Papers by Eugene Rameckers
Neuroreport, 2009
Humans are able to correct an ongoing movement very quickly in response to a suddenly moving targ... more Humans are able to correct an ongoing movement very quickly in response to a suddenly moving target. Such fast responses possibly bypass the motor cortex and if so, one would expect that damage to the motor cortex would not greatly affect them. A group of children with congenital spastic hemiplegia were asked to move to a target, which, in some trials, jumped to a new position. It was found that the congenital spastic hemiplegia group was not affected more by the target jumps than the typically developing children. The moving targets made adaptive movements faster instead of slower for the affected hand. It is concluded that fast-adjusting movements do not necessarily rely on the motor cortex in these children.
Osteogenesis Imperfecta, 2014
Stimulus, 2006
... Eugene Rameckers Marlene Bronzwaer Sandra Beurskens Tim Takken ... 13 Page 2. Verder is een v... more ... Eugene Rameckers Marlene Bronzwaer Sandra Beurskens Tim Takken ... 13 Page 2. Verder is een verbeterde conditie en fitheid voor kin-deren met obesitas van groot belang, omdat de risicofac-toren die correleren met obesitas bij goede fitheid sterk afnemen (Gillis ea, 2002). ...
Introduction. To provide a state of the art on diagnostics, clinical characteristics, and treatme... more Introduction. To provide a state of the art on diagnostics, clinical characteristics, and treatment of paediatric generalised joint hypermobility (GJH) and joint hypermobility syndrome (JHS). Method. A narrative review was performed regarding diagnostics and clinical characteristics. E ectiveness of treatment was evaluated by systematic review. Searches of Medline and Central were performed and included nonsymptomatic and symptomatic forms of GJH (JHS, collagen diseases). Results. In the last decade, scienti c research has accumulated on all domains of the ICF. GJH/JHS can be considered as a clinical entity, which can have serious e ects during all stages of life. However research regarding the pathological mechanism has resulted in new potential opportunities for treatment. When regarding the e ectiveness of current treatments, the search identi ed studies, from which three were included (JHS: = 2, Osteogenesis Imperfecta: = 1). According to the best evidence synthesis, there was strong evidence that enhancing physical tness is an e ective treatment for children with JHS. However this was based on only two studies. Conclusion. Based on the sparsely available knowledge on intervention studies, future longitudinal studies should focus on the e ect of physical activity, tness, and joint stabilisation. In JHS and chronic pain, the e ectiveness of a multidisciplinary approach should be investigated.
Pediatric Physical Therapy, 2009
Purpose: To investigate the feasibility and effect of a functional physical training program on a... more Purpose: To investigate the feasibility and effect of a functional physical training program on aerobic endurance and walking ability of children with cerebral palsy. Methods: Thirteen children (8 -13 years, Gross Motor Function Classification System level I or II, with normal intelligence or mild retardation) participated in this study. A functional physical training program addressing aerobic endurance, walking distance, walking velocity, and ambulation, consisted of a circuit with 4 stations and lasted 30 minutes twice weekly for 9 weeks. The Bruce, 6-minute-run test, Timed Up and Down Stairs Test, and Ambulation Questionnaire were administered 2 weeks before the start, immediately after, and 11 weeks after the intervention. Results: Significant improvement in aerobic endurance, walking distance, and ambulation were observed immediately after the intervention. Maximum treadmill time had improved significantly at 11 weeks. Conclusion: A functional physical training improves the aerobic endurance and the functional walking ability of children with cerebral palsy. (Pediatr Phys Ther 2009;21:31-37)
Disability and rehabilitation, Jan 25, 2015
To determine the relationship between isometric leg muscle strength and mobility capacity in chil... more To determine the relationship between isometric leg muscle strength and mobility capacity in children with cerebral palsy (CP) compared to typically developing (TD) peers. Participants were 62 children with CP (6-13 years), able to walk with (n = 10) or without (n = 52) walking aids, and 47 TD children. Isometric muscle strength of five muscle groups of the leg was measured using hand-held dynamometry. Mobility capacity was assessed with the 1-min walk, the 10-m walk, sit-to-stand, lateral-step-up and timed-stair tests. Isometric strength of children with CP was reduced to 36-82% of TD. When adjusted for age and height, the percentage of variance in mobility capacity that was explained by isometric strength of the leg muscles was 21-24% (walking speed), 25% (sit-to-stand), 28% (lateral-step-up) and 35% (timed-stair) in children with CP. Hip abductors and knee flexors had the largest contribution to the explained variance, while knee extensors showed the weakest correlation. Weak or ...
