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Does acupuncture help patients with spasticity? A narrative review / Yi Zhu in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
[article]
Titre : Does acupuncture help patients with spasticity? A narrative review Type de document : texte imprimé Auteurs : Yi Zhu ; Yujie Yang ; Jianan Li Année de publication : 2019 Article en page(s) : p. 297-301 Note générale : doi.org/10.1016/j.rehab.2018.09.010 Langues : Anglais (eng) Mots-clés : Spasticity Upper motor neuron lesion Acupuncture Evidence Stroke Résumé : Spasticity is a motor disorder encountered after upper motor neuron lesions. It adversely affects quality of life in most patients and causes long-term burden of care and has significant financial implications. The effect of conventional therapies for spasticity including physical therapy, surgery, and pharmacotherapy are not always satisfying because of the short-term effects or side effects in some patients. Acupuncture is a part of traditional medicine originating from China. It has been used to resolve functional recovery problems after central nervous system injury for many years in Asian countries and is increasingly popular in western countries. Some researches suggest that acupuncture has therapeutic potential to help improve limb movement function and decrease the severity of spasticity. This review synthesizes studies involving stroke, brain injury, spinal cord injury, cerebral palsy, and multiple sclerosis to give an overall picture of the effect and potential mechanisms of acupuncture on spasticity occurring after upper motor neuron lesions. Moderate-quality evidence suggests that electroacupuncture combined with conventional routine care (pharmacological/rehabilitation) could reduce spasticity and improve motor function and activities in daily living after stroke. However, there is not enough evidence to conclude that acupuncture (including electroacupuncture) could reduce spasticity with other central nervous system diseases. En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314775 Permalink : ./index.php?lvl=notice_display&id=84135
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 297-301[article] Does acupuncture help patients with spasticity? A narrative review [texte imprimé] / Yi Zhu ; Yujie Yang ; Jianan Li . - 2019 . - p. 297-301.
doi.org/10.1016/j.rehab.2018.09.010
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 297-301
Mots-clés : Spasticity Upper motor neuron lesion Acupuncture Evidence Stroke Résumé : Spasticity is a motor disorder encountered after upper motor neuron lesions. It adversely affects quality of life in most patients and causes long-term burden of care and has significant financial implications. The effect of conventional therapies for spasticity including physical therapy, surgery, and pharmacotherapy are not always satisfying because of the short-term effects or side effects in some patients. Acupuncture is a part of traditional medicine originating from China. It has been used to resolve functional recovery problems after central nervous system injury for many years in Asian countries and is increasingly popular in western countries. Some researches suggest that acupuncture has therapeutic potential to help improve limb movement function and decrease the severity of spasticity. This review synthesizes studies involving stroke, brain injury, spinal cord injury, cerebral palsy, and multiple sclerosis to give an overall picture of the effect and potential mechanisms of acupuncture on spasticity occurring after upper motor neuron lesions. Moderate-quality evidence suggests that electroacupuncture combined with conventional routine care (pharmacological/rehabilitation) could reduce spasticity and improve motor function and activities in daily living after stroke. However, there is not enough evidence to conclude that acupuncture (including electroacupuncture) could reduce spasticity with other central nervous system diseases. En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314775 Permalink : ./index.php?lvl=notice_display&id=84135 Exemplaires (1)
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Exclu du prêtNon-pharmacological interventions for spasticity in adults: An overview of systematic reviews / Fary Khan in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
[article]
Titre : Non-pharmacological interventions for spasticity in adults: An overview of systematic reviews Type de document : texte imprimé Auteurs : Fary Khan ; Bhasker Amatya ; D. Bensmail ; Alain P. Yelnik Année de publication : 2019 Article en page(s) : p. 265-273 Note générale : doi.org/10.1016/j.rehab.2017.10.001 Langues : Anglais (eng) Mots-clés : Spasticity Non-pharmacological intervention Rehabilitation Disability Impairment Participation Résumé : Objectives
Spasticity causes significant long-term disability-burden, requiring comprehensive management. This review evaluates evidence from published systematic reviews of clinical trials for effectiveness of non-pharmacological interventions for improved spasticity outcomes.
Methods
Data sources: a literature search was conducted using medical and health science electronic (MEDLINE, EMBASE, CINAHL, PubMed, and the Cochrane Library) databases for published systematic reviews up to 15th June 2017. Data extraction and synthesis: two reviewers applied inclusion criteria to select potential systematic reviews, independently extracted data for methodological quality using Assessment of Multiple Systematic Reviews (AMSTAR). Quality of evidence was critically appraised with Grades of Recommendation, Assessment, Development and Evaluation (GRADE).
