Wendy Grevink, auteur op RRD

First PhD defence of 2024 by Kira Oberschmidt about guidelines for active involvement of stakeholders in eHealth Action Research!

Written by: Marian Hurmuz

Last Friday, the first RRD PhD defence of 2024 took place! Kira Oberschmidt defended her PhD thesis, titled: “Who, When, How: Guiding the active involvement of stakeholders in eHealth Action Research”. Action Research (AR) is a collaborative research approach in which stakeholders play an active role as co-researchers. AR fits the context of eHealth research well, as its key elements can hopefully ensure a better match between the technology being developed or implemented and the needs of relevant stakeholders. Ideally, stakeholders should take on a very active role and shape the research. However, oftentimes, neither the researcher nor the stakeholders are used to working in this way. Therefore, support is needed in terms of sharing knowledge, best practices and lessons learned between projects. Yet, in AR publications explicit reflection and description of these lessons learned is often missing. This makes it difficult for AR projects to learn from each other. Kira has dedicated her PhD to provide guidance for researchers setting up their project, and specifically to support the active involvement of stakeholders. She developed a framework on stakeholder involvement in eHealth AR projects. On Friday the 19th of January (2024), she defended her thesis, which you can find here.

Kira’s thesis covers the following topics:

Reviewing literature to identify what is currently known about AR in eHealth projects (context of these projects, definition of AR, how to conduct AR, best practices and lessons learned from AR in eHealth projects).
Studying novice action researchers’ attitude towards AR.
Investigating how champions see their role and whether this changes over the course of AR projects.
Investigating the motivation of stakeholders participation in long-term, time-consuming research projects like AR.
Identifying how to involve participants unplanned and spontaneously.
Studying the alignment of interests and needs of different stakeholders in a project, in terms of what they want to achieve from the project.
Providing a structured way for researchers to reflect together with project partners
Investigating the important elements of stakeholder skill training to enable them to be involved and to enable them to interact with each other.
Describing an iterative method to involve patients, their perspectives and lived experiences in research

Taking into account all the recommendations made in her thesis, Kira developed a framework for stakeholder engagement in eHealth AO projects. This framework describes important issues to consider in such a project. Her framework is available on our website: https://www.rrd.nl/ar-framework/

We are very proud of Kira and her hard work at RRD! And we are happy that Kira continues working at RRD for the next steps in her career!

01/23/2024

PhD defence of Martin Tenniglo: Stiff Knee Gait in Stroke!

Written by: Marian Hurmuz

Last week, the last RRD PhD defence of 2023 took place! Martin Tenniglo defended his PhD thesis, titled: “Stiff knee gait in stroke: Walking down the road of different treatment options”. Stroke survivors often struggle with functional consequences: cognitive, emotional, sensory and motor impairments. These functional consequences lead to limitations in daily life. Of which a common problem is stiff knee gait. Many times, this problem arises due to abnormal activity of the rectus femoris during the swing phase. Two options are available for assessing this abnormal activity. But are these also suitable in this group of people? There are also several treatment options to reduce stiff knee gait. But how effective are these? Martin has dedicated his PhD to this topic. On Thursday the 7th of December (2023), he defended his thesis, which you can find here.

Martin's thesis covers the following topics:

Identifying the effect of Motor Branch Block (MBB) or NeuroMuscular Block (NMB) of the rectus femoris on knee kinematics and functional outcomes.
Identifying the diagnostic value of the Duncan Ely test in predicting abnormal rectus femoris activity in people after stroke who walk with a stiff knee.
Investigating the effect of functional electrical stimulation of the hamstrings in stroke survivors with a stiff knee gait.
Investigating the effect of Botulinum toxin injection in the rectus femoris in stroke survivors with a stiff knee gait.
Investigating the effect of rectus femoris transfer in stroke survivors with a stiff knee gait.

Martin ends his thesis with 6 key messages he wants to share with the clinic and that can be applied in the clinical setting. He also indicates where the focus should be on future research related to this topic.

We are very proud of Martin and his hard work! His research has meant a lot to both science and the clinic. The three different treatment options he studies are also applied at Roessingh, Centre for Rehabilitation. Martin continues his work as a physiotherapist, gait specialist and as a specialist in electrical stimulation. Amongst others, he works on the development of a knee flexion device and on the investigation of the effect of a chemodenervation in the vastii and rectus femoris. We wish him the best of luck in his career!

