An alternative treatment for contractures of the elderly institutionalized persons: Microinvasive percutaneous needle tenotomy of the finger flexors / Alexis Schnitzler in Annals of physical and rehabilitation medicine, Vol. 59, n° 2 (April 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n° 2 (April 2016) . - p. 83-86 Titre : An alternative treatment for contractures of the elderly institutionalized persons: Microinvasive percutaneous needle tenotomy of the finger flexors Type de document : texte imprimé Auteurs : Alexis Schnitzler, Auteur ; Aurélie Diebold, Auteur ; Bernard Parratte, Auteur Année de publication : 2016 Article en page(s) : p. 83-86 Langues : Anglais (eng) Français (fre) Mots-clés : Personne âgée  Maison accueil personne âgée  Main  Muscle  Contractures,Tenotomy,Needle,Finger flexors Résumé : Background: Almost 10% of older adults in nursing homes have a fixed flexion deformity of the fingers (claw hand). Such contractures have important functional consequences, often leading to hygiene difficulties. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning) is not always effective and surgery is often not possible in such fragile patients. Microinvasive tenotomy with a large needle could be a useful alternative because it can be carried out in an ambulatory setting under local anaesthesia. Methods: A single center, retrospective study involving the 2012–2014 database from the day-hospital unit of a neuro-orthopaedic department in France. All patients who underwent percutaneous needle tenotomy of the finger or thumb flexors were included. Outcomes included Goal Attainment Scaling (GAS) and the distance in centimeters between the palm and the pulp of the most flexed digit (PPD). Results: Eighteen patients underwent tenotomy (13 women; mean age: 76+14 years); all patients lived in a nursing home. The limb to be treated was nonfunctional in all patients. The principal goal was determined by consensus with the patients and their health-care teams and was most often to facilitate hand hygiene. Eight patients had at least one secondary goal. In total, 10 patients underwent microinvasive tenotomy for 4 fingers, 5 patients 1 to 4 fingers and 3 patients only the thumb. At 3 months after treatment, goals were achieved for 11 patients, 5 patients progressed toward the goal without attaining it, and for 2 patients, scores were worse. The T-scores of the GAS and the PPD were significantly increased at 3 months (P =0.0326 and P =0.0002, respectively). No serious adverse events occurred. Conclusion: Large-needle tenotomy seems safe and effective for treating claw hand in fragile older patients. Permalink : ./index.php?lvl=notice_display&id=44278 [article] An alternative treatment for contractures of the elderly institutionalized persons: Microinvasive percutaneous needle tenotomy of the finger flexors [texte imprimé] / Alexis Schnitzler, Auteur ; Aurélie Diebold, Auteur ; Bernard Parratte, Auteur . - 2016 . - p. 83-86. Langues : Anglais (eng) Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n° 2 (April 2016) . - p. 83-86 Mots-clés : Personne âgée  Maison accueil personne âgée  Main  Muscle  Contractures,Tenotomy,Needle,Finger flexors Résumé : Background: Almost 10% of older adults in nursing homes have a fixed flexion deformity of the fingers (claw hand). Such contractures have important functional consequences, often leading to hygiene difficulties. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning) is not always effective and surgery is often not possible in such fragile patients. Microinvasive tenotomy with a large needle could be a useful alternative because it can be carried out in an ambulatory setting under local anaesthesia. Methods: A single center, retrospective study involving the 2012–2014 database from the day-hospital unit of a neuro-orthopaedic department in France. All patients who underwent percutaneous needle tenotomy of the finger or thumb flexors were included. Outcomes included Goal Attainment Scaling (GAS) and the distance in centimeters between the palm and the pulp of the most flexed digit (PPD). Results: Eighteen patients underwent tenotomy (13 women; mean age: 76+14 years); all patients lived in a nursing home. The limb to be treated was nonfunctional in all patients. The principal goal was determined by consensus with the patients and their health-care teams and was most often to facilitate hand hygiene. Eight patients had at least one secondary goal. In total, 10 patients underwent microinvasive tenotomy for 4 fingers, 5 patients 1 to 4 fingers and 3 patients only the thumb. At 3 months after treatment, goals were achieved for 11 patients, 5 patients progressed toward the goal without attaining it, and for 2 patients, scores were worse. The T-scores of the GAS and the PPD were significantly increased at 3 months (P =0.0326 and P =0.0002, respectively). No serious adverse events occurred. Conclusion: Large-needle tenotomy seems safe and effective for treating claw hand in fragile older patients. Permalink : ./index.php?lvl=notice_display&id=44278

