Vivian Weerdesteyn

Vivian Weerdesteyn
Radboud University Medical Centre (Radboudumc) · Department of Rehabilitation

About

181
Publications
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Publications

Publications (181)
Article
Background Benefits of peroneal functional electrical stimulation in people with post-stroke drop foot may particularly emerge in environments that require continual gait adaptation. Such adaption is known to increase the attentional demands of gait. Research questions Is performance of a target stepping task more accurate and less attention deman...
Article
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Background Children with Developmental Coordination Disorder (DCD-C) have motor coordination deficits which lead to difficulties in sports and play activities that require adaptations of the walking pattern. Sports and play often involve performing dual tasks, which affects performance in DCD-C more than in typically developing children (TD-C). So...
Article
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Objective Hereditary spastic paraplegia (HSP) is characterized by a bilaterally spastic gait pattern. During gait, increased trunk movements are often observed. People with HSP likely generate trunk movements to improve foot clearance and step length, but there may be additional explanations. Here, we investigate whether there is an association bet...
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Objective: Gait impairment in persons with Parkinson's disease is common and debilitating. Compensation strategies (e.g. external cues) are an essential part of rehabilitation, but their underlying mechanisms remain unclear. Using EEG, we explored the cortical correlates of three categories of strategies: external cueing, internal cueing, and acti...
Article
Introduction The StartReact (SR) effect is the accelerated release of a prepared movement when a startling acoustic stimulus is presented at the time of the imperative stimulus (IS). SR paradigms have been used to study defective control of balance and gait in people with neurological conditions, but differences in emotional state (e.g. fear of fai...
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Background Children with Developmental Coordination Disorder (DCD) have motor coordination deficits leading to difficulties in sports and play that require adaptations of the walking pattern. Children with DCD indeed demonstrate poorer walking adaptability (WA) compared to typically developing children, but it remains elusive whether WA can be impr...
Article
Introduction Children and adolescents with Cerebral Palsy (CP) show abnormalities in muscle tone, and difficulties in motor coordination and postural stability1. These difficulties lead to limitations in daily activities, such as sports, leisure and school activities2. Children/adolescents with CP have an increased risk of falling3, which points at...
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Background After stroke, some individuals have latent, propulsive capacity of the paretic leg, that can be elicited during task-specific gait training. The aim of this proof-of-concept study was to investigate the effect of five-week robotic gait training for improving propulsion symmetry by increasing paretic propulsion in chronic stroke survivors...
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Background: Regaining gait capacity is an important rehabilitation goal post stroke. Compared to clinically available robotic gait trainers, robots with an assist-as-needed approach and multiple degrees of freedom (AANmDOF) are expected to support motor learning, and might improve the post-stroke gait pattern. However, their benefits compared to c...
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Background People with hereditary spastic paraplegia (HSP) experience difficulties adapting their gait to meet environmental demands, a skill required for safe and independent ambulation. Gait adaptability training is possible on the C-Mill, a treadmill equipped with augmented reality, enabling visual projections to serve as stepping targets or obs...
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Application of movement technology in the rehabilitation of neurological disorders has gained a firm position within a short time span, but the effectiveness of many technological innovations is still poorly supported by evidence. Should this burst of movement technology be considered a hype or is it offering realistic hope? This perspective focuse...
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Purpose Elucidating the complex interactions between physical activity (PA), a multidimensional concept, and physical capacity (PC) may reveal ways to improve rehabilitation interventions. This cross-sectional study aimed to explore which PA dimensions are related to PC in people after minor stroke. Materials and methods Community dwelling individ...
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Background: Hereditary spastic paraplegia (HSP) is a group of inherited disorders characterized by progressive spastic paresis of the lower limbs. Treatment is often focused on reducing spasticity and its physical consequences. To better address individual patients' needs, we investigated a broad range of experienced complaints, activity limitatio...
