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specialism
Department

Rehabilitation Medicine

The department’s mission is to perform excellent research on rehabilitation after acquired brain injury, spinal cord injury and in pediatric patients. The focus is on improving (motor) performance with registry based data-driven precision rehabilitation, physical behaviour monitoring, innovative rehabilitation technology and health-related physical fitness and lifestyle interventions.

About our department

Our research

Rijndam rehabilitation is an important contributing partner for the department in terms of patient recruitment in trials and registries. Further Rijndam is a clinical test center for innovations in care in a Living Labs test environment. The applied research conducted herein focuses on the Technology Readiness Levels 5-9. Rehabilitation Center LIBRA, located both in Tilburg and Eindhoven, also partners in research with our department with a joined catchment area of Rijndam 5 to 6 million subjects. Acquired brain injury, spinal cord injury and pediatric rehabilitation are main clinical topics in these research collaboration.

The presence of the technical University of Delft offers a unique opportunity to collaborate in technical innovations in rehabilitation. In the Medical Delta, a collaboration with the TU Delft and Leiden University MC, the department has leadership in the program management of the “Improving Mobility with Technology” theme and participates in the E-Health theme. Innovative rehabilitation technology is an important focus of the department.

Further, the department’s expertise is relevant for clinical partners such as Xpert Clinic & Handtherapy Netherlands (modelling recovery in a PROMs database of over 60.000 subjects) and Capri Cardiac Rehabilitation (improving physical fitness).

For an overview of our scientific work, please see our  Bi-Annual Scientific Report over the years 2019-2020: https://www.erasmusmc.review/

Principal Investigators

Research Lines

Health-related physical fitness and lifestyle
To build on knowledge regarding health-related physical fitness and lifestyle, we perform research in several patient groups, both ambulatory and wheelchair-dependent and focus on several constructs of health-related physical fitness -such as aerobic capacity, muscle strength, body composition- and on physical behaviour, nutrition, and sleep. We study associations with mobility, participation, quality of life, and health. To understand underlying mechanisms, we include parameters such as exercise self-efficacy, motivation, coping style, and social support. To evaluate the (cost-)effectiveness of fitness programs and lifestyle interventions, we perform pragmatic (randomized) controlled trials, with a focus on maintenance of effects.

Physical behaviour monitoring in chronic conditions
Physical behaviour can be defined as “what people physically do in their daily life” and includes, for example, physical activity, body postures and movements, arm use, sedentary behaviour and sleep. Physical behaviour is often affected in people with chronic conditions, such as stroke and spinal cord injury. This is related to poor fitness and health, fatigue, pain, and lower levels of functioning, participation and quality of life. Technology (e.g. wearables, such as accelerometers) offers the opportunity to measure physical behaviour in a feasible and valid way, by prolonged unsupervised measurements during daily life. Data from these measurements can be used for diagnosis, optimizing or tailoring treatment, monitoring progress and recovery, evaluating treatment, and for being part of treatment by providing direct feedback.

Innovative Rehabilitation Technology
The aim is to develop technology and protocols to better understand the the consequences of disorders of the nervous or locomotor systems and to create technology either assistive or therapeutic to promote high intensity and unsupervised training. Technology can assist and/or challenge the patient in improving his performance by increasing intensity and quality of practice and compensating for function loss. The TU delft is an important partner as well as Rijndam rehabilitation as a clinical test center.

Data-driven precision rehabilitation
Clinical data are often collected in an unstructured way in electronic patients files and as such they are difficult to access for the purpose of quantitative research. Moreover, patient-reported outcome measures are rarely systematically collected and, if so, traditionally collected on paper. In a collaboration with the Departments of Plastic Surgery, Public Health and Rehabilitation Medicine of the Erasmus MC and with the Xpert Clinic, GemsTracker was developed as an open source webbased application to assign measurement tracks to patients. We have the ambition to be leading in data-drive precision medicine for stroke, traumatic brain injury, spinal cord injury, and upper extremity disorders based on the unified vision on data collection and data science.
Comparative effectiveness research with observational data using techniques such as propensity score matching can be used to evaluate the effect of variability while controlling for case-mix. This approach can speed up the cycle of medical innovation and reduce research costs. Routine outcome data of large patient groups collected in a daily clinical setting is suited for clinical prediction modeling in studying determinants of diseases, disease progression and treatment outcomes. Amongst others, we collaborate with Prof Rizopoulos and Dr Andrinopoulou of Biostatistics Erasmus MC to apply the modern concept of dynamic prediction modeling and of joint modeling to our data sets.

