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Does 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 prêtRehabilitation of the upper arm early after stroke: Video games versus conventional rehabilitation. A randomized controlled trial / Isabelle Laffont in Annals of physical and rehabilitation medicine, Vol. 63, n°3 (Mai-Juin 2020)
[article]
Titre : Rehabilitation of the upper arm early after stroke: Video games versus conventional rehabilitation. A randomized controlled trial Type de document : texte imprimé Auteurs : Isabelle Laffont ; Jérôme Froger ; Claire Jourdan ; Karima Bakhti ; Liesjet E.H. van Dokkum ; Abdelkader Gouaich ; Huei Yune Bonnin ; Philippe Armingaud ; Audrey Jaussent ; Marie-Christine Picot ; Emmanuelle Le Bars ; Arnaud Dupeyron ; Caroline Arquizan ; Anthony Gélis ; Denis Mottet Année de publication : 2020 Article en page(s) : p. 173-180 Note générale : doi.org/10.1016/j.rehab.2019.10.009 Langues : Anglais (eng) Mots-clés : Stroke Upper limb Video games Rehabilitation Résumé : Background
Few rehabilitation methods have proven their efficacy in increasing sensori-motor recovery and/or function of the upper limb (UL) after stroke. Video games (VGs) are promising tools in this indication.
Objective
To compare UL rehabilitation by using VGs and conventional rehabilitation (CR) in patients with sub-acute stroke.
Design
Single-blind, multicentric trial, with central randomization and stratification by center.
Setting
Physical and rehabilitation medicine departments of 2 university hospitals.
Participants
Adults within 3 months after a first vascular cerebral accident, with UL Fugl Meyer Score (UL-FMS) < 30/66 and without major cognitive impairment.
Intervention
A 45-min additional session of conventional occupational therapy (OT) or a VG-based OT session as add-on therapy to usual rehabilitation programs, 5 days/week for 6 weeks.
Main Outcome Measures
Primary outcome: UL-FMS. Secondary outcome: Box and Block Test (BBT), Wolf Motor Function test (WMFT), Motor Activity Log (MAL), Barthel Index and quality of life (SF-36).
Results
We included 51 patients (20 women) at a mean (SD) of 27.2 (19.4) days post-stroke (mean age 58 years [range 24–83]), 26 in the CR group and 25 in the VG group (23 in each group at 6-month follow-up). The mean duration of the additional rehabilitation session was similar in both groups: 29.3 (4.3) vs 28.0 (4.4) min in CR and VG groups. Shoulder pain occurred in 4 patients in the VG group versus 7 in the CR group. At day 45, gain in UL-FMS did not significantly differ between the groups (CR mean 17.8 [14.6] vs VG 24.1 [14.8]; P = 0.10), whereas gain in BBT was doubled in the VG group (CR 7.4 [12.2] vs VG 15.7 [16.3]; P = 0.02). At 6-month follow-up, the study was inconclusive about between-group differences in UL-FMS, BBT and other criteria. Post-hoc analysis showed that gains in UL-FMS or BBT were significantly higher in the VG than CR group for patients included within 30 days post-stroke.
Conclusion
In general, we cannot conclude that video gaming and conventional OT led to different long-term sensorimotor recovery of the UL after sub-acute stroke. However, when applied within the first month after stroke, video gaming was more efficient than conventional rehabilitation on both sensorimotor recovery and gross grasping function.Permalink : ./index.php?lvl=notice_display&id=90792
in Annals of physical and rehabilitation medicine > Vol. 63, n°3 (Mai-Juin 2020) . - p. 173-180[article] Rehabilitation of the upper arm early after stroke: Video games versus conventional rehabilitation. A randomized controlled trial [texte imprimé] / Isabelle Laffont ; Jérôme Froger ; Claire Jourdan ; Karima Bakhti ; Liesjet E.H. van Dokkum ; Abdelkader Gouaich ; Huei Yune Bonnin ; Philippe Armingaud ; Audrey Jaussent ; Marie-Christine Picot ; Emmanuelle Le Bars ; Arnaud Dupeyron ; Caroline Arquizan ; Anthony Gélis ; Denis Mottet . - 2020 . - p. 173-180.
doi.org/10.1016/j.rehab.2019.10.009
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 63, n°3 (Mai-Juin 2020) . - p. 173-180
Mots-clés : Stroke Upper limb Video games Rehabilitation Résumé : Background
Few rehabilitation methods have proven their efficacy in increasing sensori-motor recovery and/or function of the upper limb (UL) after stroke. Video games (VGs) are promising tools in this indication.
