Research Report Abstracts - Gesundheit

eS620
for use in rehabilitation settings. The first aim of the current
study was to investigate the test–retest reproducibility and the
internal consistency of the MSRS in Dutch stroke patients. A
second aim of the study was to evaluate the construct validity.
The scores of the Dutch MSRS of stroke patients were
compared to those of competitive athletes.
Relevance: Several trainings principles for and theories
about motor learning in sports have been shown to also
account for the context of rehabilitation. An example of a
trainings principle is motor imagery which is traditionally
used by athletes and has become a hot item in stroke rehabilitation
during the last years. ‘Reinvestment in movements’
is another example. The Theory of Reinvestment proposes
that increased conscious attention to movement control can
lead to interrupted automaticity, or ‘deautomatisation’, during
motor performance, potentially resulting in performance
deterioration. Several studies proved the theory in athletes
(football, basketball, golf) and first explanatory studies in
neurological patients showed that the theory of reinvestment
might also account for this population. If this is true, the
MSRS potentially is a quick and easy tool with which therapists
can measure a patient’s propensity to reinvest. However,
detailed psychometric properties of the MSRS have only been
reported for movement unimpaired populations, with high
reproducibility and acceptable internal consistency.
Participants: 45 community-dwelling stroke patients and a
control group of 58 competitive athletes.
Methods: A test–retest design was used in which stroke
patients and competitive athletes completed the Dutch-MSRS
twice within a period of 3 weeks.
Analysis: The reliability was assessed with intraclass correlation
coefficients and agreement was investigate using the
method by Bland–Altman. Internal consistency was examined
using Cronbach’s alpha. Differences in scores on the
Dutch-MSRS between stroke patients and athletes were compared
using Kolmogorov–Smirnov tests. We expected no
difference between these groups because both groups are regularly
under pressure to achieve optimal motor performance.
Results: Good reliability was evident: ICC .91; CI .08–.95.
Limits of agreement were found to be 3. Cronbach’s alpha
was satisfactory for conscious motor processing (α = .64)
and for movement self-consciousness (α = .72). As expected
scores between stroke patients and athletes did not differ
significantly (p = .99).
Conclusions: Based on this study, the Dutch-MSRS appeared
to be a reproducible, internal consistent and valid tool
to investigate the propensity to reinvest in chronic stroke
patients, however to assess what the implications are of this
tool are for stroke rehabilitation more research is indicated.
Implications: Reinvestment may play an important role in
rehabilitation. If so, important issues need to be resolved.
Should therapists take into account a patient’s propensity for
reinvestment when choosing therapy content and approach?
In other words should “high-reinvestors” be treated using
different trainings principles?
Keywords: Movement specific Reinvestment Scale; Stroke;
Clinimetric aspects
Funding acknowledgements: No funding.
Ethics approval: Ethical approval was obtained at the medical
ethical committee of the academic hospital Maastricht
(azM), Maastricht, the Netherlands, MEC 10-3-006.
Research Report Poster Display
Number: RR-PO-213-9-Wed Wednesday 22 June 13:00
RAI: Exhibit Halls2&3
FUNCTIONAL TRAINING FOR PATIENTS WITH
CHRONIC OBSTRUCTIVE PULMONARY DISEASE:
A REVIEW
Aarden J. 1 , Galvelyte A. 1 , Hagenbrock J. 1 , Engelbert R. 1 ,
Klijn P. 2
1University of Applied Sciences Amsterdam, European
School of Physiotherapy, Amsterdam, Netherlands, 2Asthma Center Heideheuvel, Physical Rehabilitation and Therapy,
Hilversum, Netherlands
Purpose: Patients with chronic obstructive pulmonary disease
(COPD) often report difficulties in performing activities
of daily living (ADL).
Relevance: Although exercise training is recommended in
the guidelines for pulmonary rehabilitation, there is limited
information regarding its impact on ADL. Therefore, we
performed a review describing functional training programs
related to functional outcome in patients with COPD.
Participants: Patients with COPD.
Methods: A search of electronic databases (MEDLINE,
Physiotherapy Evidence Database (PEDro) and the Cochrane
Library of clinical trials) was complemented by screening
the reference lists of pertinent papers to identify appropriate
studies. We accepted randomized controlled trials that were
written in English, performed in human subjects with COPD
and investigated the effects of functional exercise training in
patients with COPD.
Analysis: Included studies were reviewed by two independent
investigators who assigned a score out of 10 using the
PEDro scale for assessment of study quality.
Results: Of 50 reports, 5 met the study criteria. The mean
PEDro score was 3.8 ± 0.75 (range: 0–5). The results of the
study indicate that exercise training of a functional nature
improves functional performance.
Conclusions: The five analyzed studies showed positive
effects of functional training in improving functional status.
However, results were not always statistically different from
or better than control interventions.
Implications: Larger trials with standardized functional
training methodology and outcome are required to better
understand the optimal functional training regimen for
improving ADL in patients with COPD.
Keywords: COPD; Activities of daily living; Training