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Short-term pain evolution in chronic low back pain with Modic type 1 changes treated by a lumbar rigid brace: A retrospective study / Laura Boutevillain in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 3-7 Titre : Short-term pain evolution in chronic low back pain with Modic type 1 changes treated by a lumbar rigid brace: A retrospective study Type de document : texte imprimé Auteurs : Laura Boutevillain ; Armand Bonnin ; Aurore Chabaud ; et al. Année de publication : 2019 Article en page(s) : p. 3-7 Note générale : Doi : 10.1016/j.rehab.2018.06.008 Langues : Anglais (eng) Mots-clés : Active discopathy  Modic type 1 changes  Rigid lumbar brace  Non-specific chronic low back pain Résumé : Background Blocking the lumbar or lumbosacral spine with a custom-made rigid lumbar brace, based on the mechanical origin of active discopathy, is a therapeutic option for low back pain, but no study has yet defined its applicability in low back pain. Objective To assess the pain evolution of individuals with non-specific chronic low back pain associated with Modic type 1 changes treated with custom-made rigid lumbar brace. Methods This was a retrospective observational study conducted in the Physical Medicine and Rehabilitation unit at Clermont-Ferrand University Hospital, France, between January 2014 and December 2016. Inclusion criteria were adults with non-specific chronic low back pain associated with Modic type 1 changes on the lumbar or lumbosacral spine confirmed by MRI. Patients had 4 consultations with the physician (baseline, 5 weeks, 3 months, and 5 months). The brace was progressively withdrawn at 3 months. The main outcome was pain improvement of at least 30% at 3 months (visual pain scale). The secondary outcome was an improvement of at least 50%. We also studied the association between pain improvement at the 2 thresholds (30 and 50%) and clinical data, level of Modic type 1 changes, and pain recurrence after withdrawal of the brace. Results Among the 174 patients who wore the brace, 62 were included in the study; 49/62 (79%) showed improvement of at least 30% at 3 months. Two months after brace withdrawal, pain recurred for 30/46 patients (16 missing data). No sociodemographic, clinical or radiographic criteria were associated with pain evolution. Conclusion In the present study, a rigid lumbar brace worn for 3 months was associated with a 30% reduction in pain for 79% of patients with chronic low back pain and active discopathy. However, the retrospective open and uncontrolled design of our study limits our interpretation about a specific treatment effect. A prospective randomized controlled trial is needed to clarify the effect of a rigid lumbar brace in this condition. Permalink : ./index.php?lvl=notice_display&id=82397 [article] Short-term pain evolution in chronic low back pain with Modic type 1 changes treated by a lumbar rigid brace: A retrospective study [texte imprimé] / Laura Boutevillain ; Armand Bonnin ; Aurore Chabaud ; et al. . - 2019 . - p. 3-7. Doi : 10.1016/j.rehab.2018.06.008 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 3-7 Mots-clés : Active discopathy  Modic type 1 changes  Rigid lumbar brace  Non-specific chronic low back pain Résumé : Background Blocking the lumbar or lumbosacral spine with a custom-made rigid lumbar brace, based on the mechanical origin of active discopathy, is a therapeutic option for low back pain, but no study has yet defined its applicability in low back pain. Objective To assess the pain evolution of individuals with non-specific chronic low back pain associated with Modic type 1 changes treated with custom-made rigid lumbar brace. Methods This was a retrospective observational study conducted in the Physical Medicine and Rehabilitation unit at Clermont-Ferrand University Hospital, France, between January 2014 and December 2016. Inclusion criteria were adults with non-specific chronic low back pain associated with Modic type 1 changes on the lumbar or lumbosacral spine confirmed by MRI. Patients had 4 consultations with the physician (baseline, 5 weeks, 3 months, and 5 months). The brace was progressively withdrawn at 3 months. The main outcome was pain improvement of at least 30% at 3 months (visual pain scale). The secondary outcome was an improvement of at least 50%. We also studied the association between pain improvement at the 2 thresholds (30 and 50%) and clinical data, level of Modic type 1 changes, and pain recurrence after withdrawal of the brace. Results Among the 174 patients who wore the brace, 62 were included in the study; 49/62 (79%) showed improvement of at least 30% at 3 months. Two months after brace withdrawal, pain recurred for 30/46 patients (16 missing data). No sociodemographic, clinical or radiographic criteria were associated with pain evolution. Conclusion In the present study, a rigid lumbar brace worn for 3 months was associated with a 30% reduction in pain for 79% of patients with chronic low back pain and active discopathy. However, the retrospective open and uncontrolled design of our study limits our interpretation about a specific treatment effect. A prospective randomized controlled trial is needed to clarify the effect of a rigid lumbar brace in this condition. Permalink : ./index.php?lvl=notice_display&id=82397

