-floor re-education programme for as long as they were incontinent, and for a maximum of 1 year. The control group received placebo therapy. The primary endpoint was continence rate at 3 months. Incontinence was assessed objectively with the 1 h and 24 h pad tests and subjectively by the visual analogue scale. The groups were analysed on an intention-to-treat basis by ANOVA and chi2-test. FINDINGS: In the treatment group continence was achieved after 3 months in 43 (88%) of 48 patients. In the control group, continence returned after 3 months in 29 (56%) of 52 patients. At 1 year, the difference in proportion between treatment and control group was 14% (95% CI 2-27). In the treatment group improvement in both duration (log-rank test, p=0.0001) and degree of incontinence (Wald test, p=0.0010) was significantly better than in the control group. INTERPRETATION: Pelvic-floor re-education should be considered as a first-line option in curing incontinence after radical prostatectomy.

Biofeedback, Psychology↗
PubMed2000

Predicting motor recovery of the upper limb after stroke rehabilitation: value of a clinical examination.

BACKGROUND AND PURPOSE: Only a few studies have been conducted to predict motor recovery of the arm after stroke. The aims of this study were to identify which clinical variables, assessed at different points in time, were predictive of motor recovery, and to construct useful regression equations. METHOD: One hundred consecutive stroke patients who had an obvious motor deficit of the upper limb were evaluated on entry to the study (two to five weeks post-stroke) and at two, six and 12 months after stroke. The Brunnström-Fugl-Meyer test was used as the outcome measure. Predictors included demographic data, overall disability, clinical neurological features, neuropsychological factors and secondary shoulder complications. RESULTS: In multiple regression analyses, motor performance was invariably retained as the predictive factor with the highest R-square. Other significant predictive variables were overall disability, muscle tone, proprioception and hemi-inattention. Between 53% and 89% of the total amount of variance was accounted for in all selected models. The accuracy of prediction from clinical measurement in the acute phase diminished as the time span of measurement of outcome increased. Similarly, assessment of the variables at two and six months, rather than in the acute stage, resulted in a considerable improvement in the percentage variance explained at 12 months. The highest accuracy was obtained when predictions were made step-by-step in time. CONCLUSIONS: It is possible to predict motor recovery of the upper limb accurately through the use of a few clinical measures. Predictive equations are proposed, the use of which are practicable in both clinical practice and research.

Adult↗
PubMed2000

Predicting arm recovery following stroke: value of site of lesion.

OBJECTIVES: The aims of this study were to assess whether the site of lesion is predictive of upper limb recovery after stroke and to determine whether this information adds to the predictive ability of the clinical examination. MATERIAL AND METHODS: Forty-five patients were examined at entry to the study and at 2 and 12 months after stroke. The Brunnström-Fugl-Meyer test was used as outcome measurement. Predictor variables included clinical parameters and classifications of lesion site (obtained by CT/MRI). RESULTS: Correlation analysis revealed small to moderate relationships between lesions of subcortical structures and arm outcome at 2 months. In multiple regression analysis, the best model for predicting recovery at 2 months was found to be a combination of the clinical parameters with a purely subcortical lesion. Motor recovery at 12 months was best predicted by the clinical tests alone. The results further indicated that patients with subcortical damage tended to take longer to recover. CONCLUSIONS: Clinical assessment is most useful for determination of the prognosis of upper limb recovery after stroke. Neuroanatomical parameters measured by CT or MRI can only act as an adjunct.

Adult↗
PubMed2000

Value of somatosensory and motor evoked potentials in predicting arm recovery after a stroke.

