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Educational self-care objectives within a functional spine restoration program. Retrospective study of 104 patients / Isabelle Tavares Figueiredo in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 289-293 Titre : Educational self-care objectives within a functional spine restoration program. Retrospective study of 104 patients Type de document : texte imprimé Auteurs : Isabelle Tavares Figueiredo ; Arnaud Dupeyron ; Bao Tran ; [et al...] Année de publication : 2016 Article en page(s) : p. 289-293 Langues : Français (fre) Mots-clés : Self-care  Chronic low-back pain  Bio-psychosocial  Functional restoration of the spine Résumé : Background Defining individual educational, or learning, targets is part of the initial educational assessment in rehabilitation programs, but no data are available on how to achieve these goals. Objective We aimed to evaluate whether educational objectives established with the patient as part of a functional spine restoration program integrating self-care sessions were met after the program and associated therapy outcomes. Methods This retrospective study involved 104 patients with chronic low-back pain who participated in a self-care rehabilitation program between 2008 and 2012. The program included both physical and educational approaches to dealing with the condition. The main evaluation criterion was achieving the educational objectives established with the patient at 6 months. Secondary criteria were a return to work, pain intensity and impact on function, satisfaction with the program and implementation of physical activity and self-rehabilitation at 6 months. Results At 6 months, 55% of the established educational objectives were fully achieved and satisfaction was close to 90%. Significantly, more patients were involved in a physical activity at 6 and 12 months and self-rehabilitation exercises at 6 months as compared with at inclusion. Overall, 43.4% were working at inclusion, 64.2% at 6 months and 58.2% at 12 months (P<0.05 compared with inclusion). Pain intensity and scores from the Quebec, Dallas and FABQ questionnaires had significantly decreased at 6 months. Conclusion For more than half of the patients in this self-care rehabilitation program, educational objectives established with the patient were achieved, with a positive effect on returning to work and both professional and physical activities at 6 and 12 months. Permalink : ./index.php?lvl=notice_display&id=47161 [article] Educational self-care objectives within a functional spine restoration program. Retrospective study of 104 patients [texte imprimé] / Isabelle Tavares Figueiredo ; Arnaud Dupeyron ; Bao Tran ; [et al...] . - 2016 . - p. 289-293. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 289-293 Mots-clés : Self-care  Chronic low-back pain  Bio-psychosocial  Functional restoration of the spine Résumé : Background Defining individual educational, or learning, targets is part of the initial educational assessment in rehabilitation programs, but no data are available on how to achieve these goals. Objective We aimed to evaluate whether educational objectives established with the patient as part of a functional spine restoration program integrating self-care sessions were met after the program and associated therapy outcomes. Methods This retrospective study involved 104 patients with chronic low-back pain who participated in a self-care rehabilitation program between 2008 and 2012. The program included both physical and educational approaches to dealing with the condition. The main evaluation criterion was achieving the educational objectives established with the patient at 6 months. Secondary criteria were a return to work, pain intensity and impact on function, satisfaction with the program and implementation of physical activity and self-rehabilitation at 6 months. Results At 6 months, 55% of the established educational objectives were fully achieved and satisfaction was close to 90%. Significantly, more patients were involved in a physical activity at 6 and 12 months and self-rehabilitation exercises at 6 months as compared with at inclusion. Overall, 43.4% were working at inclusion, 64.2% at 6 months and 58.2% at 12 months (P<0.05 compared with inclusion). Pain intensity and scores from the Quebec, Dallas and FABQ questionnaires had significantly decreased at 6 months. Conclusion For more than half of the patients in this self-care rehabilitation program, educational objectives established with the patient were achieved, with a positive effect on returning to work and both professional and physical activities at 6 and 12 months. Permalink : ./index.php?lvl=notice_display&id=47161

