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See detailInfluence du mode de contraction sur le tendon : modèle animal
Kaux, Jean-François ULg; Drion, Pierre ULg; Besançon, Benoît et al

in 3ème Congrès Commun SFMS - SFTS (2010, October 01)

Introduction : Les tendinopathies sont fréquentes et touchent aussi bien les membres supérieurs que les membres inférieurs. La rééducation excentrique constitue une thérapeutique de choix dans le ... [more ▼]

Introduction : Les tendinopathies sont fréquentes et touchent aussi bien les membres supérieurs que les membres inférieurs. La rééducation excentrique constitue une thérapeutique de choix dans le traitement des tendinopathies. Malgré les résultats favorables en clinique, les effets morphologiques et biochimiques n’ont pas encore été élucidés. Matériel et méthodes : Dix-huit rats de souche Sprague-Dawley adultes ont été répartis en trois groupes : 6 témoins (groupe T) qui ne sont soumis à aucune contrainte physique ; 6 soumis à un effort concentrique (groupe C), course en montée ; 6 soumis à un effort excentrique (groupe E), course en descente. Les 12 rats des groupes C et E ont dû courir sur un tapis roulant incliné à +15° (groupe C) ou -15° (groupe E) à une vitesse de 17m/min (1km/h) pendant une heure à raison de trois séances par semaine pendant 5 semaines. Au terme de l’entraînement, les tendons achilléens, rotuliens et tricipitaux ont été prélevés bilatéralement. Les tendons de cinq rats de chaque groupe ont bénéficié d’une évaluation biomécanique (test de traction à l’aide de mors type « cryo-jaws »). Les tendons du sixième rat de chaque groupe ont permis l’étude histologique (coloration à l’hématoxyline-éosine et trichrome de Masson). Résultats : Le groupe E présente une augmentation de la tension de rupture des tendons rotuliens (29 ,5% ; p=0,047) et tricipitaux (72% ; p=0,018), une amélioration du rapport Force/Masse pour le tendon tricipital (54% ; p=0,043) ainsi qu’une augmentation de la section tendineuse tricipitale (74% ; p=0,008). Aucune variation pour aucun des tendons entre les groupes n’est relevée pour le paramètre contrainte (=Force/Section). Histologiquement, les tendons du groupe E se caractérisent par une plus grande quantité de vaisseaux sanguins périphériques ainsi qu’une plus grande proportion de collagène. Conclusion : Cette étude démontre que les propriétés mécaniques du tendon sont améliorées après un entraînement excentrique. Le tendon plus résistant augmente sa quantité de collagène et probablement les interactions entre les fibres de collagène. [less ▲]

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See detailPhysiotherapy Intervention for Joint Hypermobility in Three Cases with Heritable Connective Tissue Disorders
Kaux, Jean-François ULg; Foidart-Dessalle, Marguerite ULg; Croisier, Jean-Louis ULg et al

in Journal of Musculoskeletal Pain (2010), 18(3), 254-60

Introduction: In Joint Hypermobility Syndromes, chronic pain is the most disabling symptom. Its origin can be multiple (i.e. subluxations, sprains, pathologies of tendons, ligaments, peripheral nerves ... [more ▼]

Introduction: In Joint Hypermobility Syndromes, chronic pain is the most disabling symptom. Its origin can be multiple (i.e. subluxations, sprains, pathologies of tendons, ligaments, peripheral nerves, multiple operations). The goal of this article was intended to discuss appropriate physiotherapy in hyperlax patients. Patients and Method: The recovery process was analyzed in three cases (Marfan Syndrome, Ehlers-Danlos Syndrome and Osteogenesis Imperfecta). Hypermobility was assessed using the Brighton scale, pain using the Visual Analogue Scale and quality of life using the Medical Outcome Study Short Form-36. Bone density was evaluated by QDR X-ray absorptiometry. We emphasized that it was important to avoid stretching and to train the patient within a controlled range of motion. Submaximal eccentric exercises within a safe range of motion were incorporated to increase the active control of the joint positioning. Thus, in one patient, isokinetic rehabilitation was successfully undertaken. Each treatment had to be adapted to the individual patient and had to include specific home exercises. Conclusion: In each case, physiotherapy gave good results in relation to pain, quality of life and stability of rehabilitated joints. Safety must be assured and specific evaluations such osteodensitometry, cardiac explorations and interventions of bracing, proprioceptive and functional strengthening can be very helpful. [less ▲]

