B A de Jong

VU University Amsterdam, Amsterdamo, North Holland, Netherlands

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Publications (31)

  • Agnes F Hoeksma · Anne Marie ter Steeg · Rob G H H Nelissen · [...] · Bareld A de Jong
    [Show abstract] [Hide abstract] ABSTRACT: An historical cohort study was conducted to investigate the rate and extent of neurological recovery in obstetric brachial plexus injury (OBPI) and to identify possible prognostic factors in a cohort of children with OBPI from birth to 7 years. All children (n=56; 31 females, 25 males) with OBPI were evaluated at fixed time intervals by one examiner. They underwent a final neurological examination at a mean age of 3 years 10 months (range 1 to 7 years). Neurological outcome was not as favourable as is often reported: complete neurological recovery occurred in 37 out of 56 children (66%). In half of these there was delayed recovery, in which case complete neurological recovery was assessed from 1.5 to 16 months of age (median age 6.5 months, SD 4.2 months). External rotation and supination were the last to recover and recovered the least. Although biceps function at three months was considered to be the best indicator for operative treatment, external rotation and supination were found to be better in predicting eventual complete recovery. Initial symptoms directly post partum were not found to be prognostic. Functional outcome was mainly reported to be good.
    Article · Mar 2004 · Developmental Medicine & Child Neurology
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    [Show abstract] [Hide abstract] ABSTRACT: Rheumatoid arthritis (RA) is a common, severe, chronic inflammatory joint disease. Since the disease may initially be indistinguishable from other forms of arthritis, early diagnosis can be difficult. Autoantibodies seen in RA can be detected years before clinical symptoms develop. In an inception cohort of patients with recent-onset arthritis, we undertook this study to assess the predictive value of RA-specific autoantibodies to cyclic citrullinated peptides (CCPs) in patients with undifferentiated arthritis (UA). Anti-CCP2 antibody tests were performed at baseline in 936 consecutive, newly referred patients with recent-onset arthritis. Patients who could not be properly classified 2 weeks after inclusion were categorized as having UA. Patients with UA were followed up for 3 years and evaluated for progression of their disease to RA as defined by the American College of Rheumatology (ACR) 1987 revised criteria. Three hundred eighteen of 936 patients with recent-onset arthritis were classified as having UA and were available for analysis. After 3 years of followup, 127 of 318 UA patients (40%) had been classified as having RA. RA had developed in 63 of 249 patients (25%) with a negative anti-CCP test and in 64 of 69 patients (93%) with a positive anti-CCP test (odds ratio 37.8 [95% confidence interval 13.8-111.9]). Multivariate analysis of the presence of anti-CCP antibodies and parameters from the ACR criteria identified polyarthritis, symmetric arthritis, erosions on radiographs, and anti-CCP antibodies as significant predictors of RA. Testing for anti-CCP antibodies in UA allows accurate prediction of a substantial number of patients who will fulfill the ACR criteria for RA.
    Full-text available · Article · Mar 2004 · Arthritis & Rheumatology
  • [Show abstract] [Hide abstract] ABSTRACT: Quadriceps strength, maximal anatomical cross-sectional area (CSA), maximal voluntary activation (MVA), and maximal relaxation rate (MRR) were studied in 48 subjects with a past history of polio, 26 with and 22 without postpoliomyelitis syndrome (PPS), and in 13 control subjects. It was also investigated whether, apart from CSA, MVA and MRR were determinants of muscle strength. Polio subjects had significantly less strength, CSA, and MRR in the more-affected quadriceps than control subjects. MVA was reduced in 18 polio subjects and normal in all controls. PPS subjects differed from non-PPS subjects only in that the MVA of the more-affected quadriceps was significantly lower. Both CSA and MVA were found to be associated with muscle strength. Quadriceps strength in polio subjects was dependent not only on muscle mass, but also on the ability to activate the muscles. Since impaired activation was more pronounced in PPS subjects, the new muscle weakness and functional decline in PPS may be due not only to a gradual loss of muscle fibers, but also to an increasing inability to activate the muscles.
