Research Nathalie Roussel

Abstract

Introduction Chronic low back pain (CLBP) is one of the most common chronic musculoskeletal disorders worldwide, responsible for the highest levels of disability. All state-of-the-art guidelines recommend implementing exercise therapy (ET) in CLBP management. However, more research is needed to investigate specific modalities of ET and their underlying mechanisms as this can optimize treatment effects. Our research group has shown that high intensity training (HIT) can be a valuable method to improve the effect sizes of ET in persons with severely disabling CLBP (PwCLBP). By adding technology, the adherence to HIT could be increased, encouraging PwCLBP to keep performing their exercises and prolong the rehabilitation process. Methods Conform Good Clinical Practice (GCP) regulations, a double blind (outcome assessor and statistical analysis) three-armed multicenter randomized controlled trial will be conducted, in which 168 PwCLBP will be randomized into 3 groups. Patients with cLBP who present themselves at UZA/Jesse for consultation and start-up of a rehabilitation program, who meet the inclusion criteria, will be informed about this study by the physician. If they are interestes, an approval form will be issued and signed, followed by providing the informed consent form. Patients who sign and return the informed consent within 2 weeks will be contacted for possible enrolment. All 3 groups start with a biopsychosocial education program (BPS)(4 sessions), followed by ET at the hospital for 12 weeks (12x/week). Groups 1 and 2 will receive HIT training, group 3 will receive Moderate IT (MIT) training. Then, a 12-week ET program (2x/week) at home will be continued, in which group 1 will be supported by an app (TECH-HIT: technology supported). Short- (after 12 and 24 weeks of training) and long-term (6 and 18 months after cessation of training) effects of HIT are evaluated. The primary outcome measure will be functional disability, assessed by the Modified Oswestry Disability Index (MODI). Objectives The primary goal is to evaluate the short- and long-term effectiveness of a time contingent individualized HIT protocol on disability compared to moderate intensity training (MIT) as used in usual care, in persons with severely disabling CLBP. Secondary goals entail 1) evaluating short- and long-term effectiveness of HIT on psychosocial correlates, central pain processing, and physical fitness, 2) investigating additional effects of (prolonged) HIT at home, 3) investigating added value of technology through a mobile application that offers support during home training, 4) evaluating cost-effectiveness of (technology supported) HIT compared to MIT. Process evaluation This study will start recruitment in February 2024 and have an active intervention phase of three years. The end of the recruitment phase is therefore planned around January 2027. After the recruitment phase, a period of six months is reserved for final data analysis and scientific publication writing. Data analysis will be performed with JMP Pro. For the primary objective, descriptive statistics will be performed to determine the different outcome measures for each group, and finally linear multiple regression analyses will be performed to determine associations between disability and pain processing. Conclusion This project will provide valuable insights into efficacy of HIT through a high-quality clinical evaluation study in a larger spectrum of PwCLBP in a rehabilitation center setting. The added use of technology might support HIT by encouraging PwCLBP to keep performing their exercises and prolong the rehabilitation process and retain long-term positive effects.

Researcher(s)

• Promoter: Roussel Nathalie
• Co-promoter: Meeus Mira

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

This project represents a research contract awarded by the University of Antwerp. The supervisor provides the Antwerp University research mentioned in the title of the project under the conditions stipulated by the university.

Researcher(s)

• Promoter: Roussel Nathalie
• Promoter: Truijen Steven

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Telerehabilitation and eHealth, albeit providing novel opportunities and advantages for rehabilitation and physiotherapy programs, still pose many challenges at societal, technological and individual levels. With this postdoc challenge we aim to recruit a candidate proficient in tackling these challenges at least at one of three levels: 1) societal: providing evidence of (cost-)effectiveness of telerehabilitation and eHealth in physiotherapy through large-scale intervention trials; 2) technological: advancing the technical level of eHealth in physiotherapy by research on technology and the inclusion of artificial intelligence (AI) for using collected patient data in clinical decision making; 3) individual: monitoring and/or alleviating barriers by researching emotions, cognitions, and behavior in different contexts to explain differences in outcome. By using innovative recruitment strategies (including triggering recruitment videos, and organization of a hackathon), MOVANT aims to recruit a high potential postdoc candidate to apply for an FWO postdoctoral fellowship and/or an MSCA-PF. The candidate will be supported by a promotor and a mentor team, consisting of several ZAP colleagues and the MOVANT research coordinator.