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See detailInfluence of the contraction mode on the tendon structure - Rat model
Kaux, Jean-François ULg; Drion, Pierre ULg; Besançon, Benoît et al

in 2nd Congress of European College of Sport & Exercise Physicians - Conference Brochure 2010: Abstracts and CVs (2010, September 09)

Introduction: Tendinopathies are common in sport and affect both upper and lower limbs. Eccentric rehabilitation is a successful way of treating them and now is becoming the “gold treatment”. Although ... [more ▼]

Introduction: Tendinopathies are common in sport and affect both upper and lower limbs. Eccentric rehabilitation is a successful way of treating them and now is becoming the “gold treatment”. Although clinical results are very favorable, beneficial morphological and histological effects have not yet been elucidated. The aim of our experiment was to determine if there exist any intrinsic modifications in a tendon trained in concentric or eccentric modes, in a rat model. Methods: 18 rats were divided into 3 groups: 6 for the control group, without physical restraint; 12 for a training of1 hour, 3 times a week, for 5 weeks, at a speed of 17m/min (1km/h), on a inclined treadmill: 6 rats running uphill at +15° for the concentric effort (group C) and 6 rats running downhill at -15° for the eccentric effort (group E). After this training period, the Achilles, patellar and tricipital tendons of both limbs were surgically removed in all 18 rats. Tendons taken from five rats of each group were subjected to a tensile test up to rupture using a “cryo” jaw. Tendons of the remaining rat of each group were subjected to a histological study. Results: The results showed significant changes in group E only: (1) an increase of the force required to rupture the patellar and tricipital tendons; (2) an improvement of the ratio between the force necessary to rupture the tricipital tendon and the body mass of the rats; (3) an increase of the surface area of the section of the tricipital tendon. No significant change was observed as far as constraint was concerned between groups. Histologically, we saw, in the group E, more peripheral blood vessels and a greater proportion of collagen. Conclusion: This study showed that the mechanical properties of tendon tissue are enhanced by eccentric training. Tendons become stronger, the amount of collagen increases and there is probably more interaction between collagen fibers (mechanotransduction). [less ▲]

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See detailEvaluation de la fatigue musculaire: application à l'instabilité d'épaule
Forthomme, Bénédicte ULg; Van Heule, A.-S.; Kaux, Jean-François ULg et al

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

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See detailFatigue, facteur de risque de lésions musculaires chez le sportif?
Croisier, Jean-Louis ULg; Forthomme, Bénédicte ULg; Maquet, Didier ULg et al

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

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See detailEvaluation de la fatigue musculaire des membres supérieurs
Forthomme, Bénédicte ULg; Soubeyrand, G.; Degache, F. et al

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

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See detailEvaluation isocinétique de la fatigue musculaire au genou : aspects méthodologiques
Croisier, Jean-Louis ULg; Maquet, Didier ULg; Forthomme, Bénédicte ULg et al

in JULIA, M.; PERREY, S.; DUPEYRON, A. (Eds.) et al Fatigue musculaire (2010)

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See detailEffect of the Lengthening of the Protocol on the Reliability of Muscle Fatigue Indicators
Bosquet, Laurent; Maquet, Didier ULg; Forthomme, Bénédicte ULg et al

in International Journal of Sports Medicine (2010), 31(2), 82-88

The aim of this study was to examine absolute and relative reliability of fatigue measures calculated from peak torque or total work during 20, 30, 40 and 50 reciprocal maximal concentric contractions ... [more ▼]

The aim of this study was to examine absolute and relative reliability of fatigue measures calculated from peak torque or total work during 20, 30, 40 and 50 reciprocal maximal concentric contractions performed on an isokinetic dynamometer at 180 ° · s " 1 . Eighteen moderately active men performed 50 reciprocal maximal concentric contractions on three occasions with one 7 – 10 days recovery between each session. Peak torque and total work were computed for each contraction and subsequently summed to compute cumulated performance after respectively 20, 30, 40 and 50 repetitions. Muscle fatigue was determined after 20, 30, 40 and 50 repetitions by the fatigue index, the percent decrease in performance and the slope. Reliability of average peak torque or average total work was similar and was not a! ected by the lengthening of the protocol, although a learning e! ect was evident for knee flexors. Reliability of fatigue measures calculated from peak torque or total work was similar, improved with the lengthening of the protocol and was better for knee extensors. Measuring average peak torque or average total work and the slope during a protocol involving 30 maximal reciprocal concentric contractions appear to represent a better compromise between reliability and physiological interpretability of the data. [less ▲]