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Complex regional pain syndrome associated with hyperattention rather than neglect for the healthy side: A comprehensive case study / Laure Christophe in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 294-301 Titre : Complex regional pain syndrome associated with hyperattention rather than neglect for the healthy side: A comprehensive case study Type de document : texte imprimé Auteurs : Laure Christophe ; Ludovic Delporte ; Patrice Revol ; [et al...] Année de publication : 2016 Article en page(s) : p. 294-301 Langues : Français (fre) Mots-clés : CRPS  Pain  Spatial neglect  Body representation  Reference frame  Motor neglect  ADL  Prism adaptation Résumé : Complex regional pain syndrome (CRPS) is a dehabilitating chronic condition occurring with peripheral lesions. There is growing consensus for a central contribution to CRPS. Although the nature of this central body representation disorder is increasingly debated, it has been repeatedly argued that CRPS results in motor neglect of the affected side. The present article describes a comprehensive and quantitative case report demonstrating that: (1) not all patients with chronic CRPS exhibit decreased spatial attention for the affected side and (2) patients may actually exhibit a substantial, broad and reliable attentional bias toward the painful side, akin to spatial neglect for the healthy side. This unexpected result agrees with the idea that patients can be hyper-attentive toward their pathological side as a manifestation of lowered pain threshold, allodynia and kinesiophobia. Permalink : ./index.php?lvl=notice_display&id=47162 [article] Complex regional pain syndrome associated with hyperattention rather than neglect for the healthy side: A comprehensive case study [texte imprimé] / Laure Christophe ; Ludovic Delporte ; Patrice Revol ; [et al...] . - 2016 . - p. 294-301. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 294-301 Mots-clés : CRPS  Pain  Spatial neglect  Body representation  Reference frame  Motor neglect  ADL  Prism adaptation Résumé : Complex regional pain syndrome (CRPS) is a dehabilitating chronic condition occurring with peripheral lesions. There is growing consensus for a central contribution to CRPS. Although the nature of this central body representation disorder is increasingly debated, it has been repeatedly argued that CRPS results in motor neglect of the affected side. The present article describes a comprehensive and quantitative case report demonstrating that: (1) not all patients with chronic CRPS exhibit decreased spatial attention for the affected side and (2) patients may actually exhibit a substantial, broad and reliable attentional bias toward the painful side, akin to spatial neglect for the healthy side. This unexpected result agrees with the idea that patients can be hyper-attentive toward their pathological side as a manifestation of lowered pain threshold, allodynia and kinesiophobia. Permalink : ./index.php?lvl=notice_display&id=47162

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Pelvic floor muscle reflex activity during coughing – an exploratory and reliability study / Helena Luginbuehl in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 302-307 Titre : Pelvic floor muscle reflex activity during coughing – an exploratory and reliability study Type de document : texte imprimé Auteurs : Helena Luginbuehl ; Jean-Pierre Baeyens ; Annette Kuhn ; [et al...] Année de publication : 2016 Article en page(s) : p. 302-307 Langues : Français (fre) Mots-clés : Cough  Cross-sectional study  Pelvic floor  Reproducibility  Stress urinary incontinence Résumé : Objectives Activities that provoke stress urinary incontinence (SUI) rapidly increase the intra-abdominal pressure and the impact loading on the pelvic floor muscles (PFMs). Coughing can cause urinary leakage and is often used to test SUI. However, PFM characteristics during coughing, including their reliability, have not been investigated. Here, we used electromyography (EMG) to describe PFM pre-activity and reflexivity during coughing and examined the reliability of the measurements. Methods This was an exploratory and reliability study including 11 young healthy women to characterize EMG reflex activity in PFMs during coughing. We describe 6 variables, averaged over 3 coughs per subject, and tested their reliability (intraclass