Results
Overall 18 systematic reviews were evaluated for evidence for a range of non-pharmacological interventions currently used in managing spasticity in various neurological conditions. There is “moderate” evidence for electro-neuromuscular stimulation and acupuncture as an adjunct therapy to conventional routine care (pharmacological and rehabilitation) in persons following stroke. “Low” quality evidence for rehabilitation programs targeting spasticity (such as induced movement therapy, stretching, dynamic elbow-splinting, occupational therapy) in stroke and other neurological conditions; extracorporeal shock-wave therapy in brain injury; transcranial direct current stimulation in stroke; transcranial magnetic stimulation and transcutaneous electrical nerve stimulation for other neurological conditions; physical activity programs and repetitive magnetic stimulation in persons with MS, vibration therapy for SCI and stretching for other neurological condition. For other interventions, evidence was inconclusive.
Conclusions
Despite the available range of non-pharmacological interventions for spasticity, there is lack of high-quality evidence for many modalities. Further research is needed to judge the effect with appropriate study designs, timing and intensity of modalities, and associate costs of these interventions.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065717304153 Permalink : ./index.php?lvl=notice_display&id=84131
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 265-273[article] Non-pharmacological interventions for spasticity in adults: An overview of systematic reviews [texte imprimé] / Fary Khan ; Bhasker Amatya ; D. Bensmail ; Alain P. Yelnik . - 2019 . - p. 265-273.
doi.org/10.1016/j.rehab.2017.10.001
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 265-273
Mots-clés : Spasticity Non-pharmacological intervention Rehabilitation Disability Impairment Participation Résumé : Objectives
Spasticity causes significant long-term disability-burden, requiring comprehensive management. This review evaluates evidence from published systematic reviews of clinical trials for effectiveness of non-pharmacological interventions for improved spasticity outcomes.
Methods
Data sources: a literature search was conducted using medical and health science electronic (MEDLINE, EMBASE, CINAHL, PubMed, and the Cochrane Library) databases for published systematic reviews up to 15th June 2017. Data extraction and synthesis: two reviewers applied inclusion criteria to select potential systematic reviews, independently extracted data for methodological quality using Assessment of Multiple Systematic Reviews (AMSTAR). Quality of evidence was critically appraised with Grades of Recommendation, Assessment, Development and Evaluation (GRADE).
Results
Overall 18 systematic reviews were evaluated for evidence for a range of non-pharmacological interventions currently used in managing spasticity in various neurological conditions. There is “moderate” evidence for electro-neuromuscular stimulation and acupuncture as an adjunct therapy to conventional routine care (pharmacological and rehabilitation) in persons following stroke. “Low” quality evidence for rehabilitation programs targeting spasticity (such as induced movement therapy, stretching, dynamic elbow-splinting, occupational therapy) in stroke and other neurological conditions; extracorporeal shock-wave therapy in brain injury; transcranial direct current stimulation in stroke; transcranial magnetic stimulation and transcutaneous electrical nerve stimulation for other neurological conditions; physical activity programs and repetitive magnetic stimulation in persons with MS, vibration therapy for SCI and stretching for other neurological condition. For other interventions, evidence was inconclusive.
Conclusions
Despite the available range of non-pharmacological interventions for spasticity, there is lack of high-quality evidence for many modalities. Further research is needed to judge the effect with appropriate study designs, timing and intensity of modalities, and associate costs of these interventions.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065717304153 Permalink : ./index.php?lvl=notice_display&id=84131 Exemplaires (1)
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Exclu du prêtAdjunct therapies to improve outcomes after botulinum toxin injection in children: A systematic review / L. Mathevon in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
[article]
Titre : Adjunct therapies to improve outcomes after botulinum toxin injection in children: A systematic review Type de document : texte imprimé Auteurs : L. Mathevon ; Isabelle V. Bonan ; J.-L. Barnais ; Mickael Dinomais Année de publication : 2019 Article en page(s) : p. 283-290 Note générale : doi.org/10.1016/j.rehab.2018.06.010 Langues : Anglais (eng) Mots-clés : Spasticity Cerebral palsy Botulinum toxin Casting Rehabilitation programme Résumé : Background
Botulinum toxin (BTX) injection alone is not sufficient to treat spasticity in children, notably those with cerebral palsy; thus, there is an emerging trend for adjunct therapies to offer greater outcomes than BTX alone.
Objective
The aim of this systematic review was to evaluate the general effectiveness of adjunct therapies regardless of their nature in children with spasticity.
