Tine Marieke Willems

Ghent University | UGhent · Department of Rehabilitation Sciences and Physiotherapy

Fatigue has often been considered a risk factor for developing sports injuries, modulating lower extremity jump-landing biomechanics. The impact of fatigue on proximal trunk and pelvic biomechanics has been suggested to play an important role in lower extremity loading and injury risk, yet the available evidence remains ambiguous as the trunk and p...

Objective This systematic review aimed to examine pain, functional status and return to work after a multidisciplinary intervention, with or without additional workplace intervention, for (sub)acute low back pain among adults. Data sources A comprehensive search was completed (November 2022) in six electronic databases (Embase, MEDLINE, Web of Sci...

Theoretical frameworks explain how pain-related psychological factors may influence physical performance. In this systematic review and meta-analysis, we evaluated the evidence regarding the relationship between pain-related psychological factors and maximal physical performance in patients with low back pain (LBP). Pubmed, Embase, CINAHL and Web o...

Objectives: The aim of this study was to investigate the association between SARS-CoV-2 infection and muscle strain injury in elite athletes. Methods: A prospective cohort study in three Belgian professional male football teams was performed during the first half of the 2020-2021 season (June 2020-January 2021). Injury data were collected using...

Background The use of flow diversion to treat intracranial aneurysms has increased in recent years. Objective To assess the safety and angiographic efficacy of the p64 flow modulation device. Methods Diversion-p64 is an international, prospective, multicenter, single-arm, study conducted at 26 centers. The p64 flow modulation device was used to t...

Background Impaired core stability has been suggested to influence lower extremity functioning and might contribute to the development of acute lower extremity injuries. Prospective studies that examine this relationship are currently lacking. Objective The objective of this study was to investigate the role of different components of core stabili...

Background The influence of warm-up exercises on the muscle properties has already been investigated before. Strikingly, it still remains unclear which warm-up exercises should be performed in order to properly prepare the Achilles tendon in withstanding high-forces during sport participation. Objective To investigate the acute effect of frequentl...

Background Lower extremity overuse injuries are common in athletes participating in sports with repeated bouts of landing manoeuvres. Objective To summarise and determine the relationship between kinematic alterations during a landing task and lower extremity overuse injuries in physically active populations. Design Systematic review and meta-ana...

Background The effects of dual task (DT) performance on injury incidence in sports have barely been researched. Athletes often encounter situations where cognitive and motor tasks must be performed simultaneously, with interference between tasks. An inferior DT performance could be associated with a less adequate (motor) response, increasing the in...

Background Physical active induced fatigue may result altered trunk and pelvic biomechanics during athletic tasks. Objective To summarize and determine the effect of physical fatigue on trunk and pelvic biomechanics during jump-landings in healthy, physically active populations. Design Systematic review of literature. Setting Electronic database...

An amendment to this paper has been published and can be accessed via the original article.

Background Altered lower back muscle activity is proposed as a contributing factor to the reoccurrence and chronicity of low back pain (LBP). This study compared lumbar muscle activity during trunk extension in patients with continuous chronic LBP (CLBP), non-continuous CLBP, recurrent LBP (RLBP) and healthy subjects. Methods In 75 subjects (16 co...

It has been shown that the type of stool influences lumbar posture and muscle activity during dental work. Studies investigating the effect on cervicothoracic muscle activity and posture are scarce though. The present study investigated the effect of different stool types on cervicothoracic muscle activity and posture during a dental procedure. Twe...

Objectives Stability of the core is associated with lower extremity functioning. Consequently, impaired core stability might play a role in developing non-contact acute lower extremity sports injuries. The objective was to investigate components of core stability as potential risk factors for acute lower extremity injuries. Design A cohort study w...

Pieters, D, Wezenbeek, E, De Ridder, R, Witvrouw, E, and Willems, T. Acute effects of warming up on Achilles tendon blood flow and stiffness. J Strength Cond Res XX(X): 000-000, 2020-The aim of this study was to investigate the acute effect of frequently used warm-up exercises on the Achilles tendon blood flow and stiffness. In doing so, we want to...

Objective: To investigate if motion control shoes reduce the risk of pronation-related injuries in recreational runners. Design: Secondary analysis of a randomized controlled trial of the effect of shoes on running injuries. Methods: 372 recreational runners were randomized to receive either standard neutral or motion control shoes and were fo...

Background Lower extremity overuse injuries are common in athletes participating in sports with repeated bouts of landing manoeuvres. Biomechanical alterations during landing may be associated with these types of injuries. The objective of this systematic review with meta-analysis was to summarise and determine the relationship between kinematic al...