correlation coefficient 3,1 [ICC(3,1)] and ICC(3,k), related standard error of measurement (SEM) and minimal difference [MD]). The variables represented the mean EMG activity for PFMs during 30-ms time intervals of pre-activity (initial time point of coughing [T0] and minus 30ms) and reflex activity (T0–30, 30–60, 60–90, 90–120 and 120–150ms after T0) of stretch-reflex latency responses. Results The mean %EMG (normalized to maximal voluntary PFM contraction) for EMG variables was 35.1 to 52.2 and was significantly higher during coughing than for PFM activity at rest (mean 24.9±3.7%EMG; P<0.05). ICC(3,k) ranged from 0.67 to 0.91 (SEM 6.1–13.3%EMG and MD 16.7–36.8%EMG) and was higher than ICC(3,1) (range 0.40–0.77; SEM 9.0–18.0%EMG, MD 24.9–50.0%EMG). Conclusions PFM activity during reflex latency response time intervals during coughing was significantly higher than at rest, which suggests PFM pre-activity and reflex activity during coughing. Although we standardized coughing, EMG variables for PFM activity showed poor reliability [good to excellent ICC(3,k) and fair to excellent ICC(3,1) but high SEM and MD]. Therefore, coughing is expected to be heterogeneous, with low reliability, in clinical test situations. Potential crosstalk from other muscles involved in coughing could limit the interpretation of our results. Permalink : ./index.php?lvl=notice_display&id=47163 [article] Pelvic floor muscle reflex activity during coughing – an exploratory and reliability study [texte imprimé] / Helena Luginbuehl ; Jean-Pierre Baeyens ; Annette Kuhn ; [et al...] . - 2016 . - p. 302-307. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 302-307 Mots-clés : Cough  Cross-sectional study  Pelvic floor  Reproducibility  Stress urinary incontinence Résumé : Objectives Activities that provoke stress urinary incontinence (SUI) rapidly increase the intra-abdominal pressure and the impact loading on the pelvic floor muscles (PFMs). Coughing can cause urinary leakage and is often used to test SUI. However, PFM characteristics during coughing, including their reliability, have not been investigated. Here, we used electromyography (EMG) to describe PFM pre-activity and reflexivity during coughing and examined the reliability of the measurements. Methods This was an exploratory and reliability study including 11 young healthy women to characterize EMG reflex activity in PFMs during coughing. We describe 6 variables, averaged over 3 coughs per subject, and tested their reliability (intraclass correlation coefficient 3,1 [ICC(3,1)] and ICC(3,k), related standard error of measurement (SEM) and minimal difference [MD]). The variables represented the mean EMG activity for PFMs during 30-ms time intervals of pre-activity (initial time point of coughing [T0] and minus 30ms) and reflex activity (T0–30, 30–60, 60–90, 90–120 and 120–150ms after T0) of stretch-reflex latency responses. Results The mean %EMG (normalized to maximal voluntary PFM contraction) for EMG variables was 35.1 to 52.2 and was significantly higher during coughing than for PFM activity at rest (mean 24.9±3.7%EMG; P<0.05). ICC(3,k) ranged from 0.67 to 0.91 (SEM 6.1–13.3%EMG and MD 16.7–36.8%EMG) and was higher than ICC(3,1) (range 0.40–0.77; SEM 9.0–18.0%EMG, MD 24.9–50.0%EMG). Conclusions PFM activity during reflex latency response time intervals during coughing was significantly higher than at rest, which suggests PFM pre-activity and reflex activity during coughing. Although we standardized coughing, EMG variables for PFM activity showed poor reliability [good to excellent ICC(3,k) and fair to excellent ICC(3,1) but high SEM and MD]. Therefore, coughing is expected to be heterogeneous, with low reliability, in clinical test situations. Potential crosstalk from other muscles involved in coughing could limit the interpretation of our results. Permalink : ./index.php?lvl=notice_display&id=47163