Researcher(s)

• Promoter: Meeus Mira
• Co-promoter: Gebruers Nick
• Co-promoter: Roussel Nathalie
• Fellow: Embrechts Elissa

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Le défi principal relevé par NOMADe sera d'améliorer la qualité des solutions préventives ou curatives proposées aux populations dans la zone transfrontalière France-Wallonie-Vlaanderen (FWVL) en réduisant l'écart existant actuellement entre les connaissances scientifiques émanant des laboratoires scientifiques et universités et les acteurs de terrain impliqués dans les TNMS. Il s'agit d'assurer le transfert entre les connaissances et bonnes pratiques cliniques théoriques émanant de l'evidence-based-practice (EBP) et de l'evidence-based-medecine (EBM) vers les acteurs de terrain avec pour objectif d'un bénéfice de santé pour les populations. La solution proposée pour réduire cet écart passera par le développement d'un écosystème - ensemble d'entités interagissant dans un environnement donné - spécialisé dans les TNMS et structuré autour de quatre pôles: e-learning, R&D, expertise et validation. Le pôle e-learning consistera en une plateforme d'apprentissage en ligne qui permettra: (1) de mieux former les différents acteurs de terrain et (2) de faciliter les interactions et la communication entre les acteurs de terrain et les populations (patients). Le pôle R&D développera des "intelligent devices" standardisés d'évaluation, de monitoring ou de revalidation des populations. Le pôle d'expertise biopsychosociale permettra de garantir une approche complète du problème de santé des populations et de mettre en place des essais cliniques incluant des populations des 3 versants, en respectant les aspects éthiques régionaux. Le pôle validation s'intéressera autant aux contenus de la plateforme d'apprentissage qu'aux dispositifs numériques. La coopération transfrontalière entre les partenaires réunis par NOMADe apportera une importante plus-value aux approches existant actuellement sur les 3 versants car ces derniers possèdent des expertises mono-disciplinaires fortes et complémentaires mais non coordonnées. L'écosystème aura pour objectif de les fédérer. Le projet NOMADe ambitionne donc d'améliorer les conditions de vie des populations de la zone transfrontalière FWVl, via une amélioration et une mutualisation de la formation/éducation et des équipements disponibles pour les acteurs de terrain. Les résultats collectés dans le cadre du projet alimenteront également des campagnes de sensibilisation à destination de la population souffrant de TNMS.

Researcher(s)

• Promoter: Roussel Nathalie

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Hemophilia is a genetic disorder characterized by recurrent bleedings in synovial joints. Thanks to tremendous scientific progress, patients with hemophilia (PwH) have a life expectancy that is comparable to the general population. However, the majority of adult PwH suffer from extremely intense and invalidating joint pain. Although the complexity of joint pain has been studied in other chronic joint pain conditions, there is an immense lack of studies examining pain in PwH. Current studies have not sufficiently focused on pain as primary outcome and thus lack valid and thorough assessments of prevalence and extent of pain, life impact and nociceptive processing. Moreover, pain is not yet studied within a biopsychosocial perspective and the role of beliefs, emotions and behavior is thus unexplored. Especially interactions between pain and beliefs, emotions and behavior are wasteland, since longitudinal studies are necessary to explore the bidirectional relations. Therefore the main aim of the current proposal is to gain more insights in joint pain in PwH enabling us to move towards an adequate pain management within this patient population. As the majority of studies in other chronic joint pain conditions has shown that the biopsychosocial perspective is crucial in pain management, we will use a consensus-based set of outcome measures that should be evaluated in patients with chronic joint pain. The primary objective is to examine pain characteristics (prevalence, intensity and extent) and life impact of pain (impact on physical functioning and quality of life) using validated outcome measures in an unselected and representative sample of adult PwH. As secondary objective we want to assess peripheral and central nociceptive processing in PwH, and examine the relationship with joint status to gain more insight in the pathophysiology of joint pain in PwH. The third objective is to record fluctuations and interrelations in pain intensity, intake of medication and physical activity to gain more insight in the relation between pain intensity and pain behavior in PwH. We will examine whether beliefs and emotions are predictive of pain behavior. The insights gathered with the current research proposal will lead to more comprehensive biopsychosocial pain assessments of PwH both in further research and in clinical practice. These ameliorated assessments unravelling contributors to chronic pain in this populations, will serve as base to steer interventions for the management of joint pain, accounting for nociceptive processing profiles and specific beliefs, emotions and behavior. We expect that proper pain management strategies will be more effective and less costly, resulting in enhanced quality of life and increased social participation for PwH.