12/14/2023

SenSeeAct is now open-source: allowing digital health developers to benefit from and build on top of our software platform

Written by: Dennis Hofs

We have just released the first open-source version of SenSeeAct, our software platform that has driven many of our research projects and applications for more than ten years. During that time the platform has gone through several iterations, growing into a mature, flexible and secure backend with web portals and mobile apps.

The name SenSeeAct reflects the functionalities that the platform focuses on.

Sense: Collecting data through questionnaires, diaries, wearables, and smart home devices.

See: Presenting the data in user-friendly ways to both end users and health care professionals.

Act: Coaching users toward healthier behaviour with virtual agents, video exercises and gamification.

We now published the SenSeeAct backend as open-source software to help stimulate health technology innovation and collaboration. It facilitates the development of new applications by third parties, and enables organizations to take full control of their data ownership and access.

We are continuously improving the platform. Some of the new features that we anticipate in the near future are:

Enhanced support to author your own questionnaires and use them in our mobile app with your own backend.
Improved security with two-factor authentication.
A web interface to download your data or the data of your research participants.
A major update of our iOS app bringing it to the same level as the Android app.
Extending our earlier announced collaboration with DialogueBranch toolkit by Fruit Tree Labs.
More documentation and guides to help you get started with the open-source backend.

Read more about it at https://www.senseeact.com/?lng=nl

Dennis Hofs

Email: d.hofs@rrd.nl

Tel: 088 087 5763

11/16/2023

Major research starts to tackle osteoarthritis on a tailor-made basis

By 2040, osteoarthritis is likely to be the most common chronic disease in the Netherlands. Currently, almost 1.5 million people in our country have osteoarthritis. The nature and extent of the symptoms may vary, but they always have an impact on people’s daily life. Osteoarthritis progresses differently for everyone, which requires tailor-made treatment. In order to be able to offer this as good as possible, insight is needed into the characteristics of the person and the disease process. Until now, that insight has been lacking. But this is about to change thanks to the funded research efforts of a unique partnership.

In November, researchers from the Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) will start with the TopTreat project. They will follow 500 people with osteoarthritis over the next five years and will comprehensively map their characteristics. The aim is to gain insight into who qualifies for which treatment. The reason for this is because universal treatment is not effective for everyone due to the fact that the diversity among people with osteoarthritis is quite large.

Measuring and knowing precisely with a unique technology platform

This is the first time that the various manifestations of osteoarthritis are being measured with advanced technology and collected in a platform. The aim is to map extremely accurately how people with osteoarthritis feel, how they move, how their disease develops and which medicine is most effective for whom. Because physical, psychological and social factors all play a role in health, researchers are looking at the whole spectrum, from cell to well-being, and are conducting the study in consultation with the patients themselves. The insights from the study make it possible to optimally tailor treatment to the person with osteoarthritis.

The promise of improvement

The research includes existing technologies such as 'joint-on-a-chip', accurate measurements of substances in the body that are indicative of the disease (biomarkers), analysis of movement with sensors, and making computer models of joint movement and load on cartilage. In doing so, the researchers aim to understand and capture specific characteristics of people with osteoarthritis. Based on these insights, practitioners can determine the most promising treatment for their patient.

Broad inclusion

Besides people with advanced osteoarthritis, two groups with an increased risk of osteoarthritis formation will also participate in the study. These are people with a broken or removed meniscus or with a leg amputation.

Moving forward together

TopTreat has a significant relevance for the progress of care of people with osteoarthritis. Moreover, the project is expected to develop a technology platform that is patent-worthy, and can be quickly translated into more healthcare applications. With this ambitious project, ICMS aims to maximise clinical and societal progress.

About ICMS

The Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) is a unique partnership between RadboudUMC, Sint Maartenskliniek, Roessingh Research and Development and the TechMed Centre of the University of Twente. In TopTreat, these partners work together with ReumaNederland, the companies ATRO Medical and Moveshelf, the Rheumatism Foundation Sint Maartenskliniek, the Twente Graduate School and the Dutch Ministry of Defence. Together with funding from the Top Consortium for Knowledge and Innovation High-tech Systems & Materials, the project involves about EUR 4.8 million.