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Validation of a novel activity monitor in impaired, slow-walking, crutch-supported patients / Simon N. van Laarhoven in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 308-313 Titre : Validation of a novel activity monitor in impaired, slow-walking, crutch-supported patients Type de document : texte imprimé Auteurs : Simon N. van Laarhoven ; Matthijs Lipperts ; Stijn A.A.N. Bolink ; [et al...] Année de publication : 2016 Article en page(s) : p. 308-313 Langues : Français (fre) Mots-clés : Outcome assessment  Activity monitor  Physical activity  Arthroplasty  Rehabilitation Résumé : Background A growing need in clinical practice of rehabilitation and orthopaedic medicine is for objective outcome tools to estimate physical activity. Current techniques show limited validity or are too demanding for routine clinical use. Accelerometer-based activity monitors (AMs) have shown promise for measuring physical activity in healthy people but lack validity in impaired patients. Objectives This study aimed to validate an accelerometer-based AM in impaired, slow-walking, crutch-supported patients after total joint arthroplasty (TJA). Methods Shortly after TJA, patients who were safely mobilized with 2 crutches and 8 healthy participants completed a trial of different activities while wearing the AM on the lateral upper leg and being videotaped. Outcome variables (e.g., time walking, number of gait cycles, sit-stand-sit transfers) were compared to video recordings, and sensitivity, predictive value and mean percentage difference (MPD) values were calculated. Results We included 40 patients (mean age: 65±9 years; mean BMI: 30±6kg/m2; male:female ratio: 18:22) and 8 healthy participants (mean age: 49±20 years; mean BMI: 23±0.7kg/m2; male:female ratio: 5:3). The AM showed excellent sensitivity (>95%) and predictive value (>95%) in identifying activities (e.g., walking, sitting, resting) and detecting the number of gait cycles and sit-stand-sit transfers (mean percentage difference: ±2%). Detection of number of steps ascending and descending stairs and cadence was more difficult but still showed good results (mean percentage difference: ±7%). Conclusions This is the first validation study to assess physical activity with an AM in impaired, slow-walking, crutch-supported patients. The AM was a valid tool for measuring physical activity in these patients. The tool may help in evaluating and optimizing rehabilitation programs for patients after TJA, those recovering from stroke or chronic impaired patients. Permalink : ./index.php?lvl=notice_display&id=47164 [article] Validation of a novel activity monitor in impaired, slow-walking, crutch-supported patients [texte imprimé] / Simon N. van Laarhoven ; Matthijs Lipperts ; Stijn A.A.N. Bolink ; [et al...] . - 2016 . - p. 308-313. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 308-313 Mots-clés : Outcome assessment  Activity monitor  Physical activity  Arthroplasty  Rehabilitation Résumé : Background A growing need in clinical practice of rehabilitation and orthopaedic medicine is for objective outcome tools to estimate physical activity. Current techniques show limited validity or are too demanding for routine clinical use. Accelerometer-based activity monitors (AMs) have shown promise for measuring physical activity in healthy people but lack validity in impaired patients. Objectives This study aimed to validate an accelerometer-based AM in impaired, slow-walking, crutch-supported patients after total joint arthroplasty (TJA). Methods Shortly after TJA, patients who were safely mobilized with 2 crutches and 8 healthy participants completed a trial of different activities while wearing the AM on the lateral upper leg and being videotaped. Outcome variables (e.g., time walking, number of gait cycles, sit-stand-sit transfers) were compared to video recordings, and sensitivity, predictive value and mean percentage difference (MPD) values were calculated. Results We included 40 patients (mean age: 65±9 years; mean BMI: 30±6kg/m2; male:female ratio: 18:22) and 8 healthy participants (mean age: 49±20 years; mean BMI: 23±0.7kg/m2; male:female ratio: 5:3). The AM showed excellent sensitivity (>95%) and predictive value (>95%) in identifying activities (e.g., walking, sitting, resting) and detecting the number of gait cycles and sit-stand-sit transfers (mean percentage difference: ±2%). Detection of number of steps ascending and descending stairs and cadence was more difficult but still showed good results (mean percentage difference: ±7%). Conclusions This is the first validation study to assess physical activity with an AM in impaired, slow-walking, crutch-supported patients. The AM was a valid tool for measuring physical activity in these patients. The tool may help in evaluating and optimizing rehabilitation programs for patients after TJA, those recovering from stroke or chronic impaired patients. Permalink : ./index.php?lvl=notice_display&id=47164

