MOBILITY IN AGEING

My research aims are:
- to understand the effects of ageing on neuromuscular and cognitive aspects of mobility (i.e., physical function and physical activity)
- to implement this knowledge with assistive technology to maintain and promote mobility of older individuals in their own environment 
 
The approaches for these aims are experimental studies (neuromuscular and biomechanical analyses), epidemiological studies (prediction models based on longitudinal cohort data), implementation of technological devices (e.g. accelerometry, kinect, smartphones, smartwatches) and interventions on fall prevention and active ageing in daily life behaviour.

You can find an overview of work from my group in the list of supervised PhD theses.

CURRENT RESEARCH PROJECTS

• In Balans: the (cost-)effectiveness of a fall prevention intervention on falls and fall injuries in community-dwelling older adults with an increased risk of falls.
  In project we to assess the (cost-)effectiveness of the falls prevention intervention ‘In Balans’, in community-dwelling older persons with an increased risk of falls, as compared to general exercise recommendations. We currently run a Randomized Clinical Trial in 256 participants accross the Netherlands. This ZonMw project is in a collaboration with Amsterdam University of Applied Sciences and VeiligheidNL. More information can be found here.
• MOVITA: Wearable technology to optimize prognostic evaluation and rehabilitation of gait behaviour in orthopaedic patients
  In MOVITA (Move, Visualise, Tailor), we develop a solution to remotely assess, store, and visualize an OA patient’s daily-life physical behaviour to monitor progression without costly hospital visits. Objective assessment and visualisation of daily-life physical behaviour and gait quality using new wearable technology will facilitate effectiveness in prognostics and treatment of these patients, while minimising required care and optimising patient satisfaction.
  MOVITA is a collaborative initiative between the department Human Movement Sciences (Vrije Universiteit Amsterdam), two clinical departments of orthopaedics (Noordwest Ziekenhuisgroep and Sint Maartenskliniek) and two commercial partners (McRoberts B.V. and Moveshelf Labs B.V.), and sponsored by ZonMw and Health Holland.

PREVIOUS RESEARCH PROJECTS

• REACT: advanced technology for perturbation-based treadmill training
  This project, as part of the EU-ITN programme Keep Control, was aimed at the development and evaluation of a perturbation-based treadmill training intervention. We performed an RCT with 70 older adults and compared the effects of a 4-week perturbation training against unperturbed treadmill training on balance and gait performance, self-efficacy, physical activity and daily life gait quality. 
• Falls due to a mismatch between self-perceived and actual abilities in older adults
  In my VIDI project we investigating the causes and consequences of misjudgements by older adults their biomechanical abilities in relation to biomechanical task requirements, by a combination of experimental studies and a prospective cohort study (VIBE: Veilig in Beweging Blijven). 
• PreventIT: Early risk detection and prevention of functional decline in young older adults with ICT support
  In this project we developed a proof of concept of an unobtrusive mobile health system for young old people (60-70 years). This involves assessment for the risk for functional decline and eligibility for intervention. In a feasibility RCT, we integrated balance, strength and physical activity components in the daily life activities of our target group. For more information and outcomes, visit the PreventIT website. 
• Fall Risk Assessment in Older Adults (FARAO) based on accelerometry obtained during daily life activities
  In the FARAO project we focused on predicting falls based on daily life gait characteristics obtained with one-week accelerometry data in a cohort of 300 older community-dwelling participants. We found that gait quality measures of daily life gait have added value to predicting falls. 
• Ability to respond to balance perturbations in young versus older adults
  We studied the mechanics and control of recovery responses after balance perturbations during walking. For example, we developed a unique setup with 21 hidden obstacles to trip participants repeatedly during overground walking. We showed that the rate of force generation in the lower limbs during their recovery reaction discriminates older fallers from non-fallers and young adults. 
• Identification of high-risk fallers and targets for fall prevention training
  We investigated whether fallers can be identified from results of muscle strength tests. Furthermore, we investigated the effect of strength training in a group of elderly on functional tasks as tripping.   
• MedioLateral Balance Assessement (MELBA) 
  We developed a new method to assess mediolateral balance performance using a visal tracking task. This tool was shown to be reliable, direction specific, challenging, and greater sensitivity to age than conventional balance measures. These features allow for identification of subtle balance impairments in older adults, which were predictive in instabilities in real-life gait. 

• 2016: Appointed to the Fenna Diemer-Lindeboom chair as professor of Mobility in Ageing.
• 2004: PhD Thesis Recovery from a trip in young and older adults. Mechanics and control of the support limb. Vrije Universiteit Amsterdam.

• 2021 IMDI (PI): MOVITA: wearable technology to optimize prognostic evaluation and rehabilitation of gait behaviour in orthopaedic patients (Move-Visualise-Tailor)
• 2019 ZonMw (PI): In Balance: (cost)effectiveness of a fall prevention intervention on falls and fall injuries in community-dwelling older adults with an increased risk of falls.
• 2016 EU Horizon 2020 (co-PI): PreventIT
• 2014 NWO Aspacia grant (PI): (linked to the NWO VIDI grant)
• 2014 NWO VIDI grant (PI): Falling: A mismatch between perceived and actual abilities in older adults?
• 2010 NWO TOP grant (PI): FARAO: A novel instrument to support fall prevention in extramural care.
• 2006 NWO VENI grant (PI): Physical capacity of the elderly; towards targets for fall prevention 

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