11/01/2023

Roessingh Research and Development and Fruit Tree Labs announce formal collaboration

Summary:

Roessingh Research and Development, Impact Lab for Personalised Health Technology in the Netherlands and Fruit Tree Labs, a Portuguese start-up focused on open-source dialogue technology sign a partnership agreement.
The agreement formalizes years of existing friendly relations between the two parties.
Collaboration paves the way for a deeper integration of two important software platforms: SenSeeAct, the general-purpose eHealth platform by RRD and DialogueBranch, the dialogue-scripting platform by FTL.

The fourth quarter of 2023 begins with the happy news of an official collaboration between Roessingh Research and Development and Fruit Tree Labs.

Roessingh Research and Development (RRD) is an Impact Lab for Personalized Health Technology, based in the eastern part of the Netherlands, with close connections to the University of Twente and Roessingh Center for Rehabilitation. RRD provides scientific research on innovative healthcare technology with a focus on the end user. For RRD, co-creation with end users and stakeholders is essential to ensure the innovation meets user needs and fits into the healthcare context.

Fruit Tree Labs (FTL) is a start-up, founded early in 2023 in the Lisbon Metropolitan Area, focused on dialogue-driven interaction. The core product of FTL is a free and open-source dialogue platform that gives complete freedom and creative control to author-scripted conversations between users and virtual agents in serious web- or mobile application contexts.

CEO and Co-Founder of Fruit Tree Labs, Harm op den Akker has started his career working for RRD, obtaining his PhD degree through the University of Twente, and moving into a Senior Researcher position, strengthening the HCI-focused research at RRD between 2013 and 2021. Since then, relations have always remained warm, and collaborations continued through the co-development of open-source software. With the official collaboration agreement that is now in place, these friendly relations are now formalized in a long-lasting partnership.

For both parties, the partnership agreement comes at an exciting and fun time, as both RRD and FTL embark on new adventures in the open-source software community. RRD is in the process of publicly releasing its eHealth platform "SenSeeAct", allowing digital health developers to benefit from and build on top of a highly professional and stable software platform. At the same time, FTL recently launched the DialogueBranch platform made public (fully open-source and MIT licensed) and is looking for new partners and collaboration and funding opportunities.

With the new agreement in place, both parties commit to integrating these two open software platforms, strengthening the offering from both sides and opening new opportunities for potential users of either platform. Are you looking for a stable, highly customizable Digital Health platform, with integrated virtual agent capabilities? The combination of SenSeeAct and DialogueBranch might just be the thing for you!

10/10/2023

Involving your end-users: how important is this?

Written by: Marian Hurmuz

Involving your end-users is getting more and more important in research. Also in the field of health research there is a need for a human centered focus. You can incorporate this by integrating social sciences and humanities (SSH) in your research! At RRD, our research focuses on the end-users. In this news article, I will tell why it is important to involve end-users and give an example of what we do to improve our relationships with our end-users.

Engagement of stakeholders

Through continuous engagement with end-users and other important stakeholders, we can learn a lot from their experiences regarding the topic we are studying. It is important to involve these stakeholders as soon as possible in your research. By engaging with them, you are able to take into account their actual needs and wishes and the processes in which the health technology will be used. It is very unpleasant to develop a great solution, which does not fit those needs or processes. Besides, the unpleasant feeling, it is of course also a waste of scarce resources.

The knowledge you gather in the early stage of your research, helps you to identify how to incorporate the health technology in the best way possible into the daily lives of the end-users and healthcare organisations. It is important to test and evaluate this with end-users to see whether you translated their needs correctly or changes are needed. This will help you to come to sustainable implementation of your health technology.

Giving something back to your stakeholders

Feedback is of course not a one-way pathway. When you want to build a relationship with your end-users or other stakeholders, you need to frequently interact with them. It is important that they do not forget about you and your research. Furthermore, they also need to feel that they are valuable to you. One of things we do at RRD to give them this feeling, is to share our early results of the studies with them. We noticed that they really appreciated this! It also led to some unprompted feedback if something is lacking in the results or interpreted wrongly.

When you share your findings with your stakeholders, you do not only ask for information from them, but you also give something back to them! This can encourage stakeholders to be actively involved in your research and more willing to help you out during your research.

For example, within the RE-SAMPLE project (Horizon grant no 965315), we have created feedback videos sharing our initial findings. As an example you will find one of these videos below.

