References of "Crielaard, Jean-Michel"
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See detailHazard factors of ACL rupture: Neuromuscular factors
Kaux, Jean-François ULg; Delvaux, François ULg; MASSART, Nicolas ULg et al

in European Journal of Sports Medicine (2013, September), 1(supplement 1), 50-51

Injuries to the anterior cruciate ligament (ACL) of the knee are disabling, often associated with other intra-articular damages and increase the risk of early onset of osteoarthritis. It is very probable ... [more ▼]

Injuries to the anterior cruciate ligament (ACL) of the knee are disabling, often associated with other intra-articular damages and increase the risk of early onset of osteoarthritis. It is very probable that multiple risk factors act in combination to influence injury risk. It is important to have a comprehensive understanding of these ACL risk factors, whose neuromuscular factors, even if investigations on neuromuscular factors reported to date do not provide a complete understanding of ACL injury risk. According to several recent studies, the neuromuscular control of joint biomechanics during a specific activity seems to represent a predicting factor of an ACL injury, by quantifying the intersegmental forces and moments generated about the tibio-femoral joint. Laboratory studies have shown that landing from a jump performs cutting and pivoting maneuvers with less knee and hip flexion, increases knee valgus and internal rotation of the hip coupled, with increased external rotation of the tibia and quadriceps muscle activation (especially in women). It has been hypothesized that these movement patterns increase the strain in the ACL during activity and that the large difference in knee injury incidence rates between males and females (1/4.5) may be attributed to neuromuscular differences and resultant mechanics. Although studies have shown that the position of the knee and the magnitude and sequence of muscle contraction can increase ACL strain values, it is hard to exactly correlate these movements to what occurs during activity and sport and at the time of ACL injury. Recently, a simpler assessment tool has been validated and is able to be administered in a clinic-based testing environment Consequently, the screening for ACL injury risk could be performed on a more widespread population. Athletes who went on to a primary ACL injury also demonstrated significant side to side differences in lower extremity biomechanics as well as reduced relative lower extremity flexor activation relative to an uninjured control population during the vertical drop jump. Similar mechanisms of injury risk have been identified in athletes medically cleared to return to sport after ACL reconstruction. These seminal findings indicate that these abnormal and asymmetrical biomechanical and neuromuscular control profiles are likely both residual to, and exacerbated by, the initial injury. A study revealed that a fatigue-induced protocol altered the latency as well as the magnitude of reflex responses of the hamstring muscles and the tibial translation only in women. The authors of various studies have suggested that the hamstring muscles play an important role in maintaining knee stability and that they protect the ACL during movements of the tibia relative to the femur. Therefore, decreased reflex responses of the hamstring muscles and in turn an increased the tibial translation might contribute to the pathomechanics of the ACL injuries. It is therefore conceivable that the fatigue-induced decrease of the hamstring neuromuscular function may increase the tibial translation and probably contributes to the higher incidence of ACL injuries, especially in women. A preventive approach to decrease ACL injuries could integrate muscle imbalances as a risk factor. If it has been scientifically validated than the muscle strength profile determined by an isokinetic testing offers a predictive value on the hamstring lesion occurrence, similar studies have not permitted such a conclusion about ACL injury. The isokinetic assessments after ACL reconstruction have allowed us to observe, on the healthy contralateral knee, a higher frequency of reduced hamstring/quadriceps ratios. A possible pre-existing weakness in the hamstring and the occurrence of an ACL injury is therefore possible but only a difficult prospective approach due to the multifactorial nature of ligament injuries could clarify that point. In conclusion, a functional analysis of the landing of a jump and an isokinetic muscle strength assessment have been suggested to represent predictive elements of an ACL rupture, but further studies are needed to have a stronger evidence of their predictive qualities of injury. [less ▲]

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See detailIntérêt des ondes de choc dans le traitement des fasciites plantaires
Fromm, Aurélien; Vanderthommen, Marc ULg; LAURENT, Jean-Marie ULg et al

in European Journal of Sports Medicine (2013, September), 1(Supplement 1), 276-277

Introduction : Over the past ten years, radial shock wave therapy usage has grown tremendously. Prescribed for chronic tendinopathy, its real benefit has yet to be demonstrated. Objective : Demonstrate ... [more ▼]