Methods
Medline, Cochrane and Embase databases were searched from January 1980 to March 15, 2018 for reports of parallel-group trials (randomized controlled trials [RCTs] and non-RCTs) assessing adjunct therapies after BTX injection for treating spasticity in children. Two independent reviewers extracted data and assessed the risk of bias by using the PEDro scale for RCTs and Downs and Black scale (D&B) for non-RCTs.
Results
Overall, 20 articles involving 662 participants met the inclusion criteria. The average quality was good for the 16 RCTs (mean PEDro score 7.4 [SD 1.6]) and poor to moderate for the 4 non-RCTs (D&B score 9 to 17). Adjunct therapies consisted of casting/posture, electrical stimulation, resistance training and rehabilitation programmes. Casting associated with BTX injection improved the range of passive and active motion and reduced spasticity better than did BTX alone (9 studies), with a follow-up of 1 year. Resistance training enhanced the quality and performance of muscles without increasing spasticity. Only 3 rehabilitation programmes were studied, with encouraging results for activities.
Conclusion
Lower-limb posture with casting in children has a high level of evidence, but the long-term efficacy of short-leg casting needs to be evaluated. A comparison between the different modalities of casting is missing, and studies specifically devoted to testing the different kinds of casting are needed. Moreover, the delay to casting after BTX injection is not clear. Data on electrical stimulation are not conclusive. Despite the small number of studies, resistance training could be an interesting adjunct therapy notably to avoid loss of strength after BTX injection. Rehabilitation programmes after BTX injection still need to be evaluated.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314301 Permalink : ./index.php?lvl=notice_display&id=84133
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 283-290[article] Adjunct therapies to improve outcomes after botulinum toxin injection in children: A systematic review [texte imprimé] / L. Mathevon ; Isabelle V. Bonan ; J.-L. Barnais ; Mickael Dinomais . - 2019 . - p. 283-290.
doi.org/10.1016/j.rehab.2018.06.010
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 283-290
Mots-clés : Spasticity Cerebral palsy Botulinum toxin Casting Rehabilitation programme Résumé : Background
Botulinum toxin (BTX) injection alone is not sufficient to treat spasticity in children, notably those with cerebral palsy; thus, there is an emerging trend for adjunct therapies to offer greater outcomes than BTX alone.
Objective
The aim of this systematic review was to evaluate the general effectiveness of adjunct therapies regardless of their nature in children with spasticity.
Methods
Medline, Cochrane and Embase databases were searched from January 1980 to March 15, 2018 for reports of parallel-group trials (randomized controlled trials [RCTs] and non-RCTs) assessing adjunct therapies after BTX injection for treating spasticity in children. Two independent reviewers extracted data and assessed the risk of bias by using the PEDro scale for RCTs and Downs and Black scale (D&B) for non-RCTs.
Results
Overall, 20 articles involving 662 participants met the inclusion criteria. The average quality was good for the 16 RCTs (mean PEDro score 7.4 [SD 1.6]) and poor to moderate for the 4 non-RCTs (D&B score 9 to 17). Adjunct therapies consisted of casting/posture, electrical stimulation, resistance training and rehabilitation programmes. Casting associated with BTX injection improved the range of passive and active motion and reduced spasticity better than did BTX alone (9 studies), with a follow-up of 1 year. Resistance training enhanced the quality and performance of muscles without increasing spasticity. Only 3 rehabilitation programmes were studied, with encouraging results for activities.
Conclusion
Lower-limb posture with casting in children has a high level of evidence, but the long-term efficacy of short-leg casting needs to be evaluated. A comparison between the different modalities of casting is missing, and studies specifically devoted to testing the different kinds of casting are needed. Moreover, the delay to casting after BTX injection is not clear. Data on electrical stimulation are not conclusive. Despite the small number of studies, resistance training could be an interesting adjunct therapy notably to avoid loss of strength after BTX injection. Rehabilitation programmes after BTX injection still need to be evaluated.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314301 Permalink : ./index.php?lvl=notice_display&id=84133 Exemplaires (1)
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Exclu du prêtDoes botulinum toxin treatment improve upper limb active function? / Jonathan Lévy in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
[article]
Titre : Does botulinum toxin treatment improve upper limb active function? Type de document : texte imprimé Auteurs : Jonathan Lévy Année de publication : 2019 Article en page(s) : p. 234-240 Note générale : https://doi.org/10.1016/j.rehab.2018.05.1320 Langues : Anglais (eng) Mots-clés : Spasticity Botulinum toxin Rehabilitation Outcome Upper limb Stroke Résumé : Background
Spasticity following lesions of the central nervous system such as stroke is a major cause of impairment and disability, especially when it affects the upper limb, and can be focally relieved by intramuscular injections of botulinum toxin (BT). Functional improvements of the affected upper limb after a BT focal treatment remain controversial.
