Wednesday 31 May 2023
Pre congress Workshops
Not included in full congress registration. Separate registration required!
There will be 3 different rounds with workshops taking place at the same time. You can therefore attend 1 workshop per round, with a maximum of 3 workshops.
13.00-14.30 | Room 0.5
Intensity Workshop | Beth Clarke & Louise Johnson
Delivering rehabilitation intensity – it starts with us!
Delivering rehabilitation at sufficient “intensity” to optimise outcomes is a key challenge for rehabilitation service providers. There are many ways in which intensity could be increased, for example through different methods of delivery (e.g. groups or tele-rehab), or through the use of technology. Fundamental to any method for increasing rehabilitation intensity is the patient's ability to engage in the process. This workshop will first explore what is meant by the term intensity, and current evidence for intensity in rehabilitation. We will then focus on key concepts that are important for maximising a person’s participation in intensive rehabilitation – with a focus of theories of activation and behavior change. We will discuss the importance of tailored and self-directed rehabilitation, and the changing role of the rehabilitation practitioner as a coach and mentor.
Facilitators: Dr Beth Clark and Dr Louise Johnson - from the Wessex Academy for Skills in Personalised Care (WASP)
13.00-14.30 | Room 0.11
Management of gait impairments after stroke | Jaap Buurke & Jorik Nonnekes
Presenter: Dr. Jorik Nonnekes, Prof. dr. Alexander Geurts, Drs. Jip Kamphuis, Dr. Hanneke van Duijnhoven, Prof. dr. Jaap Buurke, Dr. J. Fleuren
Management of gait impairments after stroke is complex and shows a large variation across nations and institutions. During this interactive workshop, we will first introduce a novel framework detailing the causes of gait impairments after stroke. We then show how this knowledge can contribute to selecting the optimal treatment strategy, involving both training and medical-technical interventions, and obviously taking patient preferences into account. The role of instrumented gait analysis will be discussed and individual examples of treatment results will be given. Learning objectives workshop:
- To gain insight into the underlying causes of gait impairments after stroke
- To gain insight into how clinical tests and instrumented gait analysis can contribute to understand individual gait impairments
- How to select treatment options for gait impairments after stroke.
13.00-14.30 | Room 0.10
B-STARS-rTMS | Rick Dijkhuizen & Jord Vink
Despite improvements in acute stroke therapies and rehabilitation strategies, many stroke patients are left with long-term upper limb motor impairment. A recent RCT and meta-analysis from the UMC Utrecht and Rehabilitation Center De Hoogstraat as well as an international guidelines paper show that contralesional inhibitory rTMS, within the first month post-stroke, can promote upper limb recovery after stroke. During this interactive workshop, we will introduce the background of rTMS treatment, demonstrate rTMS treatment procedures and provide room for people to practice working with TMS.
- Gain insight into the background and working mechanism of rTMS treatment in the promotion of upper limb recovery after stroke
- Learn how to perform rTMS treatment (use neuronavigation, identify motor hotspot, determine resting motor threshold and execute treatment)
- Gain insight into future perspectives of rTMS treatment in promoting upper limb recovery
14.30-14.45 | Lobby
14.45-16.15 | Room 0.5
Developing understanding of Systematic Reviews, Guidelines and Consensus-based Recommendations | Bernhard Elsner & Geert Verheyden
Current developments in the field of systematic reviews, such as (i) the GRADE-approach for grading the evidence strength, (ii) Network Meta-Analysis and (iii) Machine Learning for streamlining the literature search process of systematic reviews are highlighted and examples from neurorehabilitation are provided.
Methodology, results and reflection for two recent consensus-based agreements in the domain of motor rehabilitation after stroke will be presented. In particular, the approach that was applied for developing the definition for motor rehabilitation after stroke as well as for the core set of clinical outcomes for sitting and standing balance and walking will be discussed.