The contribution of central factors to movement preparation (e.g., the contingent negative variation [CNV]) and the influence of fatigue on such factors are still unclear, even though executive cognitive functions are regarded as key elements in motor control. Therefore, this study examined CNV amplitude with electroencephalography in 22 healthy hu...

Background: Differences in pain processing, muscle structure and function have been reported in patients with low back pain (LBP) with different grades of pain chronicity. Objective: The present study aims to examine differences in psychological factors, disability and subjective fatigue between subgroups of LBP based on their chronification gra...

Background: Runners and walkers often suffer from lower extremity injuries. Little is known about the relationship between their consumer behaviour towards footwear and the development of those injuries. Therefore, the aim of this study was to investigate if consumer behaviour towards footwear is a risk factor for lower extremity injuries. Method...

Background Spondyloartritis (SpA) can seriously affect spinal mobility and trunk strength. Even though exercise therapy is considered one of the keystones of non-pharmacological treatment¹, guidelines on exercise programs remain vague due to a lack of objective measurements of physical parameters such as trunk mobility and strength. Data on these p...

Background: Core stability has been suggested to influence lower extremity functioning and might contribute to the development of lower extremity overuse injuries. However, prospective studies to investigate this relationship are limited. Purpose: To research the role of different components of core stability as risk factors for the development...

Context: Wearable sensor devices have notable advantages, such as cost-effectiveness, easy to use, and real-time feedback. Wirelessness ensures full-body motion, which is required during movement in a challenging environment such as during sports. Research on the reliability and validity of commercially available systems, however, is indispensable...

Context: Although taping has been proven effective in reducing ankle sprain events in individuals with chronic ankle instability, insight into the precise working mechanism remains limited. Objectives: To evaluate whether the use of taping changes ankle joint kinematics during a sagittal and frontal plane landing task in subjects with chronic an...

Objectives: The need to accurately assess trunk and lumbopelvic proprioception and neuromuscular control is widely accepted. However, based on current literature, there is a lack of reliable clinical tests to evaluate these aspects in clinical practice. The objective of this study is to investigate intra- and inter-tester reliability of the latera...

Objectives To investigate reliability and validity of handheld dynamometry (HHD) strength tests to accurately measure isometric trunk flexion and extension strength. Design Test-retest design and comparative analysis to investigate reliability and validity respectively. Setting Isometric trunk flexion and extension strength, measured with a handh...

Background: Previous research of a young adult population identified a lower increase in Achilles tendon blood flow immediately after a running activity as a significant predictor for the development of Achilles tendinopathy (AT). Furthermore, advancing age is often mentioned as a risk factor for the development of AT, and the highest incidence fo...

Background and aims: Some low back pain (LBP) patients recover after every pain episode whereas others develop chronicity. Research indicates that the amount of atrophy and fat infiltration differs between patients with LBP. Also enhanced pain sensitivity is present only in a subgroup of LBP patients. The relationship between pain sensitivity and...

Background: Several risk factors have been suggested in the development of Achilles tendinopathy, but large-scale prospective studies are limited. Purpose: To investigate the role of the vascular response to activity of the Achilles tendon, tendon thickness, ultrasound tissue characterization (UTC) of tendon structure, and foot posture as possib...

Objectives To research and summarize the literature regarding the role of core stability as a risk factor in the development of lower extremity injuries in an athletic population. Methods Pubmed, Web of Science and Embase were searched in August 2016 to systematically review studies, which related core muscle functioning and core stability to lowe...

The aims of present study were to research the amplitude and median frequency characteristics of selected abdominal, back and hip muscles of healthy subjects during a prone bridging endurance test, based on surface electromyography (sEMG), (1) to determine if the prone bridging test is a valid field test to measure abdominal muscle fatigue, and (2)...

In the etiology of Achilles tendinopathy (AT), it is frequently suggested that excessive pronation causes a vascular constriction of the Achilles tendon, described as the "whipping phenomenon" (Clement et al., 1984). Although previous studies focused on the association between pronation and AT, it is striking that the underlying association between...

Background The most popular hypothesis of the etiology of Achilles tendinopathy suggests that excessive pronation causes conflicting rotational motions, leading to a vascular constriction of the Achilles tendon, described as the “whipping phenomenon” (Clement et al., 1984). Although several studies identified pronation as a risk factor for the deve...

Recently, ultrasound tissue characterization (UTC) was introduced as a reliable method for quantification of tendon structure. Despite increasing publications on the use of UTC, it is striking that there is a lack of normative data in active adolescents. Therefore, the aim of this study was to provide normative values of the Achilles tendon as quan...