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Is recovery from ankle sprains negatively affected by obesity? / I.A. Bielska in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 8-13 Titre : Is recovery from ankle sprains negatively affected by obesity? Type de document : texte imprimé Auteurs : I.A. Bielska ; R. Brison ; B. Brouwer ; et al. Année de publication : 2019 Article en page(s) : p. 8-13 Note générale : Doi : 10.1016/j.rehab.2018.08.006 Langues : Anglais (eng) Mots-clés : Body mass index  BMI  Ankle sprains  Recovery  Outcomes Résumé : Highlights At 6 months, a sizeable proportion of participants with ankle sprains had not fully recovered. Higher levels of incomplete recovery were observed among individuals with obesity. This finding was statistically significant but not clinically meaningful on 2 foot and ankle outcome score subscales. Abstract Objective Ankle sprains are common injuries that may lead to long-term morbidity. Individuals with obesity are at increased risk for ankle sprains; however, prognostic associations between body mass index (BMI) and recovery are less well understood. This study investigated whether BMI status affects recovery from ankle sprains. Methods We included individuals≥16 years old with grade 1 or 2 ankle sprains who sought emergency department treatment in Kingston, Ontario, Canada. Height in centimeters and weight in kilograms were measured at baseline by using a height rod and a standard medical column scale, respectively. BMI was calculated and categorized as non-overweight,<25.0kg/m2; overweight, 25.0–29.9kg/m2; and obese,≥30kg/m2. Recovery was assessed at 1, 3 and 6 months post-injury by the Foot and Ankle Outcome Score (FAOS). Continuous FAOS and binary recovery status were compared by BMI group at each assessment using a repeated measures linear mixed effects model and logistic regression, respectively. Results In total, 504 individuals were recruited and 6-month follow-up data were collected for 80%. We observed no significant differences in recovery at 1 and 3 months post-injury. At 6 months, between 53% and 66% of the participants were considered to have recovered according to the FAOS. The mean difference in unadjusted FAOS between participants classified as obese and non-overweight was −23.02 (95% confidence interval, −38.99 to −7.05) but decreased after adjusting for confounders. The odds ratio for recovery was 0.60 (0.37–0.97) before adjustment and 0.74 (0.43–1.29) after adjustment. Six-month recovery was significantly lower for participants with obesity than non-overweight participants on the FAOS Pain and Function in Daily Living subscales but were not clinically meaningful. Conclusions All BMI groups showed improvements from ankle sprain over time. However, at 6 months, a sizeable proportion of the participants had not fully recovered particularly among individuals classified as obese. The findings suggest that individuals with obesity may benefit from specialized interventions focused on symptom management and functional activity. Permalink : ./index.php?lvl=notice_display&id=82398 [article] Is recovery from ankle sprains negatively affected by obesity? [texte imprimé] / I.A. Bielska ; R. Brison ; B. Brouwer ; et al. . - 2019 . - p. 8-13. Doi : 10.1016/j.rehab.2018.08.006 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 8-13 Mots-clés : Body mass index  BMI  Ankle sprains  Recovery  Outcomes Résumé : Highlights At 6 months, a sizeable proportion of participants with ankle sprains had not fully recovered. Higher levels of incomplete recovery were observed among individuals with obesity. This finding was statistically significant but not clinically meaningful on 2 foot and ankle outcome score subscales. Abstract Objective Ankle sprains are common injuries that may lead to long-term morbidity. Individuals with obesity are at increased risk for ankle sprains; however, prognostic associations between body mass index (BMI) and recovery are less well understood. This study investigated whether BMI status affects recovery from ankle sprains. Methods We included individuals≥16 years old with grade 1 or 2 ankle sprains who sought emergency department treatment in Kingston, Ontario, Canada. Height in centimeters and weight in kilograms were measured at baseline by using a height rod and a standard medical column scale, respectively. BMI was calculated and categorized as non-overweight,<25.0kg/m2; overweight, 25.0–29.9kg/m2; and obese,≥30kg/m2. Recovery was assessed at 1, 3 and 6 months post-injury by the Foot and Ankle Outcome Score (FAOS). Continuous FAOS and binary recovery status were compared by BMI group at each assessment using a repeated measures linear mixed effects model and logistic regression, respectively. Results In total, 504 individuals were recruited and 6-month follow-up data were collected for 80%. We observed no significant differences in recovery at 1 and 3 months post-injury. At 6 months, between 53% and 66% of the participants were considered to have recovered according to the FAOS. The mean difference in unadjusted FAOS between participants classified as obese and non-overweight was −23.02 (95% confidence interval, −38.99 to −7.05) but decreased after adjusting for confounders. The odds ratio for recovery was 0.60 (0.37–0.97) before adjustment and 0.74 (0.43–1.29) after adjustment. Six-month recovery was significantly lower for participants with obesity than non-overweight participants on the FAOS Pain and Function in Daily Living subscales but were not clinically meaningful. Conclusions All BMI groups showed improvements from ankle sprain over time. However, at 6 months, a sizeable proportion of the participants had not fully recovered particularly among individuals classified as obese. The findings suggest that individuals with obesity may benefit from specialized interventions focused on symptom management and functional activity. Permalink : ./index.php?lvl=notice_display&id=82398