14.45-16.15 | Room 0.4
Contrast 2.0 The assessment protocol | Carel Meskers & Ruud Selles
The Contrast/Impulse- consortium: how a new collaboration with neurologists and radiologists creates opportunities for neurorehabilitation research
Presenters: Dr Marjanka Heijenbrok, Prof dr. G. Kwakkel, Prof dr. Carel Meskers, Prof dr. Ruud Selles, Dr. Sarah Zandviet
This workshop aims to highlight the opportunities that arise from a close collaboration between research in acute and chronic care for neurorehabilitation of stroke patients. The CONTRAST (COllaboration for New TReatments of Acute STroke) is a nationwide Dutch collaboration of academic researchers, private and public partners aiming to improve outcome of patients with stroke by merging translational research and pragmatic randomized clinical trials. Initially, CONTRAST focused acute treatment by improving and optimizing microvascular reperfusion. Recently, the consortium’s scope enlarged to the subacute and chronic phase. In this workshop we will discuss a blueprint for a collaborative comprehensive research effort to optimize and improve long term outcome of stroke patients adopting a seamless progression from acute to chronic care. Topics involve:
- From acute to chronic care: Introducing the contrast consortium
- Theoretical background: from recovery to participation
- Long term follow-up and health care consumption: the contrast minimal assessment battery
- Understanding neurological recovery and prediction of outcome: the contrast extended assessment battery
- Contrast’s Infrastructure and health economics (Lahr/Buskers)
- Discussion and participants input for the study protocols
14.45-16.15 | Room 0.10
Measurement of Cognition | Caroline van Heugten & Fleur Domensino
After an acquired brain injury, many people have cognitive impairments which can persist into the long term. Cognitive functioning can be measured on many different levels of functioning. How cognition is measured depends on the purpose of the assessment. Cognitive screening should be done to detect cognitive deficits at an early stage which will give information for further diagnostic assessment and treatment planning. In a diagnostic setting, the focus will be on detecting neurological dysfunction and guiding the differential diagnosis, and identifying the cognitive strengths and weaknesses. In addition to cognitive testing, information from the medical history, the intake, hetero-anamnesis, observations and questionnaires are used. In a rehabilitation setting,, it is important to gather information on the influence of cognitive functioning in daily life. For this purpose many different assessment techniques are available which can be discussed on a continuum from test situation to daily life experiences. In this workshop, the difference purposes and methods of measuring cognition will be considered in an interactive discussion with the participants based on their own practice.
14.45-16.15 | Room 0.11
Functional electrical stimulation clinical practice guidelines to support walking in upper motor neuron conditions | Tamsyn Street
Presenters: Dr. Tamsyn Street, MSc. Adine Adonis, Prof. dr. Jane Burridge
Functional electrical stimulation (FES) has been used for over 25 years in clinical practice to support mobility for people with an upper motor neuron diagnosis such as multiple sclerosis and stroke. Despite increasingly becoming a standard treatment, until recently there have been no established clinical practice guidelines (CPG) to support delivery of treatment. Recently, clinical practice guidelines have been developed to support walking for all upper motor neuron conditions. The objectives of the workshop are to:
- Describe how the recently developed FES CPG were developed and what they recommend.
- Understand how the recommendations may have an impact on clinical practice.
- Identify and understand potential barriers to implementing CPGs as well as strategies for overcoming potential barriers through shared experience and learning.
- Share experience CPG implementation and critically evaluate for future best practice.
16.15-16.30 | Lobby
16.30-18.00 | Room 0.11
High Intensity Training and Physical Fitness Training for PD | Erwin van Wegen & Karlijn Musch
This workshop focuses on the use of high intensity interval training (HIIT) as a potentially effective intervention in people with Parkinson's disease. There is growing evidence that HIIT can lead to improved motor and non-motor function, cardiovascular health and quality of life in people with Parkinson's.
The workshop starts with an introduction of the rationale behind the use of HIIT in Parkinson's disease. Subsequently, it is discussed how exercise testing can be used to determine individual training intensity and how training protocols can be adapted to the individual needs of the participants.
The emphasis is on developing a safe and effective exercise program, teaching participants how to adjust exercise intensity based on individual symptoms and how to monitor exercise progression.
Other topics covered are the measurement of effects of HIIT on motor and non-motor function, balance, strength and endurance in people with Parkinson's. Participants will gain insight into the latest research findings on HIIT in Parkinson's and how these findings can be applied in practice.
Finally, attention is paid to the role of the therapist in guiding patients in HIIT. This includes aspects such as monitoring training intensity, adapting training protocols to individual needs and supporting participants in achieving their goals.
All in all, this workshop provides therapists and researchers with a practical and scientifically based overview of the use of HIIT in people with Parkinson's disease.
16.30-18.00 | Room 0.10
Virtual reality in neurorehabilitation: entertainment or treatment? | Eva Swinnen & Anke van Bladel & Iris Brunner
This workshop aims to explore:
- different virtual reality options for gait and upper limb rehabilitation in neurological populations.
- the advantages but also the pitfalls of using virtual reality for rehabilitation in neurological populations.
- the literature gaps concerning the use of virtual reality for gait rehabilitation in neurological populations.
- recent data concerning the influence of different modalities (i.e. level of immersion and optic flow speed) on the movement pattern of stroke survivors.
- recent data concerning the use of VR for unilateral spatial neglect and upper limb motor training in stroke survivors
- case studies of using virtual reality in stroke survivors, patients with brain injuries and patients with an incomplete spinal cord injury.