    Article · Aug 2003 · Muscle & Nerve
  • A. M. TER STEEG · A F Hoeksma · P F Dijkstra · [...] · B A De Jong
    [Show abstract] [Hide abstract] ABSTRACT: Description of shoulder sequelae in obstetrical brachial plexus injury (OBPI) patients who had spontaneous functional recovery, in the context of historical and current conservative methods of treatment. Case study of a baby with serious complications, followed by a review of the literature from 1900 until 2001 about conservative treatment of OBPI with respect to the prevention of shoulder complications. Description of contractures and bony deformities did not show important discrepancies over time, other than more detailed images because of new technical possibilities. There is no agreement on the explanation of the development of these deformities. Secondary changes caused by muscular imbalance and longstanding contracture are recognized by all authors. A primary osteoarticular lesion was recognized as a possible cause in the beginning of the twentieth century, then forgotten for a long time and only in the 1980s had gained interest again. The main change in treatment concerns the use of arm braces. This was strongly recommended in the first half of the twentieth century, then advised against and is at this moment not anymore mentioned. There is no consensus on the cause of contractures and bony deformities in children with OBPI. Conservative methods of treatment have changed over the years, without research on the outcome of these treatment changes.
    Article · Feb 2003 · Disability and Rehabilitation
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    Agnes F Hoeksma · Anne Marie Ter Steeg · Piet Dijkstra · [...] · Bareld A de Jong
    [Show abstract] [Hide abstract] ABSTRACT: The purposes of this study were to determine the prevalence of and the association between shoulder contracture and osseous deformity in a cohort of children with an obstetrical brachial plexus injury and to identify the risk factors for these complications. In a retrospective cohort study, all children with an obstetrical brachial plexus injury who had been born between January 1991 and January 1998 at one academic medical center and all those with the same diagnosis who had been born elsewhere during the same period and were referred to the medical center within six weeks after delivery were evaluated at fixed time-intervals by one examiner. The patients underwent a final orthopaedic, neurological, and radiographic examination at a mean age of 3.7 years (range, one to seven years). Shoulder contracture was defined as a decrease in the passive range of motion in one or more directions compared with the range on the unaffected side. Osseous deformity was defined as a nonspherical humeral head or an abnormal glenoid. The prevalence of a shoulder contracture of >10 degrees was 56% (twenty-nine of fifty-two patients), and the prevalence of an osseous deformity was 33% (sixteen of forty-eight patients with complete radiographic follow-up). In the children in whom complete neurological recovery was delayed (i.e., recovery was more than three weeks after birth), the prevalence of shoulder contracture was 54% (thirteen of twenty-four patients) and the prevalence of osseous deformity was 26% (six of twenty-three patients). A strong association was noted between shoulder contracture and osseous deformity (p = 0.004). Directly after birth, the presence of a clavicular fracture was the only factor that was associated (p = 0.016) with the development of an osseous deformity (but not with a shoulder contracture). At a later stage, speed and extent of neurological recovery were related to shoulder contracture and osseous deformity. An asymmetric appearance was noticed in children who had a contracture, including those who had complete neurological recovery. The prevalence of shoulder contracture and osseous deformity in children with obstetrical brachial plexus injury was high, even in those with complete neurological recovery. These complications were strongly associated with one another. No symptom that appeared immediately after birth was identified as a factor that would predict the development of future shoulder contracture. A clavicular fracture was found to be significantly associated with the development of an osseous deformity at a later stage.