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Physical activity level and association with behavioral factors in knee osteoarthritis / Chloé Gay in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 14-20 Titre : Physical activity level and association with behavioral factors in knee osteoarthritis Type de document : texte imprimé Auteurs : Chloé Gay ; Candy Guiguet-Auclair ; Charline Mourgues ; Laurent Gerbaud Année de publication : 2019 Article en page(s) : p. 14-20 Note générale : Doi : 10.1016/j.rehab.2018.09.005 Langues : Anglais (eng) Mots-clés : Knee osteoarthritis  Physical activity  Exercise  Epidemiology  Behavior Résumé : Highlights This study provides new epidemiological data, while highlighting new elements regarding physical activity in osteoarthritis. Measurement of physical activity level was supplemented by modifiable osteoarthritis risk factors analysis. The osteoarthritis population appears more affected by these risk factors, and the most severely affected patients are those with less active lifestyles. Abstract Background The effects of physical activity (PA) in disease prevention and therapy have well-known effects on lower-limb osteoarthritis (OA), decreasing pain and improving function. Objective We aimed to describe the level and factors affecting PA practices of people with knee OA. Design Prospective epidemiological study. Setting In all, 548 people with knee OA were interviewed by use of self-administered anonymous questionnaires. Main outcome measurement The main outcome was physical activity level evaluated by the International physical activity questionnaire (IPAQ) (short version). Secondary outcomes included sociodemographic and clinical data, comorbidities, and barriers to and facilitators of practicing regular PA evaluated by 24 specific elements. Results The mean (SD) age of the study population was 67.6 (7.9) years; 73.9% were women and 30.9% had obesity (mean [SD] body mass index [BMI] 28.2 [5.7] kg/m2). Multi-joint OA affected 92% of the population, and 71.6% had comorbidities. The mean (SD) visual analog scale score for pain intensity was 4.5/10 (2.5), which was 51.4% better than the patient acceptable symptom state (PASS). The mean (SD) Western Ontario and McMaster Universities Osteoarthritis Index function score was 36.6/100 (20.7), which was 57.5% better than the PASS. In total, 67% of patients used analgesics, half of them at least once a week. According to the IPAQ, 42.6% of patients reported high, 38.6% moderate, and 18.8% low PA level; the median IPAQ total activity score was 2628 metabolic equivalent of task (MET)-min/week and time spent sitting was 257.1min/day. Only one third of participants received non-pharmacological treatment corresponding to the latest recommendations. Variables significantly related to inactive or minimally active PA levels were BMI (P=0.0294), sex (P=0.0008), and biomedical barriers, related to self-efficacy (P=0.0118). Conclusions The OA study population was less active, more sedentary, and had more comorbidities and more barriers to PA practice than the overall population. Permalink : ./index.php?lvl=notice_display&id=82399 [article] Physical activity level and association with behavioral factors in knee osteoarthritis [texte imprimé] / Chloé Gay ; Candy Guiguet-Auclair ; Charline Mourgues ; Laurent Gerbaud . - 2019 . - p. 14-20. Doi : 10.1016/j.rehab.2018.09.005 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 14-20 Mots-clés : Knee osteoarthritis  Physical activity  Exercise  Epidemiology  Behavior Résumé : Highlights This study provides new epidemiological data, while highlighting new elements regarding physical activity in osteoarthritis. Measurement of physical activity level was supplemented by modifiable osteoarthritis risk factors analysis. The osteoarthritis population appears more affected by these risk factors, and the most severely affected patients are those with less active lifestyles. Abstract Background The effects of physical activity (PA) in disease prevention and therapy have well-known effects on lower-limb osteoarthritis (OA), decreasing pain and improving function. Objective We aimed to describe the level and factors affecting PA practices of people with knee OA. Design Prospective epidemiological study. Setting In all, 548 people with knee OA were interviewed by use of self-administered anonymous questionnaires. Main outcome measurement The main outcome was physical activity level evaluated by the International physical activity questionnaire (IPAQ) (short version). Secondary outcomes included sociodemographic and clinical data, comorbidities, and barriers to and facilitators of practicing regular PA evaluated by 24 specific elements. Results The mean (SD) age of the study population was 67.6 (7.9) years; 73.9% were women and 30.9% had obesity (mean [SD] body mass index [BMI] 28.2 [5.7] kg/m2). Multi-joint OA affected 92% of the population, and 71.6% had comorbidities. The mean (SD) visual analog scale score for pain intensity was 4.5/10 (2.5), which was 51.4% better than the patient acceptable symptom state (PASS). The mean (SD) Western Ontario and McMaster Universities Osteoarthritis Index function score was 36.6/100 (20.7), which was 57.5% better than the PASS. In total, 67% of patients used analgesics, half of them at least once a week. According to the IPAQ, 42.6% of patients reported high, 38.6% moderate, and 18.8% low PA level; the median IPAQ total activity score was 2628 metabolic equivalent of task (MET)-min/week and time spent sitting was 257.1min/day. Only one third of participants received non-pharmacological treatment corresponding to the latest recommendations. Variables significantly related to inactive or minimally active PA levels were BMI (P=0.0294), sex (P=0.0008), and biomedical barriers, related to self-efficacy (P=0.0118). Conclusions The OA study population was less active, more sedentary, and had more comorbidities and more barriers to PA practice than the overall population. Permalink : ./index.php?lvl=notice_display&id=82399