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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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Participation in work and leisure activities after stroke: A national study / Alexis Schnitzler in Annals of physical and rehabilitation medicine, Vol. 62, n°5 (Septembre 2019)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°5 (Septembre 2019) . - p. 351-355 Titre : Participation in work and leisure activities after stroke: A national study Type de document : texte imprimé Auteurs : Alexis Schnitzler ; Claire Jourdan ; Loïc Josseran ; Philippe Azouvi ; Louis Jacob ; François Genêt Année de publication : 2019 Article en page(s) : p. 351-355 Note générale : doi.org/10.1016/j.rehab.2019.04.005 Langues : Anglais (eng) Résumé : Background Stroke is a common and debilitating neurological disorder having a negative impact on quality of life. Objectives We aimed to compare differences in participation in work and leisure activities between patients with and without a self-reported stroke at the national level in France. Methods This study used cross-sectional data from the Disability Health Survey that was administered in people's homes (DHH) in 2008 and in institutions (DHI) in 2009. Stroke history and levels of participation in work and leisure activities were collected by interviews. The levels of participation in these activities were compared between participants with and without a history of stroke. Results Among the 33,785 interviewed participants, 1725 reported a history of stroke. After weighting, this represented a mean (SD) of 766,641 (36,650) people among 49 million adults living in France. After adjustment, as compared with people without stroke, those with stroke were less likely to work (odds ratio 0.19 [95% confidence interval 0.13–0.27]), use the telephone (0.21 [0.17–0.25]) and drive (0.25 [0.21–0.32]). In the age group 19–59 years, as compared with people without stroke, those with stroke less frequently worked (35.9% vs. 72.2%), drove (54.3% vs. 81.3%) and participated in sports (26.6% vs. 55.8%). Conclusions Overall, our study indicates that people with a history of stroke report more difficulties in participating in work and leisure activities than those without a history of stroke. Permalink : ./index.php?lvl=notice_display&id=84150 [article] Participation in work and leisure activities after stroke: A national study [texte imprimé] / Alexis Schnitzler ; Claire Jourdan ; Loïc Josseran ; Philippe Azouvi ; Louis Jacob ; François Genêt . - 2019 . - p. 351-355. doi.org/10.1016/j.rehab.2019.04.005 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°5 (Septembre 2019) . - p. 351-355 Résumé : Background Stroke is a common and debilitating neurological disorder having a negative impact on quality of life. Objectives We aimed to compare differences in participation in work and leisure activities between patients with and without a self-reported stroke at the national level in France. Methods This study used cross-sectional data from the Disability Health Survey that was administered in people's homes (DHH) in 2008 and in institutions (DHI) in 2009. Stroke history and levels of participation in work and leisure activities were collected by interviews. The levels of participation in these activities were compared between participants with and without a history of stroke. Results Among the 33,785 interviewed participants, 1725 reported a history of stroke. After weighting, this represented a mean (SD) of 766,641 (36,650) people among 49 million adults living in France. After adjustment, as compared with people without stroke, those with stroke were less likely to work (odds ratio 0.19 [95% confidence interval 0.13–0.27]), use the telephone (0.21 [0.17–0.25]) and drive (0.25 [0.21–0.32]). In the age group 19–59 years, as compared with people without stroke, those with stroke less frequently worked (35.9% vs. 72.2%), drove (54.3% vs. 81.3%) and participated in sports (26.6% vs. 55.8%). Conclusions Overall, our study indicates that people with a history of stroke report more difficulties in participating in work and leisure activities than those without a history of stroke. Permalink : ./index.php?lvl=notice_display&id=84150