Objective
To compare UL rehabilitation by using VGs and conventional rehabilitation (CR) in patients with sub-acute stroke.
Design
Single-blind, multicentric trial, with central randomization and stratification by center.
Setting
Physical and rehabilitation medicine departments of 2 university hospitals.
Participants
Adults within 3 months after a first vascular cerebral accident, with UL Fugl Meyer Score (UL-FMS) < 30/66 and without major cognitive impairment.
Intervention
A 45-min additional session of conventional occupational therapy (OT) or a VG-based OT session as add-on therapy to usual rehabilitation programs, 5 days/week for 6 weeks.
Main Outcome Measures
Primary outcome: UL-FMS. Secondary outcome: Box and Block Test (BBT), Wolf Motor Function test (WMFT), Motor Activity Log (MAL), Barthel Index and quality of life (SF-36).
Results
We included 51 patients (20 women) at a mean (SD) of 27.2 (19.4) days post-stroke (mean age 58 years [range 24–83]), 26 in the CR group and 25 in the VG group (23 in each group at 6-month follow-up). The mean duration of the additional rehabilitation session was similar in both groups: 29.3 (4.3) vs 28.0 (4.4) min in CR and VG groups. Shoulder pain occurred in 4 patients in the VG group versus 7 in the CR group. At day 45, gain in UL-FMS did not significantly differ between the groups (CR mean 17.8 [14.6] vs VG 24.1 [14.8]; P = 0.10), whereas gain in BBT was doubled in the VG group (CR 7.4 [12.2] vs VG 15.7 [16.3]; P = 0.02). At 6-month follow-up, the study was inconclusive about between-group differences in UL-FMS, BBT and other criteria. Post-hoc analysis showed that gains in UL-FMS or BBT were significantly higher in the VG than CR group for patients included within 30 days post-stroke.
Conclusion
In general, we cannot conclude that video gaming and conventional OT led to different long-term sensorimotor recovery of the UL after sub-acute stroke. However, when applied within the first month after stroke, video gaming was more efficient than conventional rehabilitation on both sensorimotor recovery and gross grasping function.Permalink : ./index.php?lvl=notice_display&id=90792 Exemplaires (1)
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Exclu du prêtAssessment of bimanual performance in 3-D movement analysis : Validation of a new clinical protocol in children with unilateral cerebral palsy / Florence Gaillard in Annals of physical and rehabilitation medicine, Vol. 63, n°5 (Octobre 2020)
[article]
Titre : Assessment of bimanual performance in 3-D movement analysis : Validation of a new clinical protocol in children with unilateral cerebral palsy Type de document : texte imprimé Auteurs : Florence Gaillard ; Marine Cacioppo ; Brice Bouvier ; Guillaume Bouzille ; Christopher J. Newman ; Thibault Pasquet ; Armel Crétual (1972-....) ; Hélène Rauscent ; Isabelle V. Bonan Année de publication : 2020 Article en page(s) : p. 408-415 Note générale : doi.org/10.1016/j.rehab.2019.06.008 Langues : Anglais (eng) Mots-clés : Unilateral cerebral palsy 3-D movement analysis Upper limb Bimanual task Bimanual performance Résumé : Background
The “Be an Airplane Pilot” (BE-API) protocol is a novel 3-D movement analysis (3DMA) protocol assessing the bimanual performance of children during a game.
Objective
This study aimed to investigate the reliability and validity of this protocol in children with unilateral cerebral palsy (uCP).
Methods
Angular waveforms (WAVE), maximum angles (MAX) and range of motion (ROM) of the trunk, shoulder, elbow and wrist joints were collected in children with uCP and in typically developing children (TDC) during 4 tasks of the BE-API protocol designed to explore specific degrees of freedom (DoF). The inter-trial reliability for children with uCP was assessed with the coefficient of multiple correlation (CMC) for WAVE and the intraclass correlation coefficient (ICC) and standard error of measurement (SEM) for MAX and ROM. Clinical performance-based measures, including the Assisting Hand Assessment (AHA) and ABILHAND-Kids scores, were used to explore correlations between clinical measures and kinematic parameters in children with uCP.