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Patients’ outcome expectations and their fulfilment in multidisciplinary stroke rehabilitation / Iris F. Groeneveld in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 21-27 Titre : Patients’ outcome expectations and their fulfilment in multidisciplinary stroke rehabilitation Type de document : texte imprimé Auteurs : Iris F. Groeneveld ; Paulien Goossens ; Inke van Braak ; et al. Année de publication : 2019 Article en page(s) : p. 21-27 Note générale : Doi : 10.1016/j.rehab.2018.05.1321 Langues : Anglais (eng) Mots-clés : Stroke  Rehabilitation  Expectations  Health-related quality of life Résumé : Highlights Patients’ expectations of inpatient stroke rehabilitation are relatively high. For half of the patients, expectations are fulfilled. An improvement in quality of life enhances the fulfilment of expectations. Management of expectations regarding stroke rehabilitation is important. Abstract Background Patients’ expectations of the outcomes of rehabilitation may influence the outcomes and satisfaction with treatment. Objectives For stroke patients in multidisciplinary rehabilitation, we aimed to explore patients’ outcome expectations and their fulfilment as well as determinants. Methods The Stroke Cohort Outcomes of REhabilitation (SCORE) study included consecutive stroke patients admitted to an inpatient rehabilitation facility after hospitalisation. Outcome expectations were assessed at the start of rehabilitation (admission) by using the three-item Expectancy scale (sum score range 3–27) of the Credibility/Expectancy Questionnaire (CEQ). After rehabilitation, patients answered the same questions formulated in the past tense to assess fulfilment of expectations. Baseline patient characteristics were recorded and health-related quality of life (EQ-5D) was measured at baseline and after rehabilitation. The number of patients with expectations unfulfilled or fulfilled or exceeded was computed by subtracting the admission and discharge CEQ Expectancy scores. Multivariable regression analysis was used to determine the factors associated with outcome expectations and their fulfilment, estimating odds ratios (ORs) and 95% confidence intervals (CIs). Results We included 165 patients (96 males [58.2%], mean (SD) age 60.2 years [12.7]) who completed the CEQ Expectancy instrument at admission (median score 21.6, interquartile range [IQR] 17.0–24.0); 79 completed it both at admission (median score 20.6, IQR 16.6–24.4) and follow-up (median score 20.0, IQR 16.4–22.8). For 40 (50.6%) patients, expectations of therapy were fulfilled or exceeded. No patient characteristic at admission was associated with baseline CEQ Expectancy score. Odds of expectation fulfilment were associated with low expectations at admission (OR 0.70, 95% CI 0.60–0.83) and improved EQ-5D score (OR 1.35, 95% CI 1.04–0.75). Conclusions In half of the stroke patients in multidisciplinary rehabilitation, expectations were fulfilled or exceeded, most likely in patients with low expectations at admission and with improved health-related quality of life. More research into the role of health professionals regarding the measurement, shaping and management of outcome expectations is needed. Permalink : ./index.php?lvl=notice_display&id=82401 [article] Patients’ outcome expectations and their fulfilment in multidisciplinary stroke rehabilitation [texte imprimé] / Iris F. Groeneveld ; Paulien Goossens ; Inke van Braak ; et al. . - 2019 . - p. 21-27. Doi : 10.1016/j.rehab.2018.05.1321 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 21-27 Mots-clés : Stroke  Rehabilitation  Expectations  Health-related quality of life Résumé : Highlights Patients’ expectations of inpatient stroke rehabilitation are relatively high. For half of the patients, expectations are fulfilled. An improvement in quality of life enhances the fulfilment of expectations. Management of expectations regarding stroke rehabilitation is important. Abstract Background Patients’ expectations of the outcomes of rehabilitation may influence the outcomes and satisfaction with treatment. Objectives For stroke patients in multidisciplinary rehabilitation, we aimed to explore patients’ outcome expectations and their fulfilment as well as determinants. Methods The Stroke Cohort Outcomes of REhabilitation (SCORE) study included consecutive stroke patients admitted to an inpatient rehabilitation facility after hospitalisation. Outcome expectations were assessed at the start of rehabilitation (admission) by using the three-item Expectancy scale (sum score range 3–27) of the Credibility/Expectancy Questionnaire (CEQ). After rehabilitation, patients answered the same questions formulated in the past tense to assess fulfilment of expectations. Baseline patient characteristics were recorded and health-related quality of life (EQ-5D) was measured at baseline and after rehabilitation. The number of patients with expectations unfulfilled or fulfilled or exceeded was computed by subtracting the admission and discharge CEQ Expectancy scores. Multivariable regression analysis was used to determine the factors associated with outcome expectations and their fulfilment, estimating odds ratios (ORs) and 95% confidence intervals (CIs). Results We included 165 patients (96 males [58.2%], mean (SD) age 60.2 years [12.7]) who completed the CEQ Expectancy instrument at admission (median score 21.6, interquartile range [IQR] 17.0–24.0); 79 completed it both at admission (median score 20.6, IQR 16.6–24.4) and follow-up (median score 20.0, IQR 16.4–22.8). For 40 (50.6%) patients, expectations of therapy were fulfilled or exceeded. No patient characteristic at admission was associated with baseline CEQ Expectancy score. Odds of expectation fulfilment were associated with low expectations at admission (OR 0.70, 95% CI 0.60–0.83) and improved EQ-5D score (OR 1.35, 95% CI 1.04–0.75). Conclusions In half of the stroke patients in multidisciplinary rehabilitation, expectations were fulfilled or exceeded, most likely in patients with low expectations at admission and with improved health-related quality of life. More research into the role of health professionals regarding the measurement, shaping and management of outcome expectations is needed. Permalink : ./index.php?lvl=notice_display&id=82401