Background context: Heterogeneity exists within the low back pain (LBP) population. Some patients recover after every pain episode, whereas others suffer daily from LBP complaints. Until now, studies rarely make a distinction between recurrent low back pain (RLBP) and chronic low back pain (CLBP), although both are characterized by a different cli...

Background: Ankle sprain is frequently encountered, both in primary care and in emergency departments. Since 1992, the Ottawa ankle rules (OAR) can assist clinicians in determining whether an X-ray should be performed to exclude a fracture. Several guidelines recommend the use of OAR based on a systematic review from 2003. Ten years later, one can...

Background Chronic ankle instability is a frequently reported residual pathology which occurs as a result of an initial ankle sprain. Although tape is a commonly used treatment modality, the precise mechanism of efficacy of tape remains unclear. Objective To evaluate the effect of taping on ankle joint landing kinematics during a jump landing proto...

To evaluate the effect of balance surface type on muscle activity of ankle stabilizing muscles in subjects with chronic ankle instability. Case-controlled, repeated-measures study design. Twenty-eight subjects with chronic ankle instability and 28 healthy controls. Subjects performed a barefooted single-legged stance on uniaxial and multidirectiona...

The aim of this study was to establish the presence of postural deficits in subjects with chronic ankle instability (CAI) and to assess the effect of an 8-week balance training program on dynamic postural control. A total of 43 subjects with CAI and 31 controls participated in this case-control study. Participants with CAI performed an 8-week home-...

The objective of our study was to evaluate the effect of taping on the dynamic postural stability during a jump landing protocol in subjects with chronic ankle instability (CAI). For this purpose, 28 subjects with CAI performed a sagittal and frontal plane landing task in a non-taped and taped condition. As main outcome measure, the dynamic postura...

Purpose: The literature on lower limb kinematic deviations in subjects with chronic ankle instability (CAI) during landing tasks is limited and not consistent. Several studies only report joint angles at defined events rather than considering the whole kinematic curve, which might obscure possibly relevant information. Therefore, the main goal of...

Chronic ankle instability (CAI) is associated with inadequate control during landing tasks. Joint kinematics have been shown influential in the capacity to accommodate for the incurred high loading. The purpose of this study was to evaluate whether multi-segmented foot kinematics of the impact phase of landing tasks can reveal further control issue...

Chronic ankle instability (CAI) is a frequently reported residual outcome after an acute ankle sprain. Balance training is common daily practice in treatment of CAI, but its effect on CAI associated mechanisms as postural control remains unclear. The aim of this study was to establish the presence of postural deficits in subjects with CAI and asses...

Enhancing the accuracy of a risk factor screening test is an important element of sports injury prevention. Purpose: To determine the impact of muscle fatigue on a screening tool for those at risk of exertional medial tibial pain (EMTP). Study Design: In this cohort study, 3D-kinematic parameters in frontal and transverse plane were prospectively...

To prospectively analyse the role of factors on the contralateral side of the kinetic chain in the development of exertional medial tibial pain (EMTP). Eighty-one female physical education students were tested at the beginning of their first academic year. Within the testing protocol, contralateral isokinetic hip muscle strength and full-body kinem...

Chronic pelvic pain (CPP) is a complex pain syndrome. Since its pathogenesis is still poorly understood and structural alterations in pain related brain regions may be present, there is a greater acceptance that sensitization of the central nervous system (CNS) plays an important role in the development and maintenance of chronicity. Objective: Th...

To prospectively determine risk factors contributing to the development of exertional medial tibial pain (EMTP). Data were prospectively collected on healthy female students in physical education, who were freshmen in 2010-2011 and 2011-2012. Eighty-six female students aged 19.38±0.85 years, were tested at the beginning of their first academic year...

Chronic pelvic pain (CPP) is a complex pain syndrome. Since its pathogenesis is still poorly understood and structural alterations in pain related brain regions may be present, there is a greater acceptance that sensitization of the central nervous system (CNS) plays an important role in the development and maintenance of chronicity. The purpose of...

A new version of The Knee Society Knee Scoring System(©) (KSS) has recently been developed. Before this scale can be used in non-English-speaking populations, it has to be translated and validated for a particular population. We evaluated the construct and content validity, the test-retest reliability, and the internal consistency of the Dutch vers...

Purpose: Many patients who sustain an acute lateral ankle sprain develop chronic ankle instability (CAI). Altered ankle kinematics have been reported to play a role in the underlying mechanisms of CAI. In previous studies, however, the foot was modeled as one rigid segment, ignoring the complexity of the ankle and foot anatomy and kinematics. The...