Results
20 children with uCP (13 boys; mean age 12.0 [SD 3.2] years) and 20 TDC (11 boys; mean age 11.9 [SD 3.4] years) were included. In children with uCP, most kinematic parameters showed high reliability (WAVE: CMC ≥ 0.82; MAX and ROM: ICC ≥ 0.85, SEM ≤ 4.7°). Elbow extension, forearm supination, and wrist adduction were reduced and wrist flexion was increased for children with uCP versus TDC (P < 0.01). In children with uCP, MAX and ROM values were moderately correlated with clinical assessments (AHA score: r = 0.48–0.65; ABILHAND-Kids score: r = 0.48–0.49).
Conclusions
The BE-API protocol is a 3DMA-bimanual performance-based assessment that is highly reliable in children with uCP. Children with uCP and TDC significantly differed in some clinically relevant kinematic parameters. The BE-API is a promising playful tool, helpful for better understanding upper-limb motor movement abnormalities in bimanual conditions and for tailoring treatments to individual deficits.Permalink : ./index.php?lvl=notice_display&id=91310
in Annals of physical and rehabilitation medicine > Vol. 63, n°5 (Octobre 2020) . - p. 408-415[article] Assessment of bimanual performance in 3-D movement analysis : Validation of a new clinical protocol in children with unilateral cerebral palsy [texte imprimé] / Florence Gaillard ; Marine Cacioppo ; Brice Bouvier ; Guillaume Bouzille ; Christopher J. Newman ; Thibault Pasquet ; Armel Crétual (1972-....) ; Hélène Rauscent ; Isabelle V. Bonan . - 2020 . - p. 408-415.
doi.org/10.1016/j.rehab.2019.06.008
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 63, n°5 (Octobre 2020) . - p. 408-415
Mots-clés : Unilateral cerebral palsy 3-D movement analysis Upper limb Bimanual task Bimanual performance Résumé : Background
The “Be an Airplane Pilot” (BE-API) protocol is a novel 3-D movement analysis (3DMA) protocol assessing the bimanual performance of children during a game.
Objective
This study aimed to investigate the reliability and validity of this protocol in children with unilateral cerebral palsy (uCP).
Methods
Angular waveforms (WAVE), maximum angles (MAX) and range of motion (ROM) of the trunk, shoulder, elbow and wrist joints were collected in children with uCP and in typically developing children (TDC) during 4 tasks of the BE-API protocol designed to explore specific degrees of freedom (DoF). The inter-trial reliability for children with uCP was assessed with the coefficient of multiple correlation (CMC) for WAVE and the intraclass correlation coefficient (ICC) and standard error of measurement (SEM) for MAX and ROM. Clinical performance-based measures, including the Assisting Hand Assessment (AHA) and ABILHAND-Kids scores, were used to explore correlations between clinical measures and kinematic parameters in children with uCP.
Results
20 children with uCP (13 boys; mean age 12.0 [SD 3.2] years) and 20 TDC (11 boys; mean age 11.9 [SD 3.4] years) were included. In children with uCP, most kinematic parameters showed high reliability (WAVE: CMC ≥ 0.82; MAX and ROM: ICC ≥ 0.85, SEM ≤ 4.7°). Elbow extension, forearm supination, and wrist adduction were reduced and wrist flexion was increased for children with uCP versus TDC (P < 0.01). In children with uCP, MAX and ROM values were moderately correlated with clinical assessments (AHA score: r = 0.48–0.65; ABILHAND-Kids score: r = 0.48–0.49).
Conclusions
The BE-API protocol is a 3DMA-bimanual performance-based assessment that is highly reliable in children with uCP. Children with uCP and TDC significantly differed in some clinically relevant kinematic parameters. The BE-API is a promising playful tool, helpful for better understanding upper-limb motor movement abnormalities in bimanual conditions and for tailoring treatments to individual deficits.Permalink : ./index.php?lvl=notice_display&id=91310 Exemplaires (1)
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Exclu du prêt