Evaluation de la fatigue musculaire des membres supérieurs

in Julia, M.; Perrey, S.; Dupeyron, A. (Eds.) et al Fatigue musculaire (2010)

Effectiveness of a semi-intensive multidisciplinary outpatient rehabilitation program in chronic low back pain

in Joint Bone Spine (2010), 77

Objectives: To evaluate the efficacy of a semi-intensive multidisciplinary outpatient program complying with the requirements of the Belgian National Institute for Health and Disability Insurance and ... [more ▼]

Objectives: To evaluate the efficacy of a semi-intensive multidisciplinary outpatient program complying with the requirements of the Belgian National Institute for Health and Disability Insurance and intended for patients with chronic low back pain. Methods: Weincluded 262 patients with nonspecific chronic low back pain, amongwhom136 (73women and 63 men) with a mean pain duration of 11.3 years completed the outpatient program (36 sessions each lasting 2 h). The program consisted of education about back-sparing techniques, interventions by an occupational therapist and psychologist, and physical reconditioning. Three sessions (sessions 1, 18, and 36) were used to evaluate pain intensity, functional impairment, kinesiophobia, cognitive knowledge, knowledge of appropriate spinal movement technique, and physical performance (trunk muscle strength and endurance, mobility of the pelvis and lumbar spine, and aerobic capacity). Results: All study variables were significantly improved at study completion compared to baseline: pain intensity was decreased by 44%, functional impairment by 40%, and kinesiophobia by 11% whereas knowledge was improved by 59%, back-sparing technique by 95%, trunk muscle strength by 40% on average, trunk extensor muscle endurance by 90%, mobility by 8%, and aerobic capacity by 18%. Conclusions: A semi-intensive multidisciplinary outpatient program was beneficial in patients with chronic low back pain. Careful patient selection and increased patient involvement in the program may help to improve adherence. [less ▲]

Fibromyalgie et affections voisines : analyse du comportement électromyographique au cours d’un effort musculaire isométrique

in Revue du Rhumatisme (2010), 77

Fibromyalgia and related conditions: Electromyogram profile during isometric muscle contraction

in Joint Bone Spine (2010), 77

Objectives: To evaluate electromyogram (EMG) profiles in patients with three related conditions: fibromyalgia, chronic fatigue syndrome, and depression. Methods: We studied 44 healthy volunteers, 22 ... [more ▼]

Objectives: To evaluate electromyogram (EMG) profiles in patients with three related conditions: fibromyalgia, chronic fatigue syndrome, and depression. Methods: We studied 44 healthy volunteers, 22 patients with fibromyalgia, 11 patients with chronic fatigue syndrome, and 10 patients admitted for depression. The trapezius electromyogram was recorded during maximally sustained, bilateral, 90◦ abduction of the shoulders. EMG signal frequency and amplitude were measured throughout the test. Results: In the fibromyalgia group, isometric contraction duration was significantly shorter than in the other two patient groups (P < 0.001) and the EMG frequency and amplitude pattern indicated premature discontinuation of the muscle contraction. Findings in the chronic fatigue patients were similar to those in the healthy controls. The patients with depression had a distinctive EMG profile characterized by excessive initial motor-unit recruitment with a shift in the frequency spectrum. Conclusions: Fibromyalgia was associated with a specific EMG pattern indicating premature discontinuation of the muscle contraction. Therefore, maximal voluntary muscle contraction tests may be of limited value for assessing function in fibromyalgia patients. Chronic fatigue syndrome patients had similar EMG findings to those in the healthy controls. The EMG alterations in the patients with depression were consistent with manifestations of psychomotor retardation. [less ▲]

Rehabilitation in osteoarthritis

in Therapy (2010), 7(6), 669-674

Comparaison de 5 techniques de prération du PRP (Platelet-Rich Plasma ou plasma)

in Annales de Réadaptation et de Médecine Physique (2009, October), 52(Sup. 1), 109