Projects

For our projects see the Bi-Annual Scientific Report over the years 2019-2020: https://www.erasmusmc.review/

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ABI-Motion

An implementation project that integrates outpatient rehabilitation and community patient support to improve aftercare for patients with acquired brain injury.

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Activwalks 2.0

The relation between strain of walking and physical behavior in ambulatory people with long-standing spinal cord injury based on objective measurements

Arm coach for stroke

We aim to develop and evaluate an interactive coach, using wearable motion sensors to stimulate and optimize paretic arm use and exercise in the home context.

BACH

BACH

The BACH study aims to investigate fear of movement and participation in physical activity and sport in patients with congenital heart disease.

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Cloudwalker

The overall objective is to provide accessibility to exoskeletons for people with spinal cord injury by developing a lightweight and affordable exoskeleto

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CO-FLOW

The sudden COVID-19 pandemic forced a quick development of aftercare pathways for patients after hospitalization. This was mainly based on expert opinion. To further develop this aftercare, the CO-FLOW project evaluates long-term physical, cognitive and psychological recovery in patients after hospitalization for COVID-19 and satisfaction with the aftercare.

Convergence HMC

Convergence Human Mobility Center

Initiated by partners from TU Delft, Erasmus MC, EUR, Rijndam Rehabilitation and Laurens geriatric rehabilitation, the Convergence Human Mobility Center (CHMC) will enhance the effectiveness and acceptability of user-centered technology-based minimally supervised motor rehabilitation interventions in stroke with equal access for all. This requires integrating expertise in motor learning, sensors and robotics, data science and AI, and biomechanical modelling. In addition, it also requires understanding the complexity of settings and attitudes and beliefs of both clinicians and patients, including vulnerable patients and patients with a low socioeconomic status (SES).

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CO-TRAINER

We study the effectiveness of a computerized training of attention and working memory in Post-COVID-19 patients with cognitive complaints.

KIK

Kinderafasie in Kaart (KIK)

Acquired childhood aphasia (ACA) is a language disorder following acquired brain injury. We have created a national register on ACA, collecting longitudinal data.

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Low Socioeconomic status and eHealth

The project aims at developing and testing a guideline that consists of design principles that enhance alignment of eHealth to people with a low socioeconomic position.

Measuring cognitive load of stroke patients at home

To personalize rehabilitation to the patient’s capabilities, we develop new ways to measure the cognitive load of stroke patients at home.

OPTICARE M/F

The OPTICARE M/F study aims to explore the role of sex and gender differences in the effectiveness of different types of cardiac rehabilitation interventions.

PREPARE NL

This pilot project evaluates the feasibility of a prehabilitation program for patients scheduled for surgery after a diagnosis of liver or head/neck cancer

Towards Home Rehab

The project aims at designing a tailored monitoring and training tool for at-home upper-limb stroke rehabilitation.

Publications

For publications see researchgate profiles of individual researchers.

Vacancies

Rehabilitation medicine aims to enhance and restore functional ability after injury to the brain, peripheral nervous system and locomotor system. As such the department collaborates in research with many departments such as neuroscience (motor learning in stroke), neurology (aphasia, long term outcome of subarachnoid haemorrhage and stroke), neurosurgery and neuro oncology (cognition in patients with low grade glioma, TBI registry), plastic surgery (predicting and improving outcome after hand surgery), cardiology (fitness after myocardial infarction), and biostatistics (prediction modelling). This network is strengthened by being involved in the ACEs Brain Motion (motor learning), Health Care Quality (Value Based Health Care and data science) and Stroke. The presence of the technical University of Delft offers a unique opportunity to collaborate in technical innovations in rehabilitation with Rijndam as clinical test centre.

Science is a team effort and diversity of the scientific staff is considered essential for its viability and innovative capacity. We aim for a mix in terms educational background, age and clinical knowledge. The scientific staff is composed of movement scientists, clinical researchers (one on neurorehabilitation, one on pediatric rehabilitation and one on spinal cord injury and a clinical linguist), an engineer and a clinical epidemiologist. Post docs and PhD students are represented in the scientific staff through a “linking pin construction” and “meet- the-professor sessions”. Talent management from junior to senior staff members is a priority.

News, events and awards

Education