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Indicators of long-term return to work after severe traumatic brain injury: A cohort study / V. Wang in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 28-34 Titre : Indicators of long-term return to work after severe traumatic brain injury: A cohort study Type de document : texte imprimé Auteurs : V. Wang ; E. Fort ; M. Beaudoin-Gobert ; et al. Année de publication : 2019 Article en page(s) : p. 28-34 Note générale : Doi : 10.1016/j.rehab.2018.08.003 Langues : Anglais (eng) Mots-clés : Return to work  Traumatic brain injury  Occupational outcome  Job stability  Vocational rehabilitation Résumé : Background Return to work (RTW) is a major objective in the rehabilitation of individuals with severe traumatic brain injury (TBI). Implications for long-term occupational integration (beyond 5 years) have rarely been studied. Objective The objective was to assess long-term RTW and the associated factors after severe TBI. Material and methods Retrospective analysis of a cohort of individuals 16 to 60 years old admitted to hospital after severe TBI from 2005 to 2009 and followed prospectively. Medical and occupational data were collected from medical files and by systematic telephone interview to assess outcome at a minimum of 6 years post-trauma. Factors associated with RTW were investigated by multivariable regression analysis, estimating prevalence ratios (PRs) and 95% confidence intervals (CIs). A proportional hazards model was used to study RTW delay, estimating hazard ratios (HRs). Results Among the 91 individuals included (mean [SD] age 28.5 [11.3] years; 79% male), 63.7% returned to work after a mean of about 20 months, and 57.1% were still working at the time of the survey. Factors significantly associated with RTW on multivariable analysis were higher educational level (adjusted PR, 1.53; 95% CI, 1.15 to 2.03), absence of motor disability (adjusted PR, 1.82; 1.12 to 2.95) and behavioural disorder (adjusted PR, 1.26; 1.01 to 1.60), as well as disabled worker status (adjusted PR, 1.26; 1.01 to 1.60) (likelihood of the multivariate analysis model 53.1). Delayed RTW was associated with health insurance payments (adjusted HR, 0.40; 95% CI, 0.22 to 0.71), motor disability (adjusted HR, 0.34; 0.15 to 0.76), low educational level (adjusted HR, 2.20; 1.06 to 4.56) and moderate disability on the Extended Glasgow Outcome Scale (adjusted HR, 0.49; 0.27 to 0.91) (likelihood of the multivariate analysis model 335.5). Conclusion Individuals with the most severe TBI are able to RTW and remain in work. This study highlights the multiple determinants involved in RTW and the role of socioenvironmental factors. Permalink : ./index.php?lvl=notice_display&id=82636 [article] Indicators of long-term return to work after severe traumatic brain injury: A cohort study [texte imprimé] / V. Wang ; E. Fort ; M. Beaudoin-Gobert ; et al. . - 2019 . - p. 28-34. Doi : 10.1016/j.rehab.2018.08.003 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 28-34 Mots-clés : Return to work  Traumatic brain injury  Occupational outcome  Job stability  Vocational rehabilitation Résumé : Background Return to work (RTW) is a major objective in the rehabilitation of individuals with severe traumatic brain injury (TBI). Implications for long-term occupational integration (beyond 5 years) have rarely been studied. Objective The objective was to assess long-term RTW and the associated factors after severe TBI. Material and methods Retrospective analysis of a cohort of individuals 16 to 60 years old admitted to hospital after severe TBI from 2005 to 2009 and followed prospectively. Medical and occupational data were collected from medical files and by systematic telephone interview to assess outcome at a minimum of 6 years post-trauma. Factors associated with RTW were investigated by multivariable regression analysis, estimating prevalence ratios (PRs) and 95% confidence intervals (CIs). A proportional hazards model was used to study RTW delay, estimating hazard ratios (HRs). Results Among the 91 individuals included (mean [SD] age 28.5 [11.3] years; 79% male), 63.7% returned to work after a mean of about 20 months, and 57.1% were still working at the time of the survey. Factors significantly associated with RTW on multivariable analysis were higher educational level (adjusted PR, 1.53; 95% CI, 1.15 to 2.03), absence of motor disability (adjusted PR, 1.82; 1.12 to 2.95) and behavioural disorder (adjusted PR, 1.26; 1.01 to 1.60), as well as disabled worker status (adjusted PR, 1.26; 1.01 to 1.60) (likelihood of the multivariate analysis model 53.1). Delayed RTW was associated with health insurance payments (adjusted HR, 0.40; 95% CI, 0.22 to 0.71), motor disability (adjusted HR, 0.34; 0.15 to 0.76), low educational level (adjusted HR, 2.20; 1.06 to 4.56) and moderate disability on the Extended Glasgow Outcome Scale (adjusted HR, 0.49; 0.27 to 0.91) (likelihood of the multivariate analysis model 335.5). Conclusion Individuals with the most severe TBI are able to RTW and remain in work. This study highlights the multiple determinants involved in RTW and the role of socioenvironmental factors. Permalink : ./index.php?lvl=notice_display&id=82636

