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P F van Akkerveeken

Publications and source records attributed to P F van Akkerveeken.

14 recordsLinked to original sources
PubMed2004

[Practical guidelines for the prevention of chronic symptoms after a whiplash injury, based on published evidence].

Recently, systematic reviews and evidence-based guidelines on whiplash have appeared, from which preventive recommendations can be derived. Fear of moving, catastrophic thoughts and avoidance of activity seem to play an important role in the transition from acute to chronic symptoms. Early reassurance and the advice to remain active can prevent the development of chronic symptoms following whiplash. In the acute and subacute phase, if there is still no recovery despite information designed to reduce anxiety, referral to a physiotherapist for active exercise therapy and management is indicated. In the chronic phase, depending on which factors play a role in the given patient, referral to active exercise therapy or a multi-disciplinary training programme may be considered.

Anxiety↗
PubMed2000

[Multidisplinary approach to chronic back pain: postrehabilitation resumption of work the same 3-4 years later as after 6 months].

OBJECTIVE: To determine the results of a multidisciplinary programme for people with chronic back pain 3 to 4 years post-programme. DESIGN: Prospective cohort study. METHOD: In 1996, 143 patients with chronic back pain had participated in an outpatients programme, of 4 weeks duration, at a Back AdviceCentre. A follow-up study took place 6 months post-programme. This involved 99 men and 44 women, who at the start of the programme had a mean age of 41.6 (SD: 8.5; range: 23-58) and had experienced back pain for a mean period of 46.3 months (SD: 36.3). In January/February 2000 the patients were contacted by telephone and completed questionnaires concerning their current work status, pain intensity, perceived disability and complaints. The same questionnaires had been completed at the start of the programme and 6 months post-programme. Differences across the three scores were tested in a multivariate test for repeated measurements. RESULTS: Data were obtained from 130 patients; 103 (79%) persons were completely returned to work. The response was 92% (n = 130). As a result of back pain, 14 patients (11%) could not work or worked reduced hours compared with the premorbid situation. (This percentage was 13% at 6 months post-programme.) A further 9 patients (7%) could not work or worked reduced hours due to other health complaints. The average level of pain, disability and complaints was still lower (p < 0.001) than the pre-programme situation. CONCLUSION: The percentage of people who permanently returned to work following the multidisciplinary approach to chronic back pain, remained stable over a period of 3 to 4 years. The results were comparable to those obtained at 6 months post-programme.

Adult↗
PubMed2000

[Good results from a multidisciplinary and behavioral program for chronic back pain].

OBJECTIVE: To evaluate the results of a multidisciplinary and behavioral program for chronic back pain. DESIGN: Prospective cohort study. METHOD: In 1996, a total of 143 patients with chronic back pain participated in a 4-week multidisciplinary and behavioral treatment program in an outpatient centre for work reintegration (Rug AdviesCentrum) in Zeist, Eindhoven and Noordwijk, the Netherlands. At the start and six months after termination, data were collected on trunk muscle performance, pain intensity, disability and stress related physical complaints, and after 6 months about return to work, analgesics use, and health care utilization. Score differences between the first and the second measurements were tested on statistical significance using paired t-tests and on clinical relevance using the reliable change-index. RESULTS: The study group comprised 99 males and 44 females with a mean age of 41.6 years (range: 23-58). After 6 months the outcome variables were significantly improved statistically: depending on the outcome variable used, the improvement was clinically relevant in 44-91% of patients. The obtained percentage of full return to work at 6-months follow-up was 87%, while 80% had used no pain killers and 91% had made no use of health care facilities. CONCLUSION: The program resulted in important improvements in patients with chronic back pain.

Adult↗
PubMed2000

Results of a multimodal treatment program for patients with chronic symptoms after a whiplash injury of the neck.

STUDY DESIGN: A descriptive case series pre- and post-treatment design, including a 6-month follow-up. OBJECTIVES: The objective of this study was to document the improvements of patients with chronic symptoms after a "whiplash" injury of the neck, who attended a 4-week multimodal treatment program at the Rug AdviesCentra Nederland. SUMMARY OF BACKGROUND DATA: To the authors' knowledge, no studies have been conducted on the effectiveness of multidisciplinary treatment of chronic symptoms after whiplash injury. METHODS: Twenty-six patients who experienced Quebec type 1 or 2 lesions of the neck (whiplash) with persisting symptoms of longer than 6 months' duration participated in the study. The measures included were pain intensity (according to the visual analog scale), number of painful sites (determined by pain drawing), self-reported disability Quebec Back Pain Disability Scale; and symptoms of somatic and psychological distress and cognitive symptoms (according to selected Minnesota Multiphasic Personality Inventory-2 scales). Furthermore, objective outcome criteria were used regarding return to work, medication, and medical and paramedical treatment. Statistical and clinical significance of treatment results were both assessed. RESULTS: The patients' symptoms improved significantly on nearly all self-report measures. Their scores for objective outcome criteria reported during the 6-month follow-up evaluation were: complete return to work (65%); complete or partial return to work (92%); no use of analgesics in the past 6 months (58%); and no medical or paramedical treatments in the past 6 months (81%). CONCLUSION: These early results indicate that a multimodal treatment program has the potential to be an effective treatment for patients with chronic symptoms after a whiplash injury of the neck--a group of patients who have in the past been considered intractable or, at the very least, puzzling.