Introduction : Over the past ten years, radial shock wave therapy usage has grown tremendously. Prescribed for chronic tendinopathy, its real benefit has yet to be demonstrated. Objective : Demonstrate radial shock wave therapy benefits in plantar fasciitis treatment. Materials and methods : Our experimentation is a study over twelve weeks divided in 2 periods: the control phase (week 0 to week 6) and treatment phase (week 6 to week 11). It includes 3 evaluations (T1, T2 and T3) respectively at 0, 6 and 11 weeks. A standard evaluation consists of one VAS pain, an algo-functional backwash survey about the ankle (modified FFI), algometer test and dynamic analysis of the foot on strength platform. The radial shock wave therapy has been performed thanks to Swiss DolorClast machine (Electro Medical Systems) Results : Statistical analysis show radial shock wave therapy induces a highly significant improvement (p<0,0001) on EVA results (50%), ankle algo-functional backwash (62.6%) and pain sensitivity threshold (49.6%). Therefore, a significant correlation can be observed during T2- T3 period between pain sensitivity threshold improvement and patients age (p=0,012). The statistical results show a time increase trend for foot-ground contact over time. It is not significant though. Conclusion : The use of radial shock wave therapy in plantar fasciitis treatment helps decrease pain and improve step. However, additional studies performed on bigger samples have to be completed to confirm these results. [less ▲]

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See detailEccentric rehabilitation for elbow hypermobility
Kaux, Jean-François ULg; Forthomme, Bénédicte ULg; FOIDART, Marguerite ULg et al

in Journal of Novel Physiotherapies (2013), 3(6), 1805

Introduction: Joint hypermobility involves an increased range of motion compared to normal amplitudes for the same age, sex and ethnic group. Patients with hypermobility suffer from joints problems and ... [more ▼]

Introduction: Joint hypermobility involves an increased range of motion compared to normal amplitudes for the same age, sex and ethnic group. Patients with hypermobility suffer from joints problems and chronic pain is the most frequently reported symptom. Eccentric muscle strengthening could be very important to protect hypermobile joints. Case report: An Ehler-Danlos syndrome patient presented pain in the right elbow and the right wrist after a season of tennis. Her physiotherapy (18 sessions, 3 times a week) consisted of wrist prono-supination and flexion-extension muscle group reinforcement and proprioceptive training. To protect the wrist against excessive load, the eccentric strengthening exercises of prono-supinator and flexor-extensor muscles of elbow and wrist were undertaken gradually, at increasing speeds [30°/s, 60°/s, and 90°/s] within a limited range of motion in flexion and extension, on an isokinetic device after an evaluation. She was also given an ortheosis 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 an improvement in maximal torque of 20 to 25% in flexion-extension 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. Muscles can be reinforced in eccentric mode with starting position at the maximum length of these muscles when unstreched. The exercises can be carried out safely on an isokinetic device, at slow speed and limited range of joint motion to avoid risk of luxation. Thus, in this case report, the eccentric exercises using an isokinetic device were effective to safely reinforce the muscles as a protective brake for joint hypermobility. [less ▲]

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See detailAnévrisme de l’artère ulnaire chez un couvreur
Lognard, Michaël; Courtois, Anne-Catherine ULg; LECLERCQ, Daniel ULg et al

in Revue Médicale de Liège (2013), 68(7-8), 399-401

A case of ulnar artery aneurysm in an independent roofer is reported. It is a rare disease often associated with the Hammer Hypothenar Syndrome specifically found in manual workers and athletes exposed to ... [more ▼]

A case of ulnar artery aneurysm in an independent roofer is reported. It is a rare disease often associated with the Hammer Hypothenar Syndrome specifically found in manual workers and athletes exposed to repetitive palmar trauma. [less ▲]

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See detailPlatelet-rich plasma (PRP) to treat chronic upper patellar tendinopathies
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Bruyère, Olivier ULg et al

in British Journal of Sports Medicine (2013, July), 47(10 (e3)), 15

Background: Upper patellar tendinopathies remain often chronic and rebel to a thorough conservative treatment. Moreover, the option of a surgical treatment could be disappointing. New treatments are being ... [more ▼]