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Validation of French upper limb Erasmus modified Nottingham Sensory Assessment in stroke / Claire Villepinte in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 35-42 Titre : Validation of French upper limb Erasmus modified Nottingham Sensory Assessment in stroke Type de document : texte imprimé Auteurs : Claire Villepinte ; Emilie Catella ; Magali Martin ; et al. Année de publication : 2019 Article en page(s) : p. 35-42 Note générale : Doi : 10.1016/j.rehab.2018.03.004 Langues : Anglais (eng) Mots-clés : Stroke  Upper extremity  Outcome assessment  Somatosensory disorders  Reproducibility of results Résumé : Background Somatosensory impairment of the upper limb (UL) occurs in approximately 50% of adults post-stroke, associated with loss of hand motor function, activity and participation. Measurement of UL sensory impairment is a component of rehabilitation contributing to the selection of sensorimotor techniques optimizing recovery and providing a prognostic estimate of UL function. To date, no standardized official French version of a measure of somatosensory impairment has been established. Objective To develop and validate a French version of the Erasmus modified Nottingham Sensory Assessment somatosensory (EmNSA-SS) and stereognosis (EmNSA-ST) component for evaluating the UL among adults with stroke. Methods This study is a single-center observational cross-sectional study. A French version of the EmNSA for UL was developed by forward-backward translation and cross-cultural adaptation. Fifty stroke patients were recruited to establish concurrent-criterion-related validity, internal consistency, intra- and inter-rater reproducibility with intracorrelation coefficients (ICCs) for reliability and the minimal detectable change with 95% confidence interval (MDC95) for agreement, as well as ceiling and floor effects. Criterion validity was assessed against the Fugl-Meyer Assessment-Sensory (FMA-S) for the UL. Results The median (range) EmNSA-SS score was 41.5 (1–44). The Spearman rank correlation coefficient between EmNSA-SS and FMA-S total scores was moderate (rho=0.74, P<0.001). The EmNSA-SS/ST internal consistency was adequate across subscales; with Cronbach α ranging from 0.82–0.96. For the EmNSA-SS total score, intra- and inter-rater reliability was excellent (ICC=0.92 in both cases), with MDC95 of 12.3 and 14.6, respectively. EmNSA-SS/ST total scores demonstrated no ceiling or floor effects. Conclusions The French EmNSA is a valid and reproducible scale that can be used for comprehensive and accurate assessment of somatosensory modalities in adults post-stroke. Taking less than 30min to administer, the instrument has clinical utility for use in patients with cognitive comorbidities and at various stages of recovery in multidisciplinary clinical practice and research settings. Permalink : ./index.php?lvl=notice_display&id=82637 [article] Validation of French upper limb Erasmus modified Nottingham Sensory Assessment in stroke [texte imprimé] / Claire Villepinte ; Emilie Catella ; Magali Martin ; et al. . - 2019 . - p. 35-42. Doi : 10.1016/j.rehab.2018.03.004 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 35-42 Mots-clés : Stroke  Upper extremity  Outcome assessment  Somatosensory disorders  Reproducibility of results Résumé : Background Somatosensory impairment of the upper limb (UL) occurs in approximately 50% of adults post-stroke, associated with loss of hand motor function, activity and participation. Measurement of UL sensory impairment is a component of rehabilitation contributing to the selection of sensorimotor techniques optimizing recovery and providing a prognostic estimate of UL function. To date, no standardized official French version of a measure of somatosensory impairment has been established. Objective To develop and validate a French version of the Erasmus modified Nottingham Sensory Assessment somatosensory (EmNSA-SS) and stereognosis (EmNSA-ST) component for evaluating the UL among adults with stroke. Methods This study is a single-center observational cross-sectional study. A French version of the EmNSA for UL was developed by forward-backward translation and cross-cultural adaptation. Fifty stroke patients were recruited to establish concurrent-criterion-related validity, internal consistency, intra- and inter-rater reproducibility with intracorrelation coefficients (ICCs) for reliability and the minimal detectable change with 95% confidence interval (MDC95) for agreement, as well as ceiling and floor effects. Criterion validity was assessed against the Fugl-Meyer Assessment-Sensory (FMA-S) for the UL. Results The median (range) EmNSA-SS score was 41.5 (1–44). The Spearman rank correlation coefficient between EmNSA-SS and FMA-S total scores was moderate (rho=0.74, P<0.001). The EmNSA-SS/ST internal consistency was adequate across subscales; with Cronbach α ranging from 0.82–0.96. For the EmNSA-SS total score, intra- and inter-rater reliability was excellent (ICC=0.92 in both cases), with MDC95 of 12.3 and 14.6, respectively. EmNSA-SS/ST total scores demonstrated no ceiling or floor effects. Conclusions The French EmNSA is a valid and reproducible scale that can be used for comprehensive and accurate assessment of somatosensory modalities in adults post-stroke. Taking less than 30min to administer, the instrument has clinical utility for use in patients with cognitive comorbidities and at various stages of recovery in multidisciplinary clinical practice and research settings. Permalink : ./index.php?lvl=notice_display&id=82637