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Recurrence of heterotopic ossification after removal in patients with traumatic brain injury: A systematic review / Waleed Almangour in Annals of physical and rehabilitation medicine, Vol. 59, n° 4 (September 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n° 4 (September 2016) . - p. 263-269 Titre : Recurrence of heterotopic ossification after removal in patients with traumatic brain injury: A systematic review Type de document : texte imprimé Auteurs : Waleed Almangour, Auteur ; Alexis Schnitzler, Auteur ; Marjorie Salga, Auteur Année de publication : 2016 Article en page(s) : p. 263-269 Langues : Anglais (eng) Français (fre) Mots-clés : Traumatisme crânien  Revue de littérature  Traumatic brain injury,Head injury,Heterotopic ossification,Recurrence Résumé : Objective: A systematic review of the literature to determine whether in patients with neurological heterotopic ossification (NHO) after traumatic brain injury, the extent of the neurological sequelae, the timing of surgery and the extent of the initial NHO affect the risk of NHO recurrence. Data sources: We searched MEDLINE via PubMed and Cochrane library for articles published up to June 2015. Results were compared with epidemiological studies using data from the BANKHO database of 357 patients with central nervous system (CNS) lesions who underwent 539 interventions for troublesome HO. Results: A large number of studies were published in the 1980s and 1990s, most showing poor quality despite being performed by experienced surgical teams. Accordingly, results were contradictory and practices heterogeneous. Results with the BANKHO data showed troublesome NHO recurrence not associated with aetiology, sex, age at time of CNS lesion, multisite HO, or “early” surgery (before 6months). Equally, recurrence was not associated with neurological sequelae or disease extent around the joint. Conclusions: The recurrence of NHO is not affected by delayed surgery, neurological sequelae or disease extent around the joint. Surgical excision of NHO should be performed as soon as comorbid factors are under control and the NHO is sufficiently constituted for excision. Permalink : ./index.php?lvl=notice_display&id=45220 [article] Recurrence of heterotopic ossification after removal in patients with traumatic brain injury: A systematic review [texte imprimé] / Waleed Almangour, Auteur ; Alexis Schnitzler, Auteur ; Marjorie Salga, Auteur . - 2016 . - p. 263-269. Langues : Anglais (eng) Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n° 4 (September 2016) . - p. 263-269 Mots-clés : Traumatisme crânien  Revue de littérature  Traumatic brain injury,Head injury,Heterotopic ossification,Recurrence Résumé : Objective: A systematic review of the literature to determine whether in patients with neurological heterotopic ossification (NHO) after traumatic brain injury, the extent of the neurological sequelae, the timing of surgery and the extent of the initial NHO affect the risk of NHO recurrence. Data sources: We searched MEDLINE via PubMed and Cochrane library for articles published up to June 2015. Results were compared with epidemiological studies using data from the BANKHO database of 357 patients with central nervous system (CNS) lesions who underwent 539 interventions for troublesome HO. Results: A large number of studies were published in the 1980s and 1990s, most showing poor quality despite being performed by experienced surgical teams. Accordingly, results were contradictory and practices heterogeneous. Results with the BANKHO data showed troublesome NHO recurrence not associated with aetiology, sex, age at time of CNS lesion, multisite HO, or “early” surgery (before 6months). Equally, recurrence was not associated with neurological sequelae or disease extent around the joint. Conclusions: The recurrence of NHO is not affected by delayed surgery, neurological sequelae or disease extent around the joint. Surgical excision of NHO should be performed as soon as comorbid factors are under control and the NHO is sufficiently constituted for excision. Permalink : ./index.php?lvl=notice_display&id=45220

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Surmortalité dans les Ehpad pendant la première vague de la pandémie de la Covid-19 / Simon Bessis in Soins gérontologie, 159 (janvier 2023)

Public ISBD [article]  inSoins gérontologie > 159 (janvier 2023) . - p. 28-30 Titre : Surmortalité dans les Ehpad pendant la première vague de la pandémie de la Covid-19 Type de document : texte imprimé Auteurs : Simon Bessis ; Alexis Schnitzler ; Hélène Mascitti ; Clara Duran ; Aurélien Dinh Année de publication : 2023 Article en page(s) : p. 28-30 Langues : Français (fre) Mots-clés : Covid-19  Gériatrie  Maison de repos et de soin  Mortalité Résumé : La mortalité globale, en France, est de 147 568 décès depuis la première vague. Bien que représentant près de 20 % des décès en France, la surmortalité en Ehpad par rapport aux années précédentes n’a pas été entièrement étudiée. La pandémie de Covid-19 a mis en évidence la vulnérabilité des résidents des établissements de soins de longue durée, les patients âgés très dépendants étant les plus exposés au risque de décès avec des effets délétères liés aux effets du confinement. Celui-ci s’est concrétisé dans les Ehpad par un isolement majeur des résidents et l’apparition par les équipes soignantes de trouble cognitifs apparaissant ou se dégradant chez des résidents, ainsi qu’une perte significative d’autonomie. Permalink : ./index.php?lvl=notice_display&id=109272 [article] Surmortalité dans les Ehpad pendant la première vague de la pandémie de la Covid-19 [texte imprimé] / Simon Bessis ; Alexis Schnitzler ; Hélène Mascitti ; Clara Duran ; Aurélien Dinh . - 2023 . - p. 28-30. Langues : Français (fre) in Soins gérontologie > 159 (janvier 2023) . - p. 28-30 Mots-clés : Covid-19  Gériatrie  Maison de repos et de soin  Mortalité Résumé : La mortalité globale, en France, est de 147 568 décès depuis la première vague. Bien que représentant près de 20 % des décès en France, la surmortalité en Ehpad par rapport aux années précédentes n’a pas été entièrement étudiée. La pandémie de Covid-19 a mis en évidence la vulnérabilité des résidents des établissements de soins de longue durée, les patients âgés très dépendants étant les plus exposés au risque de décès avec des effets délétères liés aux effets du confinement. Celui-ci s’est concrétisé dans les Ehpad par un isolement majeur des résidents et l’apparition par les équipes soignantes de trouble cognitifs apparaissant ou se dégradant chez des résidents, ainsi qu’une perte significative d’autonomie. Permalink : ./index.php?lvl=notice_display&id=109272

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