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Care-related pain and discomfort in children with motor disabilities in rehabilitation centres / Jean-Sébastien Bourseul in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 314-319 Titre : Care-related pain and discomfort in children with motor disabilities in rehabilitation centres Type de document : texte imprimé Auteurs : Jean-Sébastien Bourseul ; Sylvain Brochard ; Laetitia Houx ; [et al...] Année de publication : 2016 Article en page(s) : p. 314-319 Langues : Français (fre) Mots-clés : Induced-pain  Motor disability  Rehabilitation  Children Résumé : Background Pain is one of the symptoms reported most by children with motor disabilities particularly during daily living activities in institutions and during rehabilitation. Despite the care and consideration of professionals, a wide range of motor and cognitive disabilities, limited communication skills, the presence of chronic pain and frequent care interventions place such children at high risk of experiencing induced pain. Objectives We aimed to identify care-related pain and discomfort in children with motor disabilities in rehabilitation centres and the characteristics of children at risk of induced pain. A further aim was to evaluate the validity of a method for the continuous assessment of care-related pain. Methods Patients were recruited from 2 paediatric rehabilitation centres. The level of pain or discomfort experienced during each daily care activity was evaluated for 5 days and 1 night by using the FLACC-r scale and a visual analog scale (VAS) rated by the caregiver (VAS caregiver) and the patient (VAS patient). Results We included 32 children (mean age: 8.5±5 years, range: 1–15 years) with 1302 care activities evaluated. Overall, 3.6% of the activities were rated as painful and 11% uncomfortable. The most frequent painful activities were mouth care, transfers standing and dressing. The most frequent uncomfortable activities were passive limb mobilisation, dressing and transfers. Children with neurological disorders were at increased risk of induced pain. Conclusions Children with motor disabilities experienced pain during daily care activities. The methodology we propose is valid and can be used in any type of institution for children with motor disability to evaluate and reduce the frequency of care-related pain. Permalink : ./index.php?lvl=notice_display&id=47165 [article] Care-related pain and discomfort in children with motor disabilities in rehabilitation centres [texte imprimé] / Jean-Sébastien Bourseul ; Sylvain Brochard ; Laetitia Houx ; [et al...] . - 2016 . - p. 314-319. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 314-319 Mots-clés : Induced-pain  Motor disability  Rehabilitation  Children Résumé : Background Pain is one of the symptoms reported most by children with motor disabilities particularly during daily living activities in institutions and during rehabilitation. Despite the care and consideration of professionals, a wide range of motor and cognitive disabilities, limited communication skills, the presence of chronic pain and frequent care interventions place such children at high risk of experiencing induced pain. Objectives We aimed to identify care-related pain and discomfort in children with motor disabilities in rehabilitation centres and the characteristics of children at risk of induced pain. A further aim was to evaluate the validity of a method for the continuous assessment of care-related pain. Methods Patients were recruited from 2 paediatric rehabilitation centres. The level of pain or discomfort experienced during each daily care activity was evaluated for 5 days and 1 night by using the FLACC-r scale and a visual analog scale (VAS) rated by the caregiver (VAS caregiver) and the patient (VAS patient). Results We included 32 children (mean age: 8.5±5 years, range: 1–15 years) with 1302 care activities evaluated. Overall, 3.6% of the activities were rated as painful and 11% uncomfortable. The most frequent painful activities were mouth care, transfers standing and dressing. The most frequent uncomfortable activities were passive limb mobilisation, dressing and transfers. Children with neurological disorders were at increased risk of induced pain. Conclusions Children with motor disabilities experienced pain during daily care activities. The methodology we propose is valid and can be used in any type of institution for children with motor disability to evaluate and reduce the frequency of care-related pain. Permalink : ./index.php?lvl=notice_display&id=47165