Introduction : Depuis une vingtaine d’années, le développement des activités sportives s’accompagne d’une incidence accrue de diverses tendinopathies, souvent rebelles aux traitements conservateurs ... [more ▼]

Introduction : Depuis une vingtaine d’années, le développement des activités sportives s’accompagne d’une incidence accrue de diverses tendinopathies, souvent rebelles aux traitements conservateurs classiques (anti-inflammatoires non stéroïdiens, orthèses, kinésithérapie, infiltrations…). De nouvelles thérapeutiques, dont l’injection de concentrés plaquettaires (plasma riche en plaquettes ou PRP), sont actuellement en cours d’évaluation clinique. Objectifs : L’injection de PRP fait actuellement l’objet de recherche comme thérapeutique des tendinopathies chroniques. L’injection intra-tendineuse nécessite idéalement un volume minimal afin de diminuer la pression lors de l’injection et minimiser les douleurs, mais il doit également présenter une concentration plaquettaire élevée ; par ailleurs, la quantité de facteurs de croissance libérés pourrait être liée au système de préparation. Méthodes : Après avoir prélevés divers échantillons de sang veineux chez 5 patients, nous avons comparé 5 techniques de préparation du PRP : celle du Service d’Hématologie Biologique du CHU de Liège, le PRP Kit de Curasan®, les techniques Plateltex®, GPS®II et RegenLab®. Résultats : Les différentes techniques permettent d’obtenir des concentrations plaquettaires plus importantes que dans le sang avec des volumes variables (de 0,3 mL à 6 mL) et un nombre de globules rouges et globules blancs limité (sauf pour GPS® II). Le nombre de plaquettes/µL apparaît plus élevé avec la technique Plateltex® et obtient le plus petit volume à injecter. Les autres techniques permettent également d’obtenir de petits volumes sauf avec le GPS®II. Le nombre de plaquettes collectées dans le PRP apparaît donc plus élevé avec cette technique mais avec une concentration faible. Discussion – Conclusion : La technique décrite par Plateltex® permet de recueillir le PRP le plus concentré dans le volume le plus faible. [less ▲]

Reproducibility of dynamometric and non-dynamometric trunk extensor muscle tests in patients with chronic low back pain

Poster (2009, September 09)

Background and Aims: Literature describes several dynamometric and non-dynamometric tests to assess trunk extensor muscle performances. In patients with chronic low back pain (CLBP), reproducibility of ... [more ▼]

Background and Aims: Literature describes several dynamometric and non-dynamometric tests to assess trunk extensor muscle performances. In patients with chronic low back pain (CLBP), reproducibility of such assessments remains understudied. The purpose of this study was to compare reproducibility of two dynamometric tests and of the widely used Sorensen test. Methods: 44 patients (22 men, 22 women; age range: 30-60 years) with CLBP (mean Roland-Morris disability scores reaching 6 ± 3.4) were randomized into two groups attending two assessment sessions. Group 1 (12 men and 12 women) underwent two tests (i.e. a maximal strength test (figure 1) and a static endurance test requiring to maintain as long as possible a torque of 50 percent of maximal strength previously determined (figure 2)) performed on a specific trunk extensor dynamometer (David Back). Group 2 (10 men and 10 women) was submitted to the non-dynamometric Sorensen test (lifting the upper trunk and maintaining the horizontal position) (figure 3). For both groups, tests were performed twice (spaced by 15 minutes) during the first session (intra-session reproducibility) and once during the second session (inter-session reproducibility) happening 2 to 7 days later. Results: Mean torques reached 2.67 ± 0.63 Nm/Kg (women) and 3.66 ± 0.75 Nm/Kg (men) for the strength test. Mean maintaining times were 83 ± 34 s for the endurance test and 99 ± 28 s for the Sorensen test. The Table presents coefficient of variations (CV) and limits of agreement (LOA) related to the intra-session and inter-session reproducibility. Conclusions: Reproducibility appeared satisfactory for the strength test, moderate for the Sorensen test and low for the dynamometric endurance test in patients with moderate CLBP. [less ▲]