Background: Upper patellar tendinopathies remain often chronic and rebel to a thorough conservative treatment. Moreover, the option of a surgical treatment could be disappointing. New treatments are being developed. Injection of PRP is one of these. Platelets contain lot of growth factors which would have the potentiality to enhance the healing process of tendons. Even if in vitro and animal experiments have demonstrated this stimulation of tendon healing process1, clinical series are subject to controversy2. Methods: Twenty patients with chronic upper patellar tendinopathy were enrolled. Assessments [VAS, clinical examination with an algometer, algofunctional scores (IKDC and VISA-P), functional assessments (isokinetic and Optojump) and imagery (ultrasounds and MRI)]were made before infiltration of PRP, and 6 weeks and 3 months after. The PRP was obtained by an apheresis system (COM.TEC, Fresenius). Six millilitres of PRP were injected without local anaesthetic. One week after infiltration, patients started a 6-week standardised sub-maximal eccentric reeducation. Results: We observed a very significant improvement of the algofunctional status as soon as 6 weeks after the infiltration of PRP, and continued to a lesser extent up to 3 months. During functional evaluation, pain decreased as well, but without significant improvement of performances. No significant improvements in the imagery were observed. Interestingly, patients who had a VAS equal or below 1 after 3 months post-infiltration were younger (24.7 vs 32.2 y.o.). Moreover, these younger patients had a significant increase of the IKDC score (p=0.003), a significant improvement of pain during isokinetic evaluations (p<0.05), and during Optojump assessments (p=0.01). Seventy-five percent of subjects were able to return to sport, even if only half of these patients recovered the same level than before the tendinopathy. Discussion / Conclusions: This study demonstrates that a local infiltration of PRP associated with a submaximal eccentric protocol is efficient to improve symptoms of chronic upper patellar tendinopathies, non-responsive to classical conservative treatments. However, up to now, there is no consensus on the method to prepare the PRP. Indeed, each technique could provide a very different PRP (variations in the platelet concentrations and of the amount of red and white cells). [less ▲]

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See detailIsocinétisme : aspects spécifiques chez le sportif
Croisier, Jean-Louis ULg; Delvaux, François ULg; Kaux, Jean-François ULg et al

in Abstract Book de la 1ère Journée de Rééducation de l'INSEP (2013, June)

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See detailThe risk factors for the rupture of the anterior cruciate ligament of the knee: the neuromuscular state
Kaux, Jean-François ULg; Delvaux, François ULg; Forthomme, Bénédicte ULg et al

in OA Sports Medicine (2013), 1(1), 95

Multiple factors act conjointly to influence the risk of injury of the anterior cruciate ligament of the knee. An understanding of neuromuscular factors remains necessary, although this does not guarantee ... [more ▼]

Multiple factors act conjointly to influence the risk of injury of the anterior cruciate ligament of the knee. An understanding of neuromuscular factors remains necessary, although this does not guarantee a complete analysis of the risks of injury to the anterior cruciate ligament. Women have a greater risk of injury to the anterior cruciate ligament in comparison to men. This can be explained by an increase in the internal rotation of the hip, coupled with an increase in the external rotation of the tibia and increased muscular activation of the quadriceps (with a concomitant decrease in hamstring activity) during landing or pivotal movements. In addition, muscular fatigue of the hamstrings and a weak hamstring/quadriceps ratio could contribute to the risk of injury to the anterior cruciate ligament. Finally, a lack of relative joint laxity can also constitute a risk factor of injury to the anterior cruciate ligament in women. Other potential neuromuscular risk factors could also be highlighted. Screening for these risk factors, for example, by means of a functional jump-landing test, together with an isokinetic test, could help to recommend new prevention protocols. The aim of this review was to discuss the risk factors for the rupture of the anterior cruciate ligament of the knee. In conclusion, thanks to an overall knowledge of all the possible risk factors (intrinsic and extrinsic, modifiable or not), sports people who are predisposed to a recurrence of rupture of the anterior cruciate ligament could be identified. However, the hypothetical neuromuscular factors reported till date (Table 1) do not offer a complete understanding of this risk. [less ▲]

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See detailExuberant inflammatory reaction after an infiltration of platelet-rich plasma to treat tendinopathy
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. Reference: Platelet-rich plasma application in the management of chronic tendinopathies. Acta Orthop Belg 2013; 79: 10-15. [less ▲]

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See detailPlatelet-rich plasma (PRP) to treat upper patellar tendinopathies
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; SIMONI, Paolo ULg et al

in Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

Introduction: Tendinopathies, especially upper patellar tendinopathy also known as jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing ... [more ▼]