    Full-text available · Article · Feb 2003 · The Journal of Bone and Joint Surgery
  • Cardol MB · B. A. de Jong · C. D. Ward
    [Show abstract] [Hide abstract] ABSTRACT: Purpose: To explore the concept of autonomy as a basis for social participation, with particular reference to rehabilitation. Method: A study of relevant literature from the field of rehabilitation, building on theory developed in other fields (ethics, social sciences), and deriving important concepts and strategies for rehabilitation practice. Results: The focus of rehabilitation for people with a chronic disabling condition is shifting from a biomedical to a client-centred perspective. Conceptions of autonomy vary among individuals and cultures, but a crucial distinction can be made between decisional autonomy (the ability to make decisions without external restraint) and executional autonomy (the ability to act as one wishes). The liberal-individualist account of autonomy over-emphasizes physical independence and does not sufficiently recognize the inter-dependency of all people, including those with disabilities. An ethic of care, complementary to the principle of respect for autonomy, should guide the development of rehabilitation strategies to enhance individual autonomy and participation in daily living. For rehabilitation, this entails an attentive attitude, maximizing opportunities for informed choices, taking full account of each person's preferences, needs and social contexts. Conclusions: Autonomy is central to client-centred rehabilitation since it is a pre-requisite for effective participation. It is suggested that autonomy, conceived as a basis for participation, is the ultimate aim of rehabilitation.
    Article · Dec 2002 · Disability and Rehabilitation
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    [Show abstract] [Hide abstract] ABSTRACT: To evaluate the responsiveness of a newly developed generic questionnaire, the Impact on Participation and Autonomy (IPA), which focuses on 2 aspects of participation: perceived participation and the experience of problems. Preliminary study of questionnaire responsiveness compared with transition indices. Participants completed 2 assessments, 3 months apart. To measure change, they completed 9 transition indices at the second assessment. One transition index assessed perceived change in general, the other 8 addressed 1 of the specific problem experience items in the IPA. Outpatient clinic of the rehabilitation department of an academic hospital. Fifty-seven consecutive persons admitted for multidisciplinary rehabilitation treatment, with various diagnoses, were enrolled in the study; 49 persons completed both assessments. Not applicable. Standardized response mean (SRM) and area under the receiver operating characteristic curve (AUC) for participation domain scores and problem scores. SRMs and AUCs for the participation domains ranged from 0.1 to 1.3 and from 50% to 92%, respectively. The SRMs of the items on the experience of problems ranged from 0.4 to 1.5, whereas their AUCs ranged from 56% to 74%. The IPA detected within-person improvement over time, but its responsiveness must be confirmed in a larger study sample.
    Full-text available · Article · Dec 2002 · Archives of Physical Medicine and Rehabilitation
  • B A de Jong · T W J Huizinga · E Zanelli · [...] · R G J Westendorp
    [Show abstract] [Hide abstract] ABSTRACT: Human leukocyte antigen (HLA)-DR2 carriership is associated with an increased risk for MS. Genome searches using microsatellite markers have consistently shown that additional genetic factors contribute to susceptibility for MS. To identify loci within the HLA region that predispose to relapse-onset MS independently of HLA-DR2. A case-control study involving 159 patients with definite relapse-onset MS and 273 control subjects was conducted. Six highly polymorphic microsatellite markers encoded within the HLA-C to DR region, that is, D6S1014, D6S273, TNFa, MIB, C1_2_5, and C1_3_2, three single-nucleotide tumor necrosis factor (TNF) promoter gene polymorphisms at positions -238, -308, and -376, and HLA-DR2 carriership were typed. These data confirmed the well-known association between the HLA-DR2 haplotype and relapse-onset MS, yielding an odds ratio (OR) of 3.6 (95% CI: 2.4 to 5.4; p < 0.0001). Multivariate analyses revealed that C1_3_2*354 was also associated with an increased risk for developing relapse-onset MS independently of HLA-DR2 (OR: 2.0; 95% CI: 1.2 to 3.1; p = 0.004). This allele is encoded within an ancestral haplotype that is highly linked to HLA-DR3. The joint effect of this ancestral haplotype and HLA-DR2 resulted in an OR of 8.7 (95% CI: 2.7 to 29; p < 0.0001) to develop relapse-onset MS. In addition, a protective risk factor was found: carriers of TNFa*107 had a 0.5-fold lower risk to develop relapse-onset MS (95% CI: 0.3 to 0.9; p = 0.026). Within the HLA region, other loci besides HLA-DR2 haplotype modulate susceptibility for relapse-onset MS.