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Background: After transfemoral amputation, many hours of practice are needed to re-learn walking with a prosthesis. The long adaptation process that consolidates a novel gait pattern seems to depend on cerebellar function for reinforcement of specific gait modifications, but the precise, step-by-step gait modifications (e.g., foot placement) most l...
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Postural responses that effectively recover balance following unexpected postural changes need to be tailored to the characteristics of the postural change. We hypothesized that cortical dynamics involved in top-down regulation of postural responses carry information about directional postural changes (i.e., sway) imposed by sudden perturbations to...
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The goal of this study was to determine whether the cortical responses elicited by whole‐body balance perturbations were similar to established cortical markers of action monitoring. Postural changes imposed by balance perturbations elicit a robust negative potential (N1) and a brisk increase of theta activity in the electroencephalogram recorded o...
Article
Purpose Walking adaptability is essential for children to participate in daily life, but no objective measurement tools exist. We determined psychometric properties of the Walking Adaptability Ladder test for Kids (WAL-K) in 6-12 year old children. Materials and methods In total, 122 typically developing (TD) children and 26 children with Developm...
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The need to perform multiple tasks more or less simultaneously is a common occurrence during walking in daily life. Performing tasks simultaneously typically impacts task performance negatively. Hypothetically, such dual-task costs may be explained by a lowered state of preparation due to competition for attentional resources, or alternatively, by...
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Changes in human balance control can objectively be assessed using system identification techniques in combination with support surface translations. However, large, expensive and complex motion platforms are required, which are not suitable for the clinic. A treadmill could be a simple alternative to apply support surface translations. In this pap...
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Background: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has shown promise for rehabilitation after stroke. Ipsilesional anodal tDCS (a-tDCS) over the motor cortex increases corticospinal excitability, while contralesional cathodal tDCS (c-tDCS) restores interhemispheric balance, both resulting...
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Background: Falls are one of the most common complications after stroke, with a reported incidence ranging between 7% in the first week and 73% in the first year post stroke. This is an updated version of the original Cochrane Review published in 2013. Objectives: To evaluate the effectiveness of interventions aimed at preventing falls in people...
Article
Background: Stroke survivors often show reduced walking velocity and gait asymmetry. These gait abnormalities are associated with reduced propulsion of the paretic leg. This review aimed to provide an overview of the potential effectiveness of post-stroke rehabilitation interventions to improve paretic propulsion, ankle kinetics and walking veloci...
Article
Compensatory stepping is an important protective mechanism to prevent falling. To recover from sideways perturbations side steps are generally more advantageous than cross-over steps. However, there is lack of understanding of the characteristics of compensatory side steps following sideways perturbations that separate successful recoveries (i.e.,...
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Background: Peripheral changes to muscle and motor nerves occur following stroke, which may further impair functional capacity. We investigated whether a year-long use of an implanted peroneal FES system reverses stroke-related changes in muscles and motor nerves in people with foot drop in the chronic phase after supratentorial stroke. Methods:...
Article
Background: Implanted peroneal functional electrical stimulation (FES) is an effective alternative treatment to ankle-foot orthosis (AFO) in people with drop foot after stroke. With FES no constraints on ankle mobility are imposed which might particularly be exploited in challenging walking environments that require adaptations of the gait pattern...
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Objective To identify the role of hyperexcitable short-latency stretch reflexes (SLRs) on balance control in people with hereditary spastic paraplegia (PwHSP). Methods Sixteen PwHSP with triceps surae spasticity and 9 healthy control subjects were subjected to toes-up support-surface perturbations. EMG data were recorded from gastrocnemius, soleus...
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Purpose: This study aimed to elucidate whether muscle activity (in terms of glucose uptake) between the legs can be considered symmetrical during walking. Furthermore, we aimed to determine whether the [18F]-fluorodeoxyglucose was distributed heterogeneously throughout each muscle, and if so, whether areas of high uptake would be clustered. Metho...