Pediatric Physical Therapy, 2016
Research in developmental disabilities, 2015
Based on a systematic review, psychometric characteristics of currently available instruments on ... more Based on a systematic review, psychometric characteristics of currently available instruments on motor abilities of children with disabilities were evaluated, with the aim to identify candidates for use in children with severe multiple (intellectual and motor) disabilities. In addition, motor abilities are essential for independent functioning, but are severely compromised in these children. The methodological quality of all studies was evaluated with the Consensus Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) Checklist; overall levels of evidence per instrument were based on the Cochrane Back Review Group strategy. As a result, 18 studies with a total of eight instruments, developed for children with cerebral palsy (CLA, GMFM-88 and LE85), spinal muscular atrophy (MHFMS), neuromuscular diseases (MFM), disabilities 0-6 years (VAB, WeeFIM), and one developed specifically for children with severe multiple disabilities (TDMMT) were found. Strong le...
Research in Developmental Disabilities, 2015
ABSTRACT The aims of this study were to adapt the Gross Motor Function Measure-88 (GMFM-88) for c... more ABSTRACT The aims of this study were to adapt the Gross Motor Function Measure-88 (GMFM-88) for children with Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) and to determine the test-retest and interobserver reliability of the adapted version. Sixteen paediatric physical therapists familiar with CVI participated in the adaptation process. The Delphi method was used to gain consensus among a panel of experts. Seventy-seven children with CP and CVI (44 boys and 33 girls, aged between 50 and 144 months) participated in this study. To assess test-retest and interobserver reliability, the GMFM-88 was administered twice within three weeks (Mean=9 days, SD=6 days) by trained paediatric physical therapists, one of whom was familiar with the child and one who wasn't. Percentages of identical scores, Cronbach's alphas and intraclass correlation coefficients (ICC) were computed for each dimension level. All experts agreed on the proposed adaptations of the GMFM-88 for children with CP and CVI. Test-retest reliability ICCs for dimension scores were between 0.94 and 1.00, mean percentages of identical scores between 29 and 71, and interobserver reliability ICCs of the adapted GMFM-88 were 0.99-1.00 for dimension scores. Mean percentages of identical scores varied between 53 and 91. Test-retest and interobserver reliability of the GMFM-88-CVI for children with CP and CVI was excellent. Internal consistency of dimension scores lay between 0.97 and 1.00. The psychometric properties of the adapted GMFM-88 for children with CP and CVI are reliable and comparable to the original GMFM-88. Copyright © 2015 Elsevier Ltd. All rights reserved.
BMC neurology, 2015
This study reports on the effects of botulinum toxin A (BoNT-A) injections in the upper extremity... more This study reports on the effects of botulinum toxin A (BoNT-A) injections in the upper extremity (UE) in children with unilateral Cerebral Palsy (uCP) combined with bimanual task-oriented therapy (BITT) or either treatment modality performed separately. Bimanual activities were measured with the Assisting Hand Assessment (AHA), the ABILHand-Kids questionnaire (AK), the Observational Skills Assessment Score (OSAS). Goal achievement was measured with Goal Attainment Scaling (GAS), using blind video assessment, and the Canadian Occupational Performance Measure (COPM). Thirty-five children, mean age 7.14 years (SD 2.63), 11 Manual Ability Classification Score (MACS) I, 15 MACS II and 9 MACS III, participated. The trial started with four study groups: BoNT-A-only (n = 5), BITT-only (n = 11), BoNT-A + BITT (n = 13), and control (n = 6). Twenty-two children were randomised, 13 children received their parents' preferred treatment: BoNT-A + BITT or BITT-only. Three comparisons were anal...