Introduction: Tendinopathies, especially upper patellar tendinopathy also known as jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing properties of platelet and their growth factors. These factors have the potentiality to improve healing of different tissues: bones, muscles, tendons... Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. On the other hand, such treatment has been totally removed of list of doping treatments. The aim of our study was to investigate the effect of 1 injection of PRP in patients suffering from chronic jumper’s knee. Methods: Patients performed imaging (US and MRI) and functional assessments, and a clinical examination using an algometer, before treatment and 6 weeks after PRP treatment. They were also invited to answer to questionnaire relative to pain and functional status. PRP was obtained from autologous blood using an apheresis system (COM.TEC, Fresenius). The injection of 6mL of PRP was realised without local anaesthesia into the proximal insertion of the patellar tendon. A 48h rest-time was recommended after infiltration. Afterwards, a submaximal eccentric reeducation was initiated 1 week after infiltration 3 times a week during 5 weeks. In case of pain, anti-inflammatory drugs were prohibited and patient were encouraged to take class I or II painbrakers. Our protocol was approved by Ethic Committee of University and University Hospital of Liège. Results: Eighteen patients with jumper’s knee were included in our study. Pre-injection tests revealed pain of the upper part of the patellar tendon just below the patella, associated with loss of function. Imaging exams confirmed diagnosis. Six weeks post-injection, the clinical status was improved for the majority of the patients, with a significant decrease of algo-functional scores. The pain reported during functional assessments was decreased (in particular for the eccentric actions), yet no significant improvement of physical performances was observed. We found no significant differences between imaging exams before and 6 weeks after PRP injection. Conclusion: One in situ injection of PRP clinically improved patients with jumper’s knee 6 weeks after treatment. Most patients reported a decrease of pain during day-life and through physical activities. However nor functional performances neither imaging were improved. A followup at 3 months is actually in process to evaluate more long term efficacy of PRP treatment. [less ▲]

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See detailExuberant inflammatory reaction after an infiltration of platelet-rich plasma (PRP)
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in British Journal of Sports Medicine (2013, June), 47(10 (e3)), 92

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. Reference: Platelet-rich plasma application in the management of chronic tendinopathies. Acta Orthop Belg 2013; 79: 10-15. [less ▲]

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See detailSyndromes canalaires rares du membre supérieur - Apport des bilans électrophysiologiques
Kaux, Jean-François ULg; MASSART, Nicolas ULg; TINANT, France ULg et al

in 32ème Séminaire de Traumatologie du Sport de l'AMDTS (2013, May)

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See detailEpreuves isocinétiques de résistance à la fatigue
Croisier, Jean-Louis ULg; Bosquet, L.; Maquet, Didier ULg et al

in Lettre de Médecine Physique et de Réadaptation (2013)

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See detailEvaluation of the impact of a 6-month training by whole body vibration on the risk of falls among nursing home residents
Beaudart, Charlotte ULg; Buckinx, Fanny ULg; Demonceau, Marie ULg et al

in Osteoporosis International (2013, April), 24(Suppl.1), 246-247

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See detailClinical characteristics of patients responsive to whole body vibration
Beaudart, Charlotte ULg; Buckinx, Fanny ULg; Maquet, Didier ULg et al

in Osteoporosis International (2013, April), 24(Suppl.1), 243

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See detailQuantitative gait assessment using an accelerometer technology as a predictive tool of falls among nursing home residents: a 6-month prospective study
Bruyère, Olivier ULg; Detalle, Anne-Sophie; Demonceau, Marie ULg et al

in Osteoporosis International (2013, April), 24(Suppl.1), 210

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See detailThérapeutiques récentes des tendinopathies du sportif (ondes de choc, injections de plaquettes, ...)
Crielaard, Jean-Michel ULg; Kaux, Jean-François ULg

in Abstract book du 21ème Séminaire hivernal de Médecine sportive 2013 (2013, April)

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See detailTendinopathies et lésions particulières de la cheville et du pied du sportif
Crielaard, Jean-Michel ULg; Kaux, Jean-François ULg

in Abstract book du 21ème Séminaire hivernal de Médecine sportive 2013 (2013, April)

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See detailLe travail excentrique : aspects musculaires et tendineux
Kaux, Jean-François ULg; Hody, Stéphanie ULg; Forthomme, Bénédicte ULg et al

in Prévention des troubles musculo-squelettiques chez le sportif (2013)

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