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Objective: To investigate the functional effects of bilateral botulinum toxin A treatment and subsequent stretching of spastic hip adductors on gait and reactive lateral stepping responses in patients with pure hereditary spastic paraplegia. Design: Explorative pre-post intervention study. Patients: Twenty-five patients with pure hereditary spasti...
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Background Recovery of walking is a primary rehabilitation goal of most stroke survivors. Control of pelvic movements is one of the essential determinants of gait, yet surprisingly, conventional robot-assisted gait trainers constrain pelvic movements. Novel robot-assisted gait trainers, such as LOPES II, are able to support pelvic movements during...
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The contributions of the cerebral cortex to human balance control are clearly demonstrated by the profound impact of cortical lesions on the ability to maintain standing balance. The cerebral cortex is thought to regulate subcortical postural centers to maintain upright balance and posture under varying environmental conditions and task demands. Ho...
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Purpose: Sedentary behavior is common in people with stroke and has devastating impact on their health. Quantifying it is important to provide people with stroke with adequate physical behavior recommendations. Sedentary behavior can be quantified in terms of posture (sitting) or intensity (low energy expenditure). We compared the effect of differe...
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Corticospinal lesions cause impairments in voluntary motor control. Recent findings suggest that some degree of voluntary control may be taken over by a compensatory pathway involving the reticulospinal tract. In humans, evidence for this notion mainly comes from StartReact studies. StartReact is the acceleration of reaction times by a startling ac...
Article
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Background: The relationships between motor impairment of the affected leg, postural control asymmetry, and impaired body sway control after stroke are not well understood. Objective: To examine the relationship between motor impairment of the affected leg and reduced contribution of this leg to body sway control (ie, dynamic control asymmetry [...
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Introduction: People with stroke often have impaired stepping responses following balance perturbations, which increases their risk of falling. Computer-controlled movable platforms are promising tools for delivering perturbation-based balance training under safe and standardized circumstances. Purpose: This proof-of-concept study aimed to identify...
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Background Finding ways to quantify resilience as a predictor of a person’s resistance to health challenges is important to improve healthy aging. This study investigated a unique sample of high-functioning older persons in whom traditional markers of frailty and functional decline are largely absent. Translating complex dynamical systems theory to...
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A startling acoustic stimulus (SAS) involuntary releases prepared movements at accelerated latencies, known as the StartReact effect. Previous work has demonstrated intact StartReact in paretic upper extremity movements in people after stroke, suggesting preserved motor preparation. The question remains whether motor preparation of lower extremity...
Article
Defective muscle coordination for balance recovery may contribute to stroke survivors’ propensity for falling. Thus, we investigated deficits in muscle coordination for postural control and their association to body sway following balance perturbations in people with stroke. Specifically, we compared the automatic postural responses of 8 leg and tr...
Article
Background: Contralesional 'drop foot' after stroke is usually treated with an ankle-foot orthosis (AFO). However, AFOs may hamper ankle motion during stance. Peroneal functional electrical stimulation (FES) is an alternative treatment that provides active dorsiflexion and allows normal ankle motion. Despite this theoretical advantage of FES, the...
Article
Full-text available
Importance Gait impairments are common in patients with chronic supratentorial upper motor neuron lesions and are a source of disability. Clinical management aimed at improving the gait pattern in these patients is generally perceived as a challenging task because many possible abnormalities may interact. Moreover, a multitude of treatment options...
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Introduction Untreated unilateral developmental dysplasia of the hip (DDH) results in asymmetry of gait and hip strength and may lead to early osteoarthritis, which is commonly treated with a total hip arthroplasty (THA). There is limited knowledge about the obtained symmetry of gait and hip strength after the THA. The objectives of this cross-sect...
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Objective To determine the predictive value of leg and trunk inclination angles at stepping-foot contact for the capacity to recover from a backward balance perturbation with a single step in people after stroke. Methods Twenty-four chronic stroke survivors and 21 healthy controls were included in a cross-sectional study. We studied reactive stepp...