Researcher(s)

• Promoter: Roussel Nathalie
• Co-promoter: Meeus Mira
• Fellow: Foubert Anthe

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Hemophilia is a genetic disorder characterized by recurrent bleedings in synovial joints. In many patients this leads to haemophilic athropathies, even at young ages. Unsurprisingly, the majority of adult PwH suffer from invalidating joint pain. Despite the high prevalence of pain in PwH pain assessment is not well developed and strongly differs between haemophilia treatment centers. Moreover, up to 39% of PwH report their pain is not well treated. This underscores the urgent need to improve both pain assessment and management in PwH. Ankle and knee are the most affected weight-bearing joints in PwH. Nowadays, knee arthropathy in PwH is better managed. However, this is not the case for ankle arthropathy, and many PwH have to deal with debilitating ankle pain. Studies examining ankle joint pain in PwH from a broad biopsychosocial framework are absolutely lacking, which contrasts to the bulk of literature in other musculoskeletal pain conditions Joint assessment in patients with chronic conditions should be performed according to the International Classification of Functioning, Disability and Health (ICF), the framework proposed by the World Health Organization (WHO) in which human functioning is described in terms of body structures & functions, activities & participation and contextual factors. The latter are personal or environmental factors that may act as barrier or facilitator of functioning. The aim of the current research proposal is to understand the complexity of ankle pain in PwH. This will allow to better asses and manage pain in order to achieve optimal functioning.

Researcher(s)

• Promoter: Roussel Nathalie

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Both modern and classical dance are characterized by a large number of injuries caused by overload. This overload is defined as "an increase in training load resulting in a decrease in performance". Overtraining in combination with poor nutrition can lead to menstrual irregularities, which can adversely affect reproductive functions and bone mass. The combination of reduced energy availability, menstrual irregularities and reduced bone mass was called the "Female Athlete Triad (FAT)". In 2014, the International Olympic Committee (IOC) introduced the term Relative Energy Dysfunction in Sport (RED-S). It replaced the term and the syndrome that was previously called "Female Athlete Triad", which indicated the combination and interaction of a disturbed diet, irregular menstruation and reduced bone density in sports women. Recent scientific insights had made it clear that the term "Female Athlete Triad" was no longer appropriate. The RED-S syndrome refers to 'reduced physiological functioning caused by a relative energy deficiency and includes, but is not limited to, disorders of (1) metabolism, (2) menstruation, (3) bone health, (4) immunity, (5) protein synthesis and (6) cardiovascular health. However, there is a lack of studies to this day that study the interrelationships between the various conditions. Low energy availability (LEA, low energy availability) is the main cause of this complex syndrome. It is not so much a disturbed eating pattern as a disturbed energy balance that is at the root of this problem. This has an impact on many more processes in the body than was initially thought. It also not only affects women, but can also occur in male athletes. The main objective of this study is "to unravel energy metabolic aspects of RED-S in elite adolescent and adult dancers and to study the relationship with menstrual irregularities, bone quality and complaints."

Researcher(s)

• Promoter: van Breda Eric
• Co-promoter: Roussel Nathalie

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

The general purpose of this study is to elucidate psychological and social risk factors for low back pain (LBP) in highly physically active adolescents. Using a qualitative research design, we will explore perceived causes (psychological and social) of LBP using female pre-professional dancers as a case study. This will lay the foundation for fundamental prospective studies examining causes of LBP in adolescents. Low back pain (LBP) is the leading cause of disability worldwide. The prevalence of LBP rapidly increases during adolescence, especially in females. The multidimensional nature (including biological, psychological and social factors) of LBP is widely recognized in adults, but has, despite the fact that LBP during adolescence is a risk factor for spinal pain in adulthood, rarely been investigated in adolescents. Elite adolescent dancers are a model population to unravel the etiology of adolescent LBP as they are a homogenous group that is highly physically active and that is at risk for developing LBP. The novelty of our approach is the unraveling of LBP from a multidisciplinary perspective in adolescents at risk for developing LBP in a challenging period of their life. The proposed qualitative methodology will allow to explore these factors in more depth, as validated questionnaires to examine psychological and social factors in adolescent dancers are lacking. The collaboration in this project between several disciplines will allow to obtain a more detailed insight in the person as a whole, including a great part of the individual and contextual factors underlying the etiology of LBP in highly active adolescents. More importantly, the results of the project will lay the foundation for the continuation of the research in the etiology of LBP in dancers and adolescents.