Cheville et pied douloureux de l'enfant sportif

in Journal de Traumatologie du Sport (2009), 26(1), 12-17

We realized an exhaustive review of literature concerning traumatic and micro-traumatic lesions of the ankle and foot in sporting children. These pathologies are on the increase due to considering the ... [more ▼]

We realized an exhaustive review of literature concerning traumatic and micro-traumatic lesions of the ankle and foot in sporting children. These pathologies are on the increase due to considering the development of sports activities. They are often considered as benign whereas they require an adequate diagnosis followed by adequate treatment. We thus described the 4 groups of pathologies of the ankle and foot in sporting children: osteodystrophies (disease of Sever, Köhler-Mouchet, Renander, Freiberg, Panner and Iselin), talar diseases (osteochondritis dissecans and osteochondral fractures), sprained ankles (benign, medium and serious) and supernumerary ossifications. [less ▲]

Pathologie ischio-jambière : évaluation et renforcement en mode excentrique

in Croisier, Jean-Louis; Codine, Philippe (Eds.) Exercice musculaire excentrique (2009)

Undoubtedly, hamstring strains have close connections with the eccentric mode of contraction. Several authors have confirmed the discriminating character of the eccentric isokinetic assessment, in ... [more ▼]

Undoubtedly, hamstring strains have close connections with the eccentric mode of contraction. Several authors have confirmed the discriminating character of the eccentric isokinetic assessment, in particular using a mixed eccentric hamstrings / concentric quadriceps ratio. Low-intensity eccentric contractions promoting healing of good quality are recommended in the early phase of rehabilitation. Subsequently, strengthening exercises at high intensity contractions will be implemented. Tools to be used and specific modalities of the protocols are discussed in this paper. [less ▲]

Programme excentrique dans le traitement de l’hyperlaxité du coude

in Croisier, Jean-Louis; Codine, Philippe (Eds.) Exercice musculaire excentrique (2009)

Introduction: Joint hypermobility involves an increased range of motion compared to normal amplitudes for the same age, sex and ethnic group. Benign Joint Hypermobility Syndrome (BJHS) affects between 5 ... [more ▼]

Introduction: Joint hypermobility involves an increased range of motion compared to normal amplitudes for the same age, sex and ethnic group. Benign Joint Hypermobility Syndrome (BJHS) affects between 5 and 10% of the Caucasian population but it also concern rare hereditary dystrophies with abnormal collagen structure or metabolism (i.e.: Ehlers-Danlos Syndrome (EDS)). Patients with hypermobility suffer from joints problems and chronic pain is the most frequently reported symptom. Case Report: An EDS patient presented pain in the right elbow and the right wrist after a season of tennis. Her physiotherapy consisted of wrist prono-supination and flexion-extension muscle group reinforcement and proprioceptive training. To protect the wrist against excessive load, strengthening exercises of prono-supinator and flexor-extensor muscles of elbow and wrist were undertaken on an isokinetic device after an evaluation. She was also given an orthosis restricting the joint range of motion of the wrist. The patient rapidly noted a decrease in pain and an increase in the stability of her right arm even when playing tennis. Isokinetic evaluation objectified symmetric values and an improvement in maximal torque of 20 to 25% in all trained muscles of the right elbow. She was also given individualized home exercises. Conclusion: The goal of rehabilitation is to avoid hypermobility by using the muscles as a protective brake in the control of joint positioning. Thus, muscles were reinforced in eccentric mode with starting position at the maximum length of these muscles when unstreched. The exercises could be carried out safely on an isokinetic device. Indeed eccentric exercises at slow speed and limited range of joint motion avoided risk of luxation. Patients must be informed that it’s a long-term treatment and that in addition to exercises with the physiotherapist personal home exercises are essential. [less ▲]