Objective
We aimed to assess the functional effects of BT treatment on upper-limb spasticity in the literature, identify flaws and deficiencies in proving these effects and propose leads for future trials.
Methods
We searched the MEDLINE and Cochrane databases for trials, reviews and meta-analyses assessing the effect of BT injection in upper-limb spasticity. This was a non-systematic narrative review, and the selection of articles was based on the authors’ expertise. The review focused on stroke-related spasticity and disability.
Results
Patients’ therapeutic targets involved use of the disability assessment scale (DAS) or goal attainment scale (GAS). Impairments and passive function goals prevailed for active function and participation and were more frequently achieved for the former than the latter. Meta-analyses showed no to mild effect sizes for improvement in upper-limb function but failed to show higher and/or better use of the paretic upper limb in activities of daily living after BT injection.
Conclusion
BT injections for impairment and passive function are related to improved kinematic parameters; however, the relation between relief of spasticity and improved upper-limb activity has not been established. Possible explanations for the lack of functional effect in studies are first, disability is mainly due to muscle weakness rather than spasticity, so patients with the best underlying motricity may benefit the most from BT injections; second, assessment methods may not be adapted to screen eligible patients; third, most studies’ endpoints were at 4 to 12 weeks after a single injection, but repeated treatment sessions might be needed to observe functional outcome on the upper limbs; and finally, the association of rehabilitation programs or non-pharmacological treatments may enhance the functional effects of BT injections.En ligne : https://www.sciencedirect.com/science/article/pii/S187706571831409X Permalink : ./index.php?lvl=notice_display&id=84128
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 234-240[article] Does botulinum toxin treatment improve upper limb active function? [texte imprimé] / Jonathan Lévy . - 2019 . - p. 234-240.
https://doi.org/10.1016/j.rehab.2018.05.1320
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 234-240
Mots-clés : Spasticity Botulinum toxin Rehabilitation Outcome Upper limb Stroke Résumé : Background
Spasticity following lesions of the central nervous system such as stroke is a major cause of impairment and disability, especially when it affects the upper limb, and can be focally relieved by intramuscular injections of botulinum toxin (BT). Functional improvements of the affected upper limb after a BT focal treatment remain controversial.
Objective
We aimed to assess the functional effects of BT treatment on upper-limb spasticity in the literature, identify flaws and deficiencies in proving these effects and propose leads for future trials.
Methods
We searched the MEDLINE and Cochrane databases for trials, reviews and meta-analyses assessing the effect of BT injection in upper-limb spasticity. This was a non-systematic narrative review, and the selection of articles was based on the authors’ expertise. The review focused on stroke-related spasticity and disability.
Results
Patients’ therapeutic targets involved use of the disability assessment scale (DAS) or goal attainment scale (GAS). Impairments and passive function goals prevailed for active function and participation and were more frequently achieved for the former than the latter. Meta-analyses showed no to mild effect sizes for improvement in upper-limb function but failed to show higher and/or better use of the paretic upper limb in activities of daily living after BT injection.
Conclusion
BT injections for impairment and passive function are related to improved kinematic parameters; however, the relation between relief of spasticity and improved upper-limb activity has not been established. Possible explanations for the lack of functional effect in studies are first, disability is mainly due to muscle weakness rather than spasticity, so patients with the best underlying motricity may benefit the most from BT injections; second, assessment methods may not be adapted to screen eligible patients; third, most studies’ endpoints were at 4 to 12 weeks after a single injection, but repeated treatment sessions might be needed to observe functional outcome on the upper limbs; and finally, the association of rehabilitation programs or non-pharmacological treatments may enhance the functional effects of BT injections.En ligne : https://www.sciencedirect.com/science/article/pii/S187706571831409X Permalink : ./index.php?lvl=notice_display&id=84128 Exemplaires (1)
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Exclu du prêtElectrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study / Alessio Baricich in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
[article]
Titre : Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study Type de document : texte imprimé Auteurs : Alessio Baricich ; Alessandro Picelli ; Stefano Carda ; Nicola Smania ; Carlo Cisari ; Andrea Santamato ; Allessandro de Sire ; Marco Invernizzi Année de publication : 2019 Article en page(s) : p. 214-219 Note générale : https://doi.org/10.1016/j.rehab.2019.06.002 Langues : Anglais (eng) Mots-clés : Stroke Spasticity Botulinum toxin type A Electrical stimulation Rehabilitation Résumé : Background
Botulinum toxin type A (BoNT-A) injection is an effective treatment for lower-limb spasticity and should be offered as first-line treatment for focal manifestations. Although its possible role has been hypothesized, the efficacy of electrical stimulation (ES) of antagonists of the injected muscles for improving clinical outcome after BoNT-A injection remains to be established.