European Journal of Physiotherapy, 2014
Research in developmental disabilities, Jan 15, 2014
This review focuses on the effects of strengthening interventions of the upper limb in children w... more This review focuses on the effects of strengthening interventions of the upper limb in children with Cerebral Palsy (CP). The strengthening intervention studies were divided in two categories: those based on stand-alone strength training, and those on strength training combined with other interventions. A search in all relevant databases was performed. Six articles were included: three randomized controlled trials (RCTs), two clinical trial (CT) and one case study. Effect sizes of strength training on muscle strength and function of the upper limb were calculated. There are no coherent recommendations for strength training, based on these studies. The causes include too much variety of types of training, level of intensity and duration. All of the reported upper limb strength training studies found an increase in muscle strength. In addition, the quality of these studies was not high. More RCTs on strength training according to the official strength training guidelines are necessary...
European Journal of Paediatric Neurology, 2015
This study reports on the effects of botulinum toxin A (BoNT-A) injections in the upper extremity... more This study reports on the effects of botulinum toxin A (BoNT-A) injections in the upper extremity (UE) of children with unilateral Cerebral Palsy (uCP) combined with bimanual task oriented therapy (BITT) or either treatment modality performed separately on UE range of motion (ROM), spasticity and (functional) strength. Thirty-five children, mean age 7.14 years (SD 2.63) of whom 11 had a Manual Ability Classification Score (MACS) I, 15 MACS II and 9 MACS III, participated. The trial started with four study groups: BoNT-A-only (n = 5), BITT-only (n = 11), BoNT-A + BITT (n = 13), and control (n = 6). Twenty-two children were randomized and, due to recruitment problems 13 children received their parents' preferred treatment: BoNT-A + BITT or BITT-only. Three comparisons were analysed: BITT (BoNT-A + BITT and BITT-only; n = 24) versus no BITT (BoNT-A-only and control; n = 11), BoNT-A (BoNT-A-only and BoNT-A + BITT; n = 18) versus no BoNT-A (BITT-only and control; n = 17), and the additional effect of BoNT-A (BoNT-A + BITT versus BITT-only). BoNT-A significantly decreased key grip strength and finger flexion tone, had a clinically relevant (additional) positive effect on active thumb abduction and supination and a significantly negative effect on unilateral functional strength. BITT + BoNT-A significantly increased active supination. BITT reduced elbow flexor tone and BITT-only resulted in more improvement than BoNT-A + BITT in functional unimanual and, to a lesser extent, in bimanual grip strength. In comparison with BoNT-A + BITT, BITT-only gives more improvement on functional grip strength and, therefore, could possibly increase bimanual performance. In this case, the (additional) role of BoNT-A may be an increase in active supination and thumb abduction.