Researcher(s)

• Promoter: Roussel Nathalie
• Co-promoter: Gielen Pascal
• Co-promoter: van Breda Eric

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Hemophilia is genetic disorder caused characterized by recurrent bleedings, with a majority of spontaneous bleedings occurring in synovial joints. Thanks to tremendous scientific progress, patients with hemophilia (PwH) have a life expectancy that has become comparable to the general population. However, despite adequate prophylactic replacement therapy, recurrent joint bleedings still occur. These bleedings have devastating effects on joint components due to iron deposits and inflammation in the joint, resulting in synovial inflammation, cartilage degeneration and bone damage, with as end-stage a very painful and invalidating hemophilic arthropathy affecting the majority of adult PwH. Despite the high prevalence of pain in PwH pain assessment is not well developed and strongly differs between haemophilia treatment centers. Moreover, up to 39% of PwH report their pain is not well treated. This underscores the urgent need to improve both pain assessment and management in PwH. Ankles and knees are the most affected weight-bearing joints in PwH. While many adult PwH have total knee replacements in case of knee arthropathy, this is not the case for ankle arthropathy, and the majority of adult PwH have to deal with debilitating ankle pain. Joint assessment in patients with chronic conditions should be performed according to the International Classification of Functioning, Disability and Health (ICF), the framework proposed by the World Health Organization (WHO) in which human functioning is described in terms of body structures & functions, activities & participation and contextual factors. The latter are personal or environmental factors that may act as barrier or facilitator of functioning. Studies examining ankle pain in PwH from this broad biopsychosocial framework are absolutely lacking, which contrasts to the bulk of literature in other musculoskeletal pain conditions such as low back pain or osteoarthritis. Understanding the complexity of ankle pain in PwH will allow to better asses and manage pain in order to achieve optimal functioning, including a better functioning of the surrounding joints. This is the first study evaluating the structural and functional status of affected ankle joints combined with the local and central pain condition in patients with haemophilia in order to better understand the complexity of ankle pain.

Researcher(s)

• Promoter: Roussel Nathalie

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

The aim of this project is the development of a tool for evaluation of the performers' quality of movement. This tool will be used by artistic experts with a different background and tested on experienced performers from the company Troubleyn and novice performers of the Royal Conservatoire of Antwerp. By using as well video's as 3Dreconstruction of video's, the movement's aspect is extracted from the context during a performing act. That way, experts blinded to the identity of the performer, may evaluate whether the quality of movement differences between novice and experiences performers.

Researcher(s)

• Promoter: Van Den Dries Luc
• Co-promoter: Roussel Nathalie

Research team(s)

• Research Centre for Visual Poetics

Project type(s)

• Research Project

Abstract

The importance of assessing predictable movements in a biomechanical context has already been demonstrated in patients, athletes and dancers. Biomechanical analysis of unpredictable, non-cyclical movements has not been examined so far. This study aims to develop a method to study motor control in unpredictable movements and to gain more insight in the motor learning processes (by comparing novice and experienced performers).

Researcher(s)

• Promoter: Roussel Nathalie

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

The purpose of this study is to examine whether a prolonged conflict between motor activity and sensory feedback triggers sensitization of the central nervous system, and whether it plays an aetiological role in the transition from acute to chronic whiplash pain. Study participants will enter a 6-months prospective longitudinal study. They will examined at 3 different occasions (within 2 weeks after the whiplash trauma, and 2 and 6 months post-whiplash).

Researcher(s)

• Promoter: Cras Patrick
• Co-principal investigator: Roussel Nathalie

Research team(s)

• Translational Neurosciences (TNW)

Project type(s)

• Research Project