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See detailL'évaluation fonctionnelle et musculaire de l'épaule pathologique
Forthomme, Bénédicte ULg

in Livre des résumés du 1er Congrès de la Société Scientifique de Kinésithérapie : "Les outils d'évaluation Peut-on encore les ignorer ?" (2009, October)

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See detailProgramme excentrique dans le traitement de l’hyperlaxité du coude
Kaux, Jean-François ULg; Foidart-Dessalle, Marguerite ULg; Debray, François-Guillaume ULg et al

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 ▲]

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See detailProgramme excentrique dans la pathologie du coude : tendinopathie épicondylienne
Croisier, Jean-Louis ULg; Foidart-Dessalle, Marguerite ULg; Crielaard, Jean-Michel ULg et al

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

Lateral epicondylitis represents a common overuse injury caused by repetitive gestures through sports activity, industrial work and hobby activities. In spite of many conservative treatment procedures ... [more ▼]

Lateral epicondylitis represents a common overuse injury caused by repetitive gestures through sports activity, industrial work and hobby activities. In spite of many conservative treatment procedures, prolonged symptoms and relapse are frequently reported. The goal of our study was to compare the outcome of patients performing an adapted isokinetic eccentric training with that of patients receiving a non-strengthening classical rehabilitation. Results, dealing with pain score evaluation, disability questionnaire, muscle strength measurement and ultrasonographic examination, highlight the relevance of implementing isokinetic adapted eccentric training in the management of lateral epicondylitis. [less ▲]

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See detailPathologie ischio-jambière : évaluation et renforcement en mode excentrique
Croisier, Jean-Louis ULg; Crielaard, Jean-Michel ULg; Maquet, Didier ULg et al

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 ▲]

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See detailRenforcement musculaire excentrique après plastie du LCA
Gremeaux, V.; Forthomme, Bénédicte ULg; Croisier, Jean-Louis ULg

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

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See detailExplorations isocinétique et électromyographique de l'épaule atteinte d'une lésion du nerf suprascapulaire
Forthomme, Bénédicte ULg; Wang, François-Charles ULg; Mazza, L. et al

in Brunon-Martinez, A.; Codine, Philippe; Hérisson, C. (Eds.) Epaule neurologique et médecine de rééducation (2009)

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See detailScapula alata : facteurs musculaires et neurologiques
Forthomme, Bénédicte ULg; Wang, François-Charles ULg; Sternon, Anne-Catherine et al

in Brunon-Martinez, A.; Codine, Philippe; Hérisson, C. (Eds.) Epaule neurologique et médecine de rééducation (2009)

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See detailQuelles applications du travail excentrique en rééducation ?
Croisier, Jean-Louis ULg; Maquet, Didier ULg; Crielaard, Jean-Michel ULg et al

in Kinesitherapie Revue (2009), 85-86

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See detailEntraînement excentrique des rotateurs d'épaule
Forthomme, Bénédicte ULg; Chague, Lucie ULg; Crielaard, Jean-Michel ULg et al

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

In this study, we have investigated the influence of the installation on the dynamometer and of the mode of contraction used during a rotator cuff muscle training. 24 subjects were divided into 3 groups ... [more ▼]

In this study, we have investigated the influence of the installation on the dynamometer and of the mode of contraction used during a rotator cuff muscle training. 24 subjects were divided into 3 groups. Two groups of 8 subjects performed a training of the Internal Rotators (IR) in concentric mode (60°/s and 240°/s) and of the External Rotators in eccentric mode (60°/s). The first group was trained at 45° of abduction; the second was trained at 90° of abduction. The third group did not perform any shoulder training. All patients were assessed thanks to the isokinetic device ((3) x 60°/s concentric – (5) x 240°/s concentric – (4) x 60°/s eccentric) before and after training. Only the group trained at 45° of abduction increased the isokinetic maximal peak torque (+ p) in concentric mode during the second isokinetic assessment. No subject showed improvement through the eccentric exercise. They also improved the throw of the ball (+ 8.5 %). Possible feeling of discomfort and signs of subacromial conflict explained that no progression was recorded after training at 90° of abduction. Likewise, the eccentric mode would major the inhibition limiting the strength increase. Even if 90° of abduction seems more specific for assessment, 45° of abduction is more suitable for training. [less ▲]

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See detailConcept d'équilibre agonistes / antagonistes de l'épaule
Forthomme, Bénédicte ULg; Crielaard, Jean-Michel ULg; Croisier, Jean-Louis ULg

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

Besides the