    Article · Aug 2002 · Neurology
  • [Show abstract] [Hide abstract] ABSTRACT: Innate differences in tumour necrosis factor (TNF) production have been associated with susceptibility for and outcome of inflammatory diseases. Several studies have tried to identify whether polymorphisms in or near the TNF gene or other markers on the short arm of chromosome 6 (6p21) are related to differences in TNF production. Data on these associations are conflicting. Therefore, we conducted a study among 129 healthy individuals in which TNF production was determined upon stimulation with endotoxin in whole blood cultures. TNFa microsatellite, TNF single nucleotide polymorphisms at position +489, -238, -308 and -376 typing was performed. The data revealed that alleles of TNFa microsatellite and carriership of TNF polymorphisms were not related to TNF production. We conclude that the genes determing the differences in endotoxin-induced TNF production have not been yet identified.
    Article · Mar 2002 · Genes and Immunity
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    Mieke Cardol · Bareld A de Jong · Geertrudis A M van den Bos · [...] · Rob J de Haan
    [Show abstract] [Hide abstract] ABSTRACT: To describe the impact of a chronic disabling condition on participation and to identify variables that may explain perceived restrictions in participation. Cross-sectional. People were recruited from the outpatient clinics of two rehabilitation centres and the rehabilitation department of an academic hospital. One hundred and twenty-six people from five diagnostic groups (neuromuscular disease, rheumatoid arthritis, spinal cord injury, stroke, fibromyalgia) participated in the study. The IPA (Impact on Participation and Autonomy) questionnaire was used to describe perceived participation. Explanatory variables were studied in terms of sociodemographic factors and health status variables. Some restrictions in participation seem comparable among diagnostic groups, others are specific to one or two groups. People with stroke, rheumatoid arthritis or fibromyalgia perceived more restrictions in participation than people with spinal cord injury or neuromuscular disorders. Emotional distress was the most important factor contributing to restrictions in participation. Perceived participation remains a complex concept in which many factors are involved. To make a contribution to meaningful participation of people with a chronic disabling condition, rehabilitation treatment should address physical, social, emotional and environmental aspects.
    Full-text available · Article · Mar 2002 · Clinical Rehabilitation
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    Frans Nollet · Anita Beelen · Anthony J. Sargeant · [...] · Bareld A. de Jong
    [Show abstract] [Hide abstract] ABSTRACT: To compare the submaximal exercise capacity of polio subjects with postpoliomyelitis syndrome (PPS) and without (non-PPS) with that of healthy control subjects, to investigate the relationship of this capacity with maximal short-term power and quadriceps strength, and to evaluate movement economy. Cross-sectional survey. University hospital. Forty-three polio subjects (25 PPS, 18 non-PPS) and 12 control subjects. Not applicable. Power output, oxygen uptake, and heart rate were measured in an incremental submaximal cycle ergometry test. Maximal short-term power was measured in 5-second all-out efforts. Knee extensor strength was measured on a chair dynamometer. The mean submaximal power +/- standard deviation at 80% of heart rate reserve of 83.8 +/- 29.9 watts in the polio subjects was significantly less than the mean submaximal power of 142.1 +/- 30.4 watts in the control group. However, expressed as a percentage of the maximal short-term power, submaximal power did not differ between the groups. Strength and maximal short-term power correlated significantly (p < .005) with submaximal power (r = .64 and .76, respectively). The oxygen uptake was higher than theoretically expected for the given submaximal power output in polio subjects, and appeared to increase with increasing asymmetry in strength and power between legs. No differences were found between PPS and non-PPS subjects. The submaximal work capacity of polio subjects was severely reduced, mainly in association with the reduced muscle capacity. And, because of a reduced movement economy, their energy cost was elevated. Although muscle loads in activities such as walking and climbing stairs differ from cycling, they also may require elevated relative levels of effort, predisposing subjects to premature fatigue in sustained activity.