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GABAergic drug use and global, cognitive, and motor functional outcomes after stroke / A.J.-P. Schwitzguébel in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 320-325 Titre : GABAergic drug use and global, cognitive, and motor functional outcomes after stroke Type de document : texte imprimé Auteurs : A.J.-P. Schwitzguébel ; Charles Benaïm ; Stefano Carda ; [et al...] Année de publication : 2016 Article en page(s) : p. 320-325 Langues : Français (fre) Mots-clés : Recovery  Rehabilitation  Stroke  GABA-A receptor agonists  Benzodiazepines  Minimal clinically important difference  Functional independence measure Résumé : Background In animal models and healthy volunteers, the use of GABA A receptor agonists (GABA-AGs) seem deleterious for functional recovery. The agents are widely used for subacute stroke, but their effect on functional recovery remains unclear. Objectives We aimed to evaluate the association between GABA-AG use and functional recovery after stroke. Methods We retrospectively recruited 434 survivors of subacute stroke admitted for inpatient rehabilitation between 2000 and 2013 in our institution (107 with and 327 without GABA-AG use). We used multivariate regression to assess the association of GABA-AG use and successful functional recovery, defined as reaching, between admission and discharge, the minimal clinically important difference (MCID) of 22 points on the global Functional Independence Measure (FIM). Secondary analyses were the associations of GABA-AG with cognitive and motor FIM MCID and constant GABA-AG exposure (24h/24 GABA-AG) with global, cognitive and motor FIM MCID. A new estimation of the MCID was performed with the standard error of measurement. Results Reaching the global FIM MCID was associated with GABA-AG use (adjusted odds ratio [aOR] 0.54 [95% CI 0.31–0.91], P=0.02) as well as 24h/24 GABA-AG use (aOR 0.25 [0.08–0.83]; P=0.02). Furthermore, GABA-AG and 24h/24 GABA-AG use was inversely but not always significantly associated with reaching the cognitive FIM MCID (aOR 0.56, P=0.07; aOR 0.26, P=0.06, respectively) and motor FIM MCID (aOR 0.51, P=0.07; aOR 0.13, P=0.01, respectively). The estimated MCID was 19 for global FIM, 4 for cognitive FIM, and 16 for motor FIM. Conclusions GABA-AG use is associated with not reaching successful functional recovery during stroke rehabilitation. Randomised trials are needed to formally establish the potential deleterious effect of GABA-AG use on functional recovery. Permalink : ./index.php?lvl=notice_display&id=47166 [article] GABAergic drug use and global, cognitive, and motor functional outcomes after stroke [texte imprimé] / A.J.-P. Schwitzguébel ; Charles Benaïm ; Stefano Carda ; [et al...] . - 2016 . - p. 320-325. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 320-325 Mots-clés : Recovery  Rehabilitation  Stroke  GABA-A receptor agonists  Benzodiazepines  Minimal clinically important difference  Functional independence measure Résumé : Background In animal models and healthy volunteers, the use of GABA A receptor agonists (GABA-AGs) seem deleterious for functional recovery. The agents are widely used for subacute stroke, but their effect on functional recovery remains unclear. Objectives We aimed to evaluate the association between GABA-AG use and functional recovery after stroke. Methods We retrospectively recruited 434 survivors of subacute stroke admitted for inpatient rehabilitation between 2000 and 2013 in our institution (107 with and 327 without GABA-AG use). We used multivariate regression to assess the association of GABA-AG use and successful functional recovery, defined as reaching, between admission and discharge, the minimal clinically important difference (MCID) of 22 points on the global Functional Independence Measure (FIM). Secondary analyses were the associations of GABA-AG with cognitive and motor FIM MCID and constant GABA-AG exposure (24h/24 GABA-AG) with global, cognitive and motor FIM MCID. A new estimation of the MCID was performed with the standard error of measurement. Results Reaching the global FIM MCID was associated with GABA-AG use (adjusted odds ratio [aOR] 0.54 [95% CI 0.31–0.91], P=0.02) as well as 24h/24 GABA-AG use (aOR 0.25 [0.08–0.83]; P=0.02). Furthermore, GABA-AG and 24h/24 GABA-AG use was inversely but not always significantly associated with reaching the cognitive FIM MCID (aOR 0.56, P=0.07; aOR 0.26, P=0.06, respectively) and motor FIM MCID (aOR 0.51, P=0.07; aOR 0.13, P=0.01, respectively). The estimated MCID was 19 for global FIM, 4 for cognitive FIM, and 16 for motor FIM. Conclusions GABA-AG use is associated with not reaching successful functional recovery during stroke rehabilitation. Randomised trials are needed to formally establish the potential deleterious effect of GABA-AG use on functional recovery. Permalink : ./index.php?lvl=notice_display&id=47166