Data
Individual trial data. Data of individual trials used in the analyses. (XLSX)
Chapter
Our activities of daily living inherently involve interacting with the physical environment. This interaction involves both reactive (feedback) and proactive (feedforward) gait adaptations. Reactive adaptations involve responses to mechanical perturbations and occur, for instance, when we stumble over a doorstep or slip on an icy spot on the paveme...
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Objective: To assess, in a cross-sectional study, the feasibility and immediate efficacy of laser shoes, a new ambulatory visual cueing device with practical applicability for use in daily life, on freezing of gait (FOG) and gait measures in Parkinson disease (PD). Methods: We tested 21 patients with PD and FOG, both "off" and "on" medication. I...
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Background Closed loop system identification (CLSIT) is a method to disentangle the contribution of underlying systems in standing balance. We investigated whether taking into account lower leg muscle activation in CLSIT could improve the reliability and accuracy of estimated parameters identifying the underlying systems. Methods Standing balance...
Article
Background and objective: Postural muscle responses are often impaired after stroke. We aimed to identify the contribution of deficits in very early postural responses to poorer reactive balance capacity, with a particular focus on reactive stepping as a key strategy for avoiding falls. Methods: A total of 34 chronic stroke survivors and 17 cont...
Article
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Introduction: Balance impairments are common in patients with hereditary spastic paraplegia and are among the most debilitating symptoms, as they frequently result in falls and fall-related injuries. Several features of hereditary spastic paraplegia contribute to balance impairments and multiple treatment options exist. However, an overview of the...
Article
Many research groups have studied fall impact mechanics to understand how fall severity can be reduced to prevent hip fractures. Yet, direct impact force measurements with force plates are restricted to a very limited repertoire of experimental falls. The purpose of this study was to develop a generic model for estimating hip impact forces (i.e. fa...
Article
After stroke, weight-bearing asymmetry (WBA) towards the non-paretic side is associated with postural instability. It remains unknown whether WBA is a cause or consequence of postural instability, as both phenomena depend on stroke severity. We investigated the effect of WBA on the ability to recover from balance perturbations in people with stroke...
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Objective: Changes in muscle architecture after stroke are usually assessed by investigating inter-limb differences. As a result bilateral changes of muscle architecture might be missed. Our aim was to investigate whether bilateral architectural changes in skeletal muscle can be detected in chronic, physically active stroke patients using quantita...
Article
Background and purpose: The purpose of this systematic review and meta-analysis was to investigate the effects of exercise training on balance capacity in people in the chronic phase after stroke. Furthermore, we aimed to identify which training regimen was most effective. Methods: Electronic databases were searched for randomized controlled tri...
Poster
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Objective: To compare the selection of stepping actions during a probabilistic reaction time task in the ON state with the OFF state in people with Parkinson’s disease (PD). Background: Dopamine is thought to be critical in encoding the precision of sensory information used to build representations of possible actions, during action selection. In P...
Poster
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Objective: To compare the selection of stepping actions during a probability reaction time task in people with Parkinson’s disease (PD) in the ON state with that of healthy elderly controls (EL). Background: Before initiating a step the brain selects the “best-at-the-time-action” from a set of possible actions – a process known as action selection,...
Article
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Parkinson's disease (PD) patients likely use attentional strategies to compensate for their gait deficits, which increases the cognitive challenge of walking. The interplay between cognitive functions and gait can be investigated by evaluating the subject's attendance to a secondary task during walking. We hypothesized that the ability to attend to...
Article
Full-text available
Introduction: StartReact is the acceleration of reaction time by a startling acoustic stimulus (SAS). The SAS is thought to release a pre-prepared motor program. Here, we investigated whether the StartReact effect is applicable to the very first trial in a series of repeated unpractised single-joint movements. Methods: Twenty healthy young subje...
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