Would you like to see this video in Dutch? Click on the following link: https://www.youtube.com/watch?v=IZQ9FWMFVSw

Are you struggling with integrating social sciences and humanities (SSH) in your research? We are always open to have a talk to help you out!

Marian Hurmuz

Email: m.hurmuz@rrd.nl

Tel: 088 087 5771

10/05/2023

Festive farewell to prof. dr. Jaap Buurke

Last week on September 7, we said goodbye to prof. dr. Jaap Buurke, together with family, friends and (former) colleagues from the field.

After working at RRD for more than 30 years, we ushered the retirement of Jaap Buurke. Jaap started his career on September 19th, 1983 as a conscientious objector within Roessingh, centre for Rehabilitation. After completing his conscientious objector period, Jaap started working as a physiotherapist at the rehabilitation centre on May 1st, 1985. Two years later, Jaap started working in the Research & Innovation Department for 18 hours a week. For a long time, he combined his career as a physiotherapist with work as a researcher at RRD.

In 2005, Jaap obtained his PhD on research into the recovery of walking after a stroke. This research formed an important basis for the introduction of neurorehabilitation principles in the Netherlands and the start of successful courses in gait image analysis that are still provided by RRD and Roessingh, Centre for Rehabilitation. On 1 May 2008, Jaap made the full transition to RRD and became a senior researcher there and had a bridging function with the rehabilitation centre. A year later, he became cluster manager and has been a manager within RRD for many years.

In many (inter)national research projects, Jaap focused on further developing rehabilitation technology and gait analysis. He combined these tasks with a position as professor at the University of Twente (UT) in the field of movement analysis and technology. From this position, he supervised many researchers in their PhD trajectories. In addition to his work at RRD and UT, Jaap's positions included adjunct professor at North Western University in Chicago, medical scientific director of IMDI SPRINT, board member of SMALLL and president of the Dutch association for Neurorehabilitation "Keypoint".

Jaap has marked his retirement from RRD, but he will continue to be involved in various courses in gait image analysis in the coming year.

09/12/2023

Interested in a database full of IMU and EMG data? We present the RRD MyPredict database

Written by: Erik Prinsen

Over the past five years, Roessingh Research and Development (RRD) participated in the H2020 MyLeg project (http://www.myleg.eu), coordinated by Raffaella Carloni from the University of Groningen. Within this project, RRD was responsible for the high-level control of a to be developed powered transfemoral prosthesis. The ultimate goal of the project was to create a smart and intuitive prosthesis that was compatible with osseointegration. In adherence to the FAIR principles, all data that was gathered on individuals without an amputation have now been published as open access. We also published an open access article that describes the data which can be found here: https://www.nature.com/articles/s41597-023-02341-6. In this article we explain what we did, what the database is and where it can be found.

Intent recognition using EMG

Surface electromyography (sEMG) is a non-invasive technique that could provide meaningful information for human motor intent recognition. Motor intent is the determination to move or change the state one is in. For instance, when we are approaching a staircase, we adapt our steps in such a way that we position our feet perfectly to ascent the steps. This intent can be captured using the signals that command our muscles to contract, precisely what sEMG records and analyzes.

The need for a lot of data

There are downsides to sEMG as well. sEMG suffers from confounding factors such as muscle fatigue, electrode placement differences and intra-subject variability. This means that a control schema that utilizes sEMG could work on one day, but could yield poor results on the next day. Therefore, a lot of data is necessary to capture the variability of sEMG between subjects and between days to develop robust human motor intent recognition systems. Furthermore, detecting the change from one activity to another is harder than detecting a continuation of the activity. Therefore it is necessary to have databases that are rich in these transitions so that algorithms can be trained properly.

The RRD MyPredict database

In the past three years we have collected the Roessingh Research & Development-MyLeg Database for activity prediction (MyPredict), containing data from 55 subjects in 85 measurement sessions. These subjects performed all kinds of gait-related activities, including regular walking, traversing uneven terrains like grass, and climbing stairs, while transitioning freely from one activity to the next. During these measurements we collected kinematics and sEMG in various forms, using traditional bipolar sEMG as well as 64 channel multi-array sEMG.