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Superficial warming and cooling of the leg affects walking speed and neuromuscular impairments in people with spastic paraparesis / A. Denton in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 326-332 Titre : Superficial warming and cooling of the leg affects walking speed and neuromuscular impairments in people with spastic paraparesis Type de document : texte imprimé Auteurs : A. Denton ; L. Bunn ; A. Hough ; [et al...] Année de publication : 2016 Article en page(s) : p. 326-332 Langues : Français (fre) Mots-clés : Temperature  Neural conduction  Muscle spasticity  Spastic paraparesis Résumé : Background People with hereditary and spontaneous spastic paraparesis (HSSP) report that their legs are stiffer and walking is slower when their legs are cold. Objectives This study explored the effects of prolonged superficial cooling and warming of the lower leg on walking speed and local measures of neuromuscular impairments. Methods This was a randomised pre- and post-intervention study of 22 HSSP participants and 19 matched healthy controls. On 2 separate occasions, one lower leg was cooled or warmed. Measurements included walking speed and measures of lower limb impairment: ankle movement, passive muscle stiffness, spasticity (stretch reflex size), amplitude and rate of force generation in dorsi- and plantarflexors and central and peripheral nerve conduction time/velocity. Results For both participants and controls, cooling decreased walking speed, especially for HSSP participants. For both groups, cooling decreased the dorsiflexor rate and amplitude of force generation and peripheral nerve conduction velocity and increased spasticity. Warming increased dorsiflexor rate of force generation and nerve conduction velocity and decreased spasticity. Conclusions Superficial cooling significantly reduced walking speed for people with HSSP. Temperature changes were associated with changes in neuromuscular impairments for both people with spastic paraparesis and controls. This study does not support the use of localised cooling in rehabilitation for people with spastic paraparesis as reported in other neurological conditions. Rehabilitation interventions that help prevent heat loss (insulation) or improve limb temperature via passive or active means, particularly when the legs and/or environment are cool, may benefit people with spastic paraparesis. Permalink : ./index.php?lvl=notice_display&id=47167 [article] Superficial warming and cooling of the leg affects walking speed and neuromuscular impairments in people with spastic paraparesis [texte imprimé] / A. Denton ; L. Bunn ; A. Hough ; [et al...] . - 2016 . - p. 326-332. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 326-332 Mots-clés : Temperature  Neural conduction  Muscle spasticity  Spastic paraparesis Résumé : Background People with hereditary and spontaneous spastic paraparesis (HSSP) report that their legs are stiffer and walking is slower when their legs are cold. Objectives This study explored the effects of prolonged superficial cooling and warming of the lower leg on walking speed and local measures of neuromuscular impairments. Methods This was a randomised pre- and post-intervention study of 22 HSSP participants and 19 matched healthy controls. On 2 separate occasions, one lower leg was cooled or warmed. Measurements included walking speed and measures of lower limb impairment: ankle movement, passive muscle stiffness, spasticity (stretch reflex size), amplitude and rate of force generation in dorsi- and plantarflexors and central and peripheral nerve conduction time/velocity. Results For both participants and controls, cooling decreased walking speed, especially for HSSP participants. For both groups, cooling decreased the dorsiflexor rate and amplitude of force generation and peripheral nerve conduction velocity and increased spasticity. Warming increased dorsiflexor rate of force generation and nerve conduction velocity and decreased spasticity. Conclusions Superficial cooling significantly reduced walking speed for people with HSSP. Temperature changes were associated with changes in neuromuscular impairments for both people with spastic paraparesis and controls. This study does not support the use of localised cooling in rehabilitation for people with spastic paraparesis as reported in other neurological conditions. Rehabilitation interventions that help prevent heat loss (insulation) or improve limb temperature via passive or active means, particularly when the legs and/or environment are cool, may benefit people with spastic paraparesis. Permalink : ./index.php?lvl=notice_display&id=47167