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Analgesic gas for rehabilitation of frozen shoulder: Protocol for a randomized controlled trial / Arnaud Dupeyron in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 43-48 Titre : Analgesic gas for rehabilitation of frozen shoulder: Protocol for a randomized controlled trial Type de document : texte imprimé Auteurs : Arnaud Dupeyron ; Marie Dénarié ; Dominique Richard ; et al. Année de publication : 2019 Article en page(s) : p. 43-48 Note générale : Doi : 10.1016/j.rehab.2018.07.007 Langues : Anglais (eng) Mots-clés : Adhesive capsulitis  Shoulder  Physical therapy  Rehabilitation  Analgesia Résumé : Background There is little evidence regarding the best way to treat adhesive capsulitis. Physical therapy can reduce pain and improve function and range of motion. However, we lack clear indications on the regimen, techniques or intensity of physical therapy to achieve better results. Intensive physical therapy seems to be confined to the later stages of adhesive capsulitis (chronic stage) given that rehabilitation-induced pain could worsen the outcomes. Here we describe a protocol for a study comparing the efficacy of a standardized program of intensive mobilization under analgesic gas to a similar program under placebo gas and questioning the impact of pain. Method/Design A randomized, double-blind, multicenter study — the MEOPA Trial — was designed to include adults with strictly defined clinical adhesive capsulitis for a 14-day intensive physical rehabilitation program under an equimolar mixture of oxygen and nitrous oxide or sham gas administration. Efficacy will be assessed by the Constant-Murley score. Data for secondary criteria including pain, disability, quality of life and perceived efficacy by the patient or physiotherapist will be collected over 6 months. Discussion This randomized controlled trial has been designed to test the effectiveness of intensive physical therapy under a simple and safe analgesic method. This study will also address the effect of pain during rehabilitation in adhesive capsulitis. Furthermore, results from the 6-month multidimensional follow-up of painful mobilization for this condition could be extrapolated to other musculoskeletal conditions. Permalink : ./index.php?lvl=notice_display&id=82638 [article] Analgesic gas for rehabilitation of frozen shoulder: Protocol for a randomized controlled trial [texte imprimé] / Arnaud Dupeyron ; Marie Dénarié ; Dominique Richard ; et al. . - 2019 . - p. 43-48. Doi : 10.1016/j.rehab.2018.07.007 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 43-48 Mots-clés : Adhesive capsulitis  Shoulder  Physical therapy  Rehabilitation  Analgesia Résumé : Background There is little evidence regarding the best way to treat adhesive capsulitis. Physical therapy can reduce pain and improve function and range of motion. However, we lack clear indications on the regimen, techniques or intensity of physical therapy to achieve better results. Intensive physical therapy seems to be confined to the later stages of adhesive capsulitis (chronic stage) given that rehabilitation-induced pain could worsen the outcomes. Here we describe a protocol for a study comparing the efficacy of a standardized program of intensive mobilization under analgesic gas to a similar program under placebo gas and questioning the impact of pain. Method/Design A randomized, double-blind, multicenter study — the MEOPA Trial — was designed to include adults with strictly defined clinical adhesive capsulitis for a 14-day intensive physical rehabilitation program under an equimolar mixture of oxygen and nitrous oxide or sham gas administration. Efficacy will be assessed by the Constant-Murley score. Data for secondary criteria including pain, disability, quality of life and perceived efficacy by the patient or physiotherapist will be collected over 6 months. Discussion This randomized controlled trial has been designed to test the effectiveness of intensive physical therapy under a simple and safe analgesic method. This study will also address the effect of pain during rehabilitation in adhesive capsulitis. Furthermore, results from the 6-month multidimensional follow-up of painful mobilization for this condition could be extrapolated to other musculoskeletal conditions. Permalink : ./index.php?lvl=notice_display&id=82638

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Virtual reality for spinal cord injury-associated neuropathic pain: Systematic review / B. Chi in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 49-57 Titre : Virtual reality for spinal cord injury-associated neuropathic pain: Systematic review Type de document : texte imprimé Auteurs : B. Chi ; B. Chau ; E. Yeo ; P. Ta Année de publication : 2019 Article en page(s) : p. 49-57 Note générale : Doi : 10.1016/j.rehab.2018.09.006 Langues : Anglais (eng) Mots-clés : Virtual reality  Spinal cord injury  Neuropathic pain Résumé : Background Treatment of spinal cord injury (SCI)-associated neuropathic pain is challenging, with limited efficacy and no definitive options, and SCI patients often show resistance to pharmacologic treatment. Virtual reality (VR) therapy is a non-invasive, non-pharmacologic alternative with minimal adverse effects. Objective To investigate the effect of VR therapy on SCI-associated neuropathic pain in a systematic review. Methods Articles needed to 1) be written in English; 2) include adult subjects, with at least half the study population with a SCI diagnosis; 3) involve any form of VR therapy; and 4) assess neuropathic pain by quantitative outcome measures. Articles were searched in MEDLINE/PubMed, CINAHL®, EMBASE, and PsycINFO up to April 2018. Reference lists of retrieved articles were hand-searched. Methodologic quality was assessed by the Physiotherapy Evidence Database Score (PEDro) for randomized controlled trials and Modified Downs and Black Tool (D&B) for all other studies. Level of evidence was determined by using a modified Sackett scale. Results Among 333 studies identified, 9 included in this review (n=150 participants) evaluated 4 methods of VR therapy (virtual walking, VR-augmented training, virtual illusion, and VR hypnosis) for treating neuropathic pain in SCI patients. Each VR method reduced neuropathic pain: 4 