    Full-text available · Article · Dec 2001 · Archives of Physical Medicine and Rehabilitation
  • Mieke Cardol · Rob J. de Haan · Bareld A. de Jong · [...] · Imelda J.M. de Groot
    [Show abstract] [Hide abstract] ABSTRACT: To examine the homogeneity, test-retest reliability, construct validity, and concurrent validity of the Impact on Participation and Autonomy Questionnaire (IPAQ). Cross-sectional study with a test-retest subsample. One hundred twenty-six persons from 5 diagnostic groups recruited from the outpatients clinics of 2 rehabilitation centers and the rehabilitation department of an academic hospital. The IPAQ and 3 other self-administered questionnaires (Sickness Impact Profile [68-item version], London Handicap Scale [LHS], Medical Outcome Study Short-Form Health Survey). The IPAQ was completed twice by 75 respondents within approximately 2 weeks. The IPAQ addresses autonomy and participation in 5 domains: autonomy indoors, family role, autonomy outdoors, social relations, and work and educational opportunities. Cronbach's alpha for the several domains ranged between.81 and.91, indicating good homogeneity. On item level, weighted kappas ranged between.56 and.90. On domain level, the test-retest reliability of the IPAQ was good: intraclass correlation coefficients ranged between.83 and.91. Convergent validity was largely supported by the correlations between 4 domains of the LHS and the IPAQ. Discriminant validity was best demonstrated by low correlations between the IPAQ and 2 domains of the LHS representing theoretically different constructs. The IPAQ is a reliable and valid instrument for assessing autonomy and participation in chronic disorders. Its responsiveness requires further study.
    Article · Mar 2001 · Archives of Physical Medicine and Rehabilitation
  • B A de Jong · H M Schrijver · T.W.J. Huizinga · [...] · R.G.J. Westendorp
    [Show abstract] [Hide abstract] ABSTRACT: Multiple sclerosis (MS) typically presents with a relapsing-remitting onset. This can be distinguished from primary progressive MS. Typical MS is characterized by a profound inflammatory reaction in which anti-inflammatory cytokine interleukin-10 (IL-10) and pro-inflammatory cytokine tumor necrosis factor (TNF) may play a pivotal role. We tested the hypothesis that patients with MS have a distinct innate cytokine production that contributes to the susceptibility for and outcome of MS. The innate cytokine production of patients was estimated as the average production of cytokines in lipopolysaccharide -stimulated whole-blood cultures of 2 to 5 first-degree healthy family members. A total of 126 family members of 50 patients with typical MS, 61 family members of 25 patients with primary progressive MS, and 129 control subjects of 54 families were enrolled in this study. We found that members of families with low IL-10 and high TNF production had a fourfold increased risk of developing typical MS compared with members of families with high IL-10 and low TNF production. Patients with MS were eightfold more likely to develop typical MS than primary progressive MS when they belonged to families with low IL-10 and high TNF production. The presence of human leukocyte antigen-DR2 was associated with MS but not with TNF production. This study shows that typical MS is associated with an innate pro-inflammatory cytokine profile in contrast to primary progressive MS.