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An update on the pathophysiology of osteoarthritis / Ali Mobasheri in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 333-339 Titre : An update on the pathophysiology of osteoarthritis Type de document : texte imprimé Auteurs : Ali Mobasheri ; Mark Batt Année de publication : 2016 Article en page(s) : p. 333-339 Langues : Français (fre) Mots-clés : Synovial joint  Articular cartilage  Synovium  Osteoarthritis (OA)  Pathophysiology  Physical Activity  Physical Rehabilitation Résumé : Introduction Osteoarthritis (OA) is one of the most common forms of arthritis. There is accumulating evidence to suggest that OA is an inflammatory disease of the entire synovial joint and has multiple phenotypes. This presents the OA research community with new challenges and opportunities. The main challenge is to understand the root cause of the disease and identify differences and similarities between OA phenotypes. The key opportunity is the possibility of developing personalized and individualized prevention and treatment strategies for OA patients with different phenotypes of the disease. Indeed, it has been suggested that this is the era of ‘personalized prevention’ for OA. The aim of this mini-review paper is to focus on the pathophysiological aspects of OA development and progression, review the current concepts and discuss the future of personalized medicine for OA. Method The PubMed/MEDLINE bibliographic database was searched using the keywords ‘pathophysiology’ and ‘osteoarthritis’. Results The PubMed/MEDLINE search yielded more than 12,000 relevant papers. A selection of these papers is reviewed here. Conclusion There has been slow but steady progress in our understanding of the pathophysiology of OA over the last two decades. However, large gaps remain in our knowledge of OA pathogenesis and this impacts negatively on patients and drug development pipeline. In the absence of new pharmaceutical agents and disease modifying osteoarthritis drugs (DMOADs) it is clear that lifestyle modification and physical activity are important and may delay the need for surgical intervention. Permalink : ./index.php?lvl=notice_display&id=47168 [article] An update on the pathophysiology of osteoarthritis [texte imprimé] / Ali Mobasheri ; Mark Batt . - 2016 . - p. 333-339. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 333-339 Mots-clés : Synovial joint  Articular cartilage  Synovium  Osteoarthritis (OA)  Pathophysiology  Physical Activity  Physical Rehabilitation Résumé : Introduction Osteoarthritis (OA) is one of the most common forms of arthritis. There is accumulating evidence to suggest that OA is an inflammatory disease of the entire synovial joint and has multiple phenotypes. This presents the OA research community with new challenges and opportunities. The main challenge is to understand the root cause of the disease and identify differences and similarities between OA phenotypes. The key opportunity is the possibility of developing personalized and individualized prevention and treatment strategies for OA patients with different phenotypes of the disease. Indeed, it has been suggested that this is the era of ‘personalized prevention’ for OA. The aim of this mini-review paper is to focus on the pathophysiological aspects of OA development and progression, review the current concepts and discuss the future of personalized medicine for OA. Method The PubMed/MEDLINE bibliographic database was searched using the keywords ‘pathophysiology’ and ‘osteoarthritis’. Results The PubMed/MEDLINE search yielded more than 12,000 relevant papers. A selection of these papers is reviewed here. Conclusion There has been slow but steady progress in our understanding of the pathophysiology of OA over the last two decades. However, large gaps remain in our knowledge of OA pathogenesis and this impacts negatively on patients and drug development pipeline. In the absence of new pharmaceutical agents and disease modifying osteoarthritis drugs (DMOADs) it is clear that lifestyle modification and physical activity are important and may delay the need for surgical intervention. Permalink : ./index.php?lvl=notice_display&id=47168

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