Objectives
This randomized single-blind pilot study aimed to investigate the efficacy of ES of antagonist muscles as adjunct treatment after BoNT-A injection to plantar flexor muscles in hemiplegic patients with spastic equinus foot.
Methods
After BoNT-A injection at triceps surae, patients were randomly allocated to 2 groups: group 1, single ES session on injected muscles plus 5 sessions of ES on antagonist muscles, and group 2, single ES session on injected muscles alone. Both groups underwent daily physical therapy for 60 min for 2 weeks (5 days/week). Assessments were performed before treatment (T0) and at 10 days (T1), 20 days (T2), and 90 days (T3) after treatment. Our primary outcome was gait velocity at a comfortable speed at T2 (10-m walk test [10MWT]). The following were secondary outcomes: triceps surae spasticity (Modified Ashworth Scale), ankle passive range of motion (pROM), strength of tibialis anterior muscle, and 2-min walk test (2MWT).
Results
The 30 patients enrolled were randomly allocated to the 2 groups: 15 in group 1 and 15 in group 2. At T1, T2 and T3, both groups showed a significant reduction in muscle tone and an increase in ankle pROM (P < 0.05). At T2 and T3, both groups showed a significant increase in 10MWT and 2MWT. The groups did not significantly differ in tibialis anterior strength or primary or secondary outcome measures.
Conclusions
ES of antagonist muscles does not improve clinical outcomes in the post-stroke spastic equinus foot after BoNT-A injection.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065719300752 Permalink : ./index.php?lvl=notice_display&id=84125
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 214-219[article] Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study [texte imprimé] / Alessio Baricich ; Alessandro Picelli ; Stefano Carda ; Nicola Smania ; Carlo Cisari ; Andrea Santamato ; Allessandro de Sire ; Marco Invernizzi . - 2019 . - p. 214-219.
https://doi.org/10.1016/j.rehab.2019.06.002
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 214-219
Mots-clés : Stroke Spasticity Botulinum toxin type A Electrical stimulation Rehabilitation Résumé : Background
Botulinum toxin type A (BoNT-A) injection is an effective treatment for lower-limb spasticity and should be offered as first-line treatment for focal manifestations. Although its possible role has been hypothesized, the efficacy of electrical stimulation (ES) of antagonists of the injected muscles for improving clinical outcome after BoNT-A injection remains to be established.
Objectives
This randomized single-blind pilot study aimed to investigate the efficacy of ES of antagonist muscles as adjunct treatment after BoNT-A injection to plantar flexor muscles in hemiplegic patients with spastic equinus foot.
Methods
After BoNT-A injection at triceps surae, patients were randomly allocated to 2 groups: group 1, single ES session on injected muscles plus 5 sessions of ES on antagonist muscles, and group 2, single ES session on injected muscles alone. Both groups underwent daily physical therapy for 60 min for 2 weeks (5 days/week). Assessments were performed before treatment (T0) and at 10 days (T1), 20 days (T2), and 90 days (T3) after treatment. Our primary outcome was gait velocity at a comfortable speed at T2 (10-m walk test [10MWT]). The following were secondary outcomes: triceps surae spasticity (Modified Ashworth Scale), ankle passive range of motion (pROM), strength of tibialis anterior muscle, and 2-min walk test (2MWT).
Results
The 30 patients enrolled were randomly allocated to the 2 groups: 15 in group 1 and 15 in group 2. At T1, T2 and T3, both groups showed a significant reduction in muscle tone and an increase in ankle pROM (P < 0.05). At T2 and T3, both groups showed a significant increase in 10MWT and 2MWT. The groups did not significantly differ in tibialis anterior strength or primary or secondary outcome measures.
Conclusions
ES of antagonist muscles does not improve clinical outcomes in the post-stroke spastic equinus foot after BoNT-A injection.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065719300752 Permalink : ./index.php?lvl=notice_display&id=84125 Exemplaires (1)
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Exclu du prêtFrench clinical guidelines for peripheral motor nerve blocks in a PRM setting / Alain P. Yelnik in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
PermalinkOrthopaedic surgery for patients with central nervous system lesions: Concepts and techniques / F. Genêt in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
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