studies supported virtual walking, and the other 3 VR methods were each supported by a different study. Combined treatment with virtual walking and transcranial direct current stimulation was the most effective. The quality of studies was a major limitation. Conclusion VR therapy could reduce SCI-associated neuropathic pain, although the clinical significance of this analgesic effect is unclear. Clinical trials evaluating VR therapy as standalone and/or adjunct therapy for neuropathic pain in SCI patients are warranted. Permalink : ./index.php?lvl=notice_display&id=82639 [article] Virtual reality for spinal cord injury-associated neuropathic pain: Systematic review [texte imprimé] / B. Chi ; B. Chau ; E. Yeo ; P. Ta . - 2019 . - p. 49-57. Doi : 10.1016/j.rehab.2018.09.006 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 49-57 Mots-clés : Virtual reality  Spinal cord injury  Neuropathic pain Résumé : Background Treatment of spinal cord injury (SCI)-associated neuropathic pain is challenging, with limited efficacy and no definitive options, and SCI patients often show resistance to pharmacologic treatment. Virtual reality (VR) therapy is a non-invasive, non-pharmacologic alternative with minimal adverse effects. Objective To investigate the effect of VR therapy on SCI-associated neuropathic pain in a systematic review. Methods Articles needed to 1) be written in English; 2) include adult subjects, with at least half the study population with a SCI diagnosis; 3) involve any form of VR therapy; and 4) assess neuropathic pain by quantitative outcome measures. Articles were searched in MEDLINE/PubMed, CINAHL®, EMBASE, and PsycINFO up to April 2018. Reference lists of retrieved articles were hand-searched. Methodologic quality was assessed by the Physiotherapy Evidence Database Score (PEDro) for randomized controlled trials and Modified Downs and Black Tool (D&B) for all other studies. Level of evidence was determined by using a modified Sackett scale. Results Among 333 studies identified, 9 included in this review (n=150 participants) evaluated 4 methods of VR therapy (virtual walking, VR-augmented training, virtual illusion, and VR hypnosis) for treating neuropathic pain in SCI patients. Each VR method reduced neuropathic pain: 4 studies supported virtual walking, and the other 3 VR methods were each supported by a different study. Combined treatment with virtual walking and transcranial direct current stimulation was the most effective. The quality of studies was a major limitation. Conclusion VR therapy could reduce SCI-associated neuropathic pain, although the clinical significance of this analgesic effect is unclear. Clinical trials evaluating VR therapy as standalone and/or adjunct therapy for neuropathic pain in SCI patients are warranted. Permalink : ./index.php?lvl=notice_display&id=82639

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Early rehabilitation after stroke: Strong recommendations but no achievement in the French Acute Healthcare Facilities / Alexis Schnitzler in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 58-59 Titre : Early rehabilitation after stroke: Strong recommendations but no achievement in the French Acute Healthcare Facilities Type de document : texte imprimé Auteurs : Alexis Schnitzler ; Marie Erbault ; Agnès Solomiac ; et al. Année de publication : 2019 Article en page(s) : p. 58-59 Note générale : Doi : 10.1016/j.rehab.2018.07.001 Langues : Anglais (eng) Permalink : ./index.php?lvl=notice_display&id=82640 [article] Early rehabilitation after stroke: Strong recommendations but no achievement in the French Acute Healthcare Facilities [texte imprimé] / Alexis Schnitzler ; Marie Erbault ; Agnès Solomiac ; et al. . - 2019 . - p. 58-59. Doi : 10.1016/j.rehab.2018.07.001 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 58-59 Permalink : ./index.php?lvl=notice_display&id=82640

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Tibialis anterior tendinopathy in a dystonic talipes calcaneovarus foot: A case treated by botulinum toxin / Nadine Sturbois-Nachef in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 60-63 Titre : Tibialis anterior tendinopathy in a dystonic talipes calcaneovarus foot: A case treated by botulinum toxin Type de document : texte imprimé Auteurs : Nadine Sturbois-Nachef Année de publication : 2019 Article en page(s) : p. 60-63 Note générale : Doi : 10.1016/j.rehab.2018.06.007 Langues : Anglais (eng) Permalink : ./index.php?lvl=notice_display&id=82641 [article] Tibialis anterior tendinopathy in a dystonic talipes calcaneovarus foot: A case treated by botulinum toxin [texte imprimé] / Nadine Sturbois-Nachef . - 2019 . - p. 60-63. Doi : 10.1016/j.rehab.2018.06.007 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 60-63 Permalink : ./index.php?lvl=notice_display&id=82641

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Static peak pressure under the sole is unrelated to gait alteration in rheumatoid arthritis / Armand Bonnin in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 64-66 Titre : Static peak pressure under the sole is unrelated to gait alteration in rheumatoid arthritis Type de document : texte imprimé Auteurs : Armand Bonnin ; Bruno Pereira ; Claire Pourtier-Piotte ; et al. Année de publication : 2019 Article en page(s) : p. 64-66 Note générale : Doi : 10.1016/j.rehab.2018.07.009 Langues : Anglais (eng) Permalink : ./index.php?lvl=notice_display&id=82642 [article] Static peak pressure under the sole is unrelated to gait alteration in rheumatoid arthritis [texte imprimé] / Armand Bonnin ; Bruno Pereira ; Claire Pourtier-Piotte ; et al. . - 2019 . - p. 64-66. Doi : 10.1016/j.rehab.2018.07.009 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 64-66 Permalink : ./index.php?lvl=notice_display&id=82642

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