Objective To prospectively identify proximal risk factors contributing to the development of exertional medial tibial pain (EMTP). Methods Data were prospectively collected on healthy female students in physical education, who were freshmen in 2010–2011 and 2011–2012. 95 female students, aged 18.15±0.84, were tested at the beginning of their first...

Background In clinical practice, out-toeing is often linked with an increased eversion and an increased medial pressure distribution. However, in the literature, there is little evidence for this relationship. On the other hand, as an increased eversion and an increased medial pressure distribution have been detected as risk factors for exercise-re...

The purpose of this study was to assess plantar pressure alterations after long-distance running. Prior to and after a 20 km run, force distribution underneath the feet of 52 participants was registered using Footscan(®) pressure plates while the participants ran shod at a constant self-selected pace. Peak force, mean force and impulse were registe...

The aim of this multicentre, non-randomised trial was to evaluate the safety and efficacy at 180+/-14 days of a pimecrolimus eluting coronary stent based on a cobalt-chromium platform and a poly-L-lactic acid (PLLA) bioresorbable polymer. Sixty-one patients, with single de novo coronary lesions <14 mm in length and a reference vessel diameter of 3....

Recurrent stenosis and stent thrombosis are still major concerns after drug eluting stent placement which inhibits not only the restenostic process but endothelialisation as well. In contrast, through accelerating rapid endothelialisation and development of an earlier functional endothelial layer, passive coatings have shown encouraging results. Th...

The main purpose of this study was to describe and interpret the COP trajectory during barefoot running in a large cohort of young adults with no history of injury. COP data were collected from 215 subjects, who ran at 3.3 ms(-1) over a 16.5m long track, with a built in Footscan pressure platform. COP data were filtered using a 50 Hz lowpass butter...

Excessive frontal plane knee movement during forward lunge movements might be associated with the occurrence of knee injuries in tennis. Here, we attempt to determine whether hip muscle strength is related to the frontal plane motion of the knee during a functional lunge movement. A correlational study. A total of 84 healthy subjects (76 men, 8 wom...

Exercise-related lower-leg pain (ERLLP) is a common chronic sports injury. In clinical practice, deviant gait biomechanics are frequently considered to play a role in the development of ERLLP, although there is scarce scientific evidence that gait-related variables predispose athletes to this injury. The purpose of this study was to examine prospec...

To investigate the efficacy of a guided and graded home-based exercise program for improving a range of physical outcomes in older people. Controlled clinical trial of 16 weeks. Two geographical areas in Gent, Belgium. 66 independent-living older people (age: 71-98) with a history of falls and moderate physical impairment. Twenty-four 30-minute tra...

The peroneus tertius is absent in 5% to 17% of the human white population. The function of the peroneus tertius is eversion and dorsiflexion of the foot. These 2 strength parameters have been identified as important parameters in the development of ankle ligament injuries. Subjects without the peroneus tertius are at higher risk for ankle ligament...

To investigate the risk of being fearful or fearless of falls in older people. Using a force plate, postural control in different sensory and rhythmic conditions was measured in 263 community-dwelling older people. Other assessments included fear of falling, and handgrip strength. Fall incidence was assessed at baseline and during a one-year follow...

The purpose of this study was to establish a reference dataset for peak pressures and pressure-time integrals during jogging, to compare this reference dataset with existing walking data and to develop a foot type classification, all based on plantar pressure data obtained from 215 healthy young adults. The subjects ran at 3.3 m s(-1) over a 16.5 m...

To construct a risk model in order to identify elderly individuals at risk of frequent falling. Prospective community-based cohort study over 12 months. Baseline measures were performed at a local community centre. Two hundred and sixty-three community-dwelling elderly people (mean age 72 years). A variety of variables were evaluated, including med...

The purpose of this study was to determine prospectively gait related risk factors for exercise-related lower leg pain (ERLLP) in 400 physical education students. Static lower leg alignment was determined, and 3D gait kinematics combined with plantar pressure profiles were collected. After this evaluation, all sports injuries were registered by the...

Anterior knee pain is known as a very common problem in the sporting population.1,5,15,16,30 Many of the patients with anterior knee pain need conservative treatment to be able to return to sport or their daily activities. On the other hand, because of this high incidence of anterior knee pain, prevention of this pathology has been an important goa...

Ankle sprains are extremely common. However, very little is known about the variables that predispose individuals to these injuries. The purpose of this study was to examine prospectively intrinsic risk factors for inversion sprains in a young physically active female population. One hundred and fifty-nine female physical education students were ev...

This prospective study determined gait related risk factors for inversion sprains in 223 physical education students. Static lower leg alignment was determined, and 3D-kinematics combined with plantar pressure profiles were collected. After evaluation, the same sports physician registered all sports injuries during the next 6-18 months. During this...