    Article · Nov 2000 · Annals of Neurology
  • [Show abstract] [Hide abstract] ABSTRACT: To determine whether volumetric magnetization transfer imaging (MTI) histogram analysis can detect abnormalities in patients with active neuropsychiatric systemic lupus erythematosus (NPSLE) and to compare the MTI findings in patients with active NPSLE, chronic NPSLE, and multiple sclerosis (MS), as well as in normal control subjects. Eight female and 1 male patient with active nonthromboembolic NPSLE (mean +/- SD age 39 +/- 9 years), 10 female patients with chronic NPSLE (age 33 +/- 11 years), 10 female patients with SLE and no history of NPSLE (non-NPSLE; age 34 +/- 11 years), 10 female patients with inactive MS (age 41 +/- 6 years), and 10 healthy control subjects (age 33 +/- 11 years) underwent MTL. Using the MTI scans, histograms were composed from which we derived a variety of parameters that quantitatively reflect the uniformity of the brain parenchyma as well as the ratio of cerebrospinal fluid to intracranial volume, which reflects atrophy. The magnetization transfer ratio (MTR) histograms in the non-NPSLE group and the healthy control group were similar, whereas those in the chronic NPSLE and MS groups were flatter. There was also flattening of the histograms in the active NPSLE group, but with a shift toward higher MTRs. Our results indicate that volumetric MTI analysis detects cerebral changes in the active phase of NPSLE. The abnormalities in the brain parenchyma of patients with chronic NPSLE produced MTI values that were the same as those in patients with inactive MS. MTI values in the active phase of NPSLE differed from those in the chronic phase, which might reflect the presence of inflammation. These preliminary results suggest that MTI might provide evidence for the presence of active NPSLE. MTI might also prove to be a valuable technique for monitoring treatment trials.
    Article · Nov 2000 · Arthritis & Rheumatology
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    [Show abstract] [Hide abstract] ABSTRACT: A systematic review of the available literature on the effectiveness of knee-ankle-foot orthoses in the treatment of Duchenne muscular dystrophy. A computer search was carried out (MEDLINE 1966-97, CINAHL 1982-97) using the key words muscular dystrophy, rehabilitation, locomotion, braces or orthotic devices. References in relevant publications and nonindexed journals were also examined. Criteria to include and exclude articles were formulated. We used a systematic review procedure to evaluate the literature. Seven methodological criteria were formulated. Thirty articles describing 35 studies met the inclusion criteria for our review, nine studies were selected based on completeness of information on study population, treatment and quantitative presentation of the effect outcome. Operations on the lower limbs were performed on most patients. A concomitant programme of rehabilitation was not described thoroughly. A percentage success of treatment was calculated for eight studies. Median percentage after one year was 75.1, after two years 47.9 and after three years 24.3. The median for the means of independent walking was 24 months, the median for the means of assisted walking was 36.2 months and the median for the means of standing ability was 50.5 months duration. The scientific strength of the studies reviewed is poor. It seems that the use of knee-ankle foot orthoses can prolong assisted walking and standing, but it is uncertain whether it can prolong functional walking. The boys that benefit most have a relatively low rate of deterioration, are capable of enduring an operation and are well motivated.
    Full-text available · Article · Sep 2000 · Clinical Rehabilitation
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    D T Wade · B A de Jong
    [Show abstract] [Hide abstract] ABSTRACT: In Western countries 13-14% of the population have some degree of disability. 1 The demand for rehabilitation services will increase as evidence accrues for their effectiveness and as more people survive longer with substantial disability. Current evidence strongly supports the provision of well organised, coordinated, multidisciplinary rehabilitation services based on a problem oriented approach. 2 In future, specific interventions will be more evidence based, leading to more appropriate use of interventions and more appropriate referrals to specialist services. Rehabilitation has recently seen many practical innovations and new evidence for specific interventions , but the major advances in rehabilitation are conceptual rather than practical. Firstly, the approach to patients has moved from a predominantly medical one to one in which psychological and sociocultural aspects are equally important. Secondly, the need for organised specialist rehabilitation services—for example , for neurological disabilities—is being recognised. Methods This review concentrates on the conceptual basis of rehabilitation and some emerging principles; the scope of rehabilitation is too large to cover all major advances. We chose topics and papers on the basis of our experience.