OBJECTIVES: Prediction of motor recovery in the arm in patients with stroke is generally based on clinical examination. However, neurophysiological measures may also have a predictive value. The aims of this study were to assess the role of somatosensory (SSEPs) and motor (MEPs) evoked potentials in the prediction of arm motor recovery and to determine whether these measures added further predictive information to that gained from clinical examination. METHODS: Sixty four patients who had had a stroke and presented with obvious motor deficit of the arm were examined in terms of three clinical variables (motor performance, muscle tone, and overall disability) and for SSEPs and MEPs. Clinical and neurophysiological examinations were done at entry to the study (2 to 5 weeks poststroke), and at about 2 months after stroke. Further clinical follow up was conducted at 6 and 12 months after stroke. RESULTS: Neurophysiological measures made in the acute phase were of little use alone in predicting motor recovery of the arm at 2, 6, and 12 months after stroke. At 2 months, the absence of SSEPs and MEPs indicated a very poor outcome. Conversely, if the responses were preserved, a great variation in motor outcome was found. Multiple regression analysis showed that the addition of SSEPs and MEPs to the clinical examination increased the possibility of predicting arm recovery in the long term. In the acute phase, the combination of the motor score and SSEPs were best able to predict outcome. The long term outcome based on variables taken at 2 months, was best predicted through incorporating the three clinical measures and MEPs. CONCLUSIONS: Neurophysiological measures alone are of limited value in predicting long term outcome. However, predictive accuracy is substantially improved through the combined use of both of these measures and clinical variables.

Analysis of Variance↗
PubMed1998

Prediction of urinary continence following radical prostatectomy.

The aim of this study was to assess the incidence of incontinence after radical prostatectomy and to identify the various factors that can predict urinary continence after radical prostatectomy. Urinary continence following a radical prostatectomy was evaluated in 175 consecutive patients who underwent surgery. Immediately after catheter withdrawal, on the 15th postoperative day, 66% of the patients were incontinent. Varying degrees of incontinence persisted in 53% of the cohort at 1 month postoperatively. Thirty-three, 12, 8 and 2% of the patients remained incontinent at respectively 3, 6, 9 and 12 months of follow-up. A number of possible pre- and peroperative factors which might predict the continence status were examined are related to it at subsequent intervals after the surgical intervention. Preservation of the neurovascular bundles, prior transurethral resection of the prostate, preoperative micturition disorders and age were significant contributors in the prediction of urinary incontinence after radical prostatectomy.

Aged↗
PubMed1995

Influence of malalignment of feet on the plantar pressure pattern in running.

When overuse injuries of the lower limbs are diagnosed in athletes, the architecture and function of the foot should be examined. Foot structure was evaluated in 10 male and 14 female athletes. Based on this examination, the subjects were classified into three groups: pes planus, pes cavus, and pes rectus. While running, the plantar pressure pattern of these athletes was assessed with pressure-measuring insoles. Using these measurements, peak pressures and impulses were calculated for different foot anatomical locations. The plantar heel load was distributed significantly (P < 0.05) more toward the anterior part of the calcaneus in the pes planus group compared with the normal group. The relative load under the midfoot region was significantly (P < 0.05) lower in the pes cavus group compared with the other foot types. The relative load of the forefoot was significantly (P < 0.05) higher in the pes cavus group and lower in the pes planus group. Both feet of an athlete showed a similar plantar pressure pattern. Three successive steps were comparable in terms of impulses, but the peak pressures varied significantly from step to step. The local impulse and peak pressure values obtained in barefoot running differed significantly from the values obtained in running with sport shoes.

Adult↗
PubMed1993

Tibial shaft fractures with an intact fibula.

The effect of several factors on the healing rates of tibial shaft fractures with an intact fibula were examined. Those found to adversely affect healing rates included: 1. Open fractures; 2. Oblique or comminuted fractures; 3. High-velocity injuries; 4. Angulation in the sagittal plane; 5. Displacement. No other factors examined were associated with delayed union. The predictive values for delayed union are estimated for each of these factors in isolation and in combination.

Adolescent↗
PubMed1992

The intact fibula.

The notes and radiographs of 281 adult tibial shaft fractures were reviewed. In 17 per cent there was an intact fibula. Delayed union rates were lower when the fibula remained intact, thus confirming that this is a good prognostic indicator. This fracture is caused by less severe trauma than fractures where both bones are broken. It is rare over the age of 30 years.

Adolescent↗
PubMed1992

Corrective osteotomy for mal- and nonunion of the tibia using the posterolateral approach.

An analysis of the results of 9 patients with a post-traumatic malalignment of the tibia, treated by an osteotomy and immediate bone grafting through a posterolateral approach is presented. Fixation was obtained with an external fixator in 8 cases and with a fibular plate in one case. Union was obtained in all cases after an average of 4.8 months. A significant improvement in the malalignment was obtained, especially in the frontal plane and somewhat less in the sagittal plane. Permanent sequellae due to the procedure were not noted.

Adult↗