Research in Developmental Disabilities, 2015
Purpose: The aims of this study were to adapt the Paediatric Evaluation of Disability Inventory, ... more Purpose: The aims of this study were to adapt the Paediatric Evaluation of Disability Inventory, Dutch version (PEDI-NL) for children with cerebral visual impairment (CVI) and cerebral palsy (CP) and determine test-retest and inter-respondent reliability. Method: The Delphi method was used to gain consensus among twenty-one health experts familiar with CVI. Test-retest and inter-respondent reliability were assessed for parents and caregivers of 75 children (aged 50-144 months) with CP and CVI. The percentage identical scores of item scores were computed, as well as the interclass coefficients (ICC) and Cronbach's alphas of scale scores over the domains self-care, mobility, and social function. Results: All experts agreed on the adaptation of the PEDI-NL for children with CVI. On item score, for the Functional Skills scale, mean percentage identical scores variations for testretest reliability were 73-79 with Caregiver Assistance scale 73-81, and for interrespondent reliability 21-76 with Caregiver Assistance scale 40-43. For all scales over all domains ICCs exceeded 0.87. For the domains self-care, mobility, and social function, the Functional Skills scale and the Caregiver Assistance scale have Cronbach's alpha above 0.88. Conclusion: The adapted PEDI-NL for children with CP and CVI is reliable and comparable to the original PEDI-NL. ß
Research Quarterly for Exercise and Sport, 2007
NeuroReport, 2004
Di¡erences related to development were investigated using a ¢nger isometric force task in childre... more Di¡erences related to development were investigated using a ¢nger isometric force task in children with cerebral palsy and control children. The increase in force and force control observed in controls did not take place in patients. In the younger subset of patients (o10 years) the force produced by the non-a¡ected hand was greater than in either hand of young controls. This e¡ect was not observed in the older subset of patients (o10 years). Older controls also di¡ered from younger controls in that they used higher frequency feedback loops. In contrast, older patients failed to show this increase. Moreover, the failure occurred both in the affected and non-a¡ected hand, indicating that abnormalities involve the force control system of both sides. NeuroReport 15:000^000
Neurorehabilitation and Neural Repair, 2008
Background. Rehabilitation of the upper extremity in children with hemiplegic cerebral palsy has ... more Background. Rehabilitation of the upper extremity in children with hemiplegic cerebral palsy has not been compared to the same intensity of therapy combined with injected botulinum toxin (BTX). Objective. To measure the short-term (2 weeks) and long-term (6 and 9 months) effects of a standardized functional training program versus without the addition of chemodernervation of forearm and hand muscles. Methods. Twenty children with spastic hemiplegia, aged 4 to 16 years, were matched for baseline characteristics and then randomized to standardized functional physical and occupational therapies for 6 months (PT/OT group) or to the same therapies plus multimuscle BTX-A (BTX+ group). Main outcome measures were isometric generated force, overshoot and undershoot (force production error), active and passive range of motion by goniometry (ROM), stretch restricted angle (SRA) of joints, Ashworth scores at the elbow and wrist, and the Melbourne assessment of unilateral upper limb function. All measures were performed at baseline, 2 weeks after BTX-A, 6 months (end of therapy), and then 3 months after termination of the therapy. Results. Clinical measures (muscle tone, active ROM of wrist and elbow) showed improvement in both groups. However, no significant differences emerged between groups on functional measures. Generated force decreased directly after the BTX-A injection but increased during the therapy period. The PT/OT group, however, showed a significantly higher increase in force and accuracy with therapy compared with the BTX+ therapy group. Conclusions. Functional rehabilitation therapies for the upper extremity increase manual isometric flexor force at the wrist and ROM, but BTX injections cause weakness and do not lead to better outcomes than therapy alone.
Neurorehabilitation and Neural Repair, 2013
Neuropsychologia, 2005
In this study the hypothesis was tested that children with spastic hemiplegia rely more on extern... more In this study the hypothesis was tested that children with spastic hemiplegia rely more on externally guided visual feedback when trying to keep force constant with their affected hand (AH) as compared to their non-affected hand (NAH) and as compared to controls. An isometric force task in which a cursor had to be moved to a visually specified target that disappeared half way the task, was performed by 19 children with cerebral palsy (CP), spastic hemiplegia, aged between 5 and 16 years and an aged matched control group. It was found that the absolute deterioration of performance after withdrawal of target visualization did differ between AH, NAH and controls. The absolute error was smaller and the variability was larger in the hemiplegic hand. However, the normalized force error and co-efficient of variation increased similarly between groups. Furthermore, power spectrum density analysis of the force signal showed that both hands in both groups had a similar loss in the energy in the 2-3 Hz range when target visualization was removed. These results suggest that CP children are equally able to produce stable force without visually monitoring their performance than children without CP, provided they are allowed to operate within their own force range.
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Papers by Eugene Rameckers