    Full-text available · Article · Jun 2000 · BMJ Clinical Research
  • Article · Jan 2000 · Huisarts en wetenschap
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    [Show abstract] [Hide abstract] ABSTRACT: To report on the feasibility and psychometric properties in terms of homogeneity and construct validity of a newly developed handicap questionnaire focusing on person-perceived handicaps: the Impact on Participation and Autonomy (IPA). Cross-sectional. SETTING, subjects and outcome measure: One hundred consecutive individuals from the outpatient clinic of the department of rehabilitation of an academic hospital administered the new questionnaire IPA. The results show good homogeneity and construct validity of the IPA. Factor analysis showed that the scale consists of four factors, explaining 68% of the total variance: social relationships, autonomy in self-care, mobility and leisure, and family role. Homogeneity of the four subscales was considered good, Cronbach's alpha ranged from 0.84 (family role) to 0.87 (social relationships). Feasibility in terms of the number of missing values and administration time needed was satisfactory. The first results suggest that the IPA promises to be a useful handicap questionnaire. Further research is needed to establish test-retest reliability, convergent validity and responsiveness to change.
    Full-text available · Article · Nov 1999 · Clinical Rehabilitation
  • M Cardol · J W Brandsma · I J de Groot · [...] · B A de Jong
    [Show abstract] [Hide abstract] ABSTRACT: There is an increasing need to get insight into the social and societal impact of chronic conditions on a person's life, i.e. person-perceived handicap. The purpose of this study is to report how current handicap questionnaires assess handicap. A literature search using both Medline and the database of the Dutch Institute of Allied Health Professions (NPi) was conducted for handicap questionnaires. Questionnaires were included if addressing handicaps or life roles, environmental influences and social consequences of a disease. Excluded were questionnaires focusing on only impairments, disabilities or quality of life. 20 questionnaires were identified. Handicap is not uniformly defined in these questionnaires. Based on different concepts, the various questionnaires encompass different domains and different aspects are emphasized in similar domains. Fourteen questionnaires assess society-perceived handicaps, and do not address the life roles, care needs or individual problem-experience. Six questionnaires are to some extent person-perceived, but a generic person-perceived handicap questionnaire could not be identified. It is concluded that development of a generic person-perceived handicap questionnaire is essential for adequate assessment of needs, outcome, and relevance of rehabilitation interventions from the individual's point of view.
    Article · Apr 1999 · Disability and Rehabilitation
  • Frans Nollet · Anita Beelen · Martin H. Prins · [...] · Bareld A. de Jong
    [Show abstract] [Hide abstract] ABSTRACT: To compare perceived health problems and disability in former polio subjects with postpolio syndrome (PPS) and those without postpolio syndrome (non-PPS), and to evaluate perceived health problems, disability, physical performance, and muscle strength. Cross-sectional survey; partially blinded data collection. One hundred three former polio subjects, aged 32 to 60yrs. This volunteer sample came from referrals and patient contacts. Criterion for PPS: new muscle weakness among symptoms. Nottingham Health Profile (NHP), adapted D-code of the International Classification of Impairments, Disabilities and Handicaps, performance test, and muscle strength assessment. PPS subjects (n = 76) showed higher scores (p < .001) than non-PPS subjects (n = 27) within the NHP categories of physical mobility, energy, and pain. On a 16-item Polio Problems List, 78% of PPS subjects selected fatigue as their major problem, followed by walking outdoors (46%) and climbing stairs (41%). The disabilities of PPS subjects were mainly seen in physical and social functioning. No differences in manually tested strength were found between patient groups. PPS subjects needed significantly more time for the performance test than non-PPS subjects and their perceived exertion was higher. Perceived health problems (NHP-PhysMobility) correlated significantly with physical disability (r = .66), performance-time (r = .54), and muscle strength (r = .38). With linear regression analysis, 54% of the NHP-PhysMobility score could be explained by the performance test (time and exertion), presence of PPS, and muscle strength, whereas strength itself explained only 14% of the NHP-PhysMobility score. PPS subjects are more prone to fatigue and have more physical mobility problems than non-PPS subjects. In former polio patients, measurements of perceived health problems and performance tests are the most appropriate instruments for functional evaluation.
    Article · Mar 1999 · Archives of Physical Medicine and Rehabilitation