Activities of Daily Living↗
PubMed1998

Assessment of chronic back pain patient characteristics using factor analysis of the MMPI-2: which dimensions are actually assessed?

Guided by the study of Deardorff et al. (Pain, 54 (1993) 153-158), the MMPI-2 data from 240 chronic back pain patients were factor-analyzed in an attempt to discern the most important dimensions for this patient population. Principal components analysis with an oblique rotation revealed four underlying factors: Psychological disturbances, Extraversion-introversion, Passivity, and Somatic complaints. The factor structure reported by Deardorff et al. was thus successfully replicated. The stability of the factors was also supported using random split subsamples. External measures relevant to pain were used to investigate the external validity of Somatic complaints in a subsample of patients (n=93). Relations were found to number of painful sites, Waddell signs, fear of movement (maximal isometric flexion and extension performance by dynamometry, and cardiovascular fitness (VO2-max). Substantial differences emerged across genders. The derived MMPI-2 dimensions appear to constitute important characteristics associated with chronic pain. It is concluded that MMPI-2 research into chronic pain may become more productive when the instrument and its clinical correlates are examined within a clear conceptual framework of distress and personality relevant for chronic pain and its treatment.

Adult↗
PubMed1994

A taxonomy of lumbar stenosis with emphasis on clinical applicability.

A taxonomy of stenosis is presented. The classifications of clinical symptoms and signs may help the clinician to understand the clinical problem and assist him in the decision-making process, particularly as related to the choice of diagnostic procedures. The classifications of radiological and pathoanatomical data may guide the surgeon in selecting the surgical approach and in deciding what amount of which tissue has to be removed at operation.

Humans↗
PubMed1993

[Lumbar spinal stenosis. Classification and clinical presentation].

A review is presented of the nomenclature, taxonomy and clinical presentation of the lumbar canal and lateral stenosis. A historical review of the literature illustrates the growing importance of this clinical entity in the narrow spinal canal. The definition of Verbiest is introduced and explained. It distinguishes two main groups of spinal stenosis: congenital and developmental stenosis. Developmental stenosis contains several subgroups. Special attention is paid to "central" lumbar canal stenosis and lateral spinal stenosis. Both entities are discussed with a description of the etiology, anatomy, and symptomatology. The importance of nerve root infiltration as a diagnostic tool in asymptomatic radiculopathy is emphasized.

Bone Diseases, Developmental↗
PubMed1992

The cost-effectiveness of a back school program in industry. A longitudinal controlled field study.

To define the cost-effectiveness of a back school program in industry, a controlled longitudinal field study was carried out in a Dutch bus company. The experimental group received a program consisting of information on back care, physical fitness, nutrition, stress, and relaxation. Objective data on absenteeism were collected and compared during a 6-year period for the control and experimental groups. Results showed that a tailor-made back school program reduced absenteeism by at least 5 days per year per employee, therefore being cost-effective to industry. A reduction was not observed in incidence, but in mean length of absenteeism. This effect turned out to be persistent during a 2-year period following the program.

Absenteeism↗
PubMedDate not supplied

[The diagnostic value of selective lumbar nerve root block].

In patients with a neurogenic claudication syndrome root tension signs and neurological deficits are usually not observed. Lumbar myelography and CT scanning show also in a number of asymptomatic elderly people signs of nerve-root involvement. When stenosis of the vertebral canal is excluded the correlation in patients between symptoms and radiological signs is not clear. To improve the diagnostic ability selective lumbar root sheath infiltration was introduced by MacNab. The diagnostic value of this test was assessed prospectively. In 24 patients with a classic disk protrusion syndrome the sensitivity was 100%. The predictive value in patients with nerve-root-entrapment due to degenerative narrowing of the nerve-root was 70-80%.

Adult↗
PubMedDate not supplied

Experimentally induced hypermobility in the lumbar spine. A pathologic and radiologic study of the posterior ligament and annulus fibrosus.

Experimental destructive lesions were produced at autopsy in the lumbar discs of nine spines including 29 radiologically normal adult lumbar intervertebral discs. Limited transverse surgical division of the posterior longitudinal ligament and adjacent annular fibers were performed followed by, in addition, the removal of the intervertebral nucleus pulposus. Without interfering with any other major structure, radiologic evidence of hypermobility was recorded in 20 of 29 normal intervertebral segments. The patterns of movement were measured by standardized radiologic criteria. The available evidence suggests that localized damage to the region of the posterior longitudinal ligament and adjacent annulus fibrosus can produce radiologic patterns of hypermobility.

Adolescent↗