The data it contains

We have made use of wearable measurement systems, enabling us to measure easily inside the laboratory, but also outside. In this way we have a rich dataset containing gait activities in various settings. Next to that, we have measured 10 subjects on four different days in the span of one week. These measurements enables researchers to explore the impact of time and electrode placement on intent recognition systems, a critical aspect in improving the robustness and adaptability of these systems.

Data validation

An essential validation step involved comparing the MyPredict database with other publicly available datasets. The results of this comparison demonstrated excellent correlation, confirming the reliability and quality of the MyPredict database. In this way we have shown that this database can be a valuable resource to the research community.

What it can be used for

The MyPredict database provides an opportunity for researchers to delve into sEMG data and develop and refine intent recognition systems. This comprehensive dataset offers a foundation for further studies in the field of human motor intent recognition. Researchers can explore innovative algorithms, machine learning techniques, and signal processing methodologies to unlock the full potential of sEMG data. Ultimately, it is the goal to develop practical applications that utilize sEMG signals to enrich human-machine interactions.

Where to find it

The database is accessible via this link: https://doi.org/10.4121/20418720. Data collection was supported by the European Union's Horizon 2020 Research and Innovation Programme grant number 780871.

Erik Prinsen

Email: e.prinsen@rrd.nl

Tel: 088 087 5761

07/25/2023

STRIDER: new project to improve mobility of stroke survivors

Written by: Christiane Grünloh

We are excited to announce that we started a new project together with two partners: Elitac Wearables (Utrecht, The Netherlands) and cereneo foundation (Vitznau, Switzerland).

What is our goal and why is this important?

Worldwide, we have 80 million stroke survivors and every year 14 million people are experiencing a stroke. This often comes with movement impairment and a lack of balance confidence, which are addressed during the rehabilitation. We want to support this rehabilitation and the transition from in-patient rehabilitation to home by building a wearable that gives haptic feedback (for example, a vibration) to the stroke survivor while walking. This feedback will improve their gait and balance confidence already during and also after rehabilitation. We want to help stroke survivors stay confident and active also after being discharged from rehabilitation.

How do we do it?

As always at RRD, the people are central to everything we do. Stroke survivors are experts when it comes to living with the consequences of stroke. The design of a feedback device needs to be informed by what stroke survivors need, what works for them and what does not. Therefore, we will carry out workshops and interviews with stroke survivors both in the Netherlands and in Switzerland by our partner cereneo. In addition, we will also interview healthcare professionals, to ensure that STRIDER is well aligned with their work practices and the patient journey, going from rehabilitation centre back home. The technology will be developed in iterations, and we will test early version with stroke survivors to learn quickly, if we get it right and what needs to improve. At the end, we will carry out a study to show that STRIDER indeed improves gait and balance confidence.

Where are we in the project?

The project has a duration of 2 years and we started about two months ago in the beginning of May 2023. We are currently carrying out the first workshops with stroke survivors in the Netherlands and Switzerland. More workshops will follow and during the summer we will conduct interviews with stroke survivors and healthcare professionals.

Are you a stroke survivor and interested in this project? Either because you want to be informed or because you want to be interviewed by us? You can always contact us!

Tijdlijn onderzoeken strider project - 20230718 Dutch

Christiane Grünloh

Email: c.grunloh@rrd.nl

Tel: 088 087 5723

Marian Hurmuz

Email: m.hurmuz@rrd.nl

Tel: 088 087 5771

07/20/2023

In-depth course Gait Image Analysis

Written by: Corien Nikamp

Over the past few months, we have, together with colleagues from Nijmegen (Sint Maartenskliniek, Loop Expertise Centrum Nijmegen), been working hard on a new course for everyone who wants to take an extra step in the field of gait image analysis! Do you work in or frequently refer to a gait imaging lab and would you like to gain more knowledge and skills in terms of performing, analysing and understanding the results? Then this in-depth course might be suitable for you!

In January 2024, we will start the in-depth course Gait Image Analysis. During this course, there will be ample opportunity to apply theory directly in practice in the form of active work forms. To participate in the course, you must have attended the course “Movement Analysis in Adults”, at Roessingh Research and Development, or a similar basic course elsewhere.

Would you like to read more about this course or participate? Click here to go the website. Registration will open soon!

20230718 Flyer Verdiepingscursus gangbeeldanalyse 2024 (1)

Corien Nikamp

Email: c.nikamp@rrd.nl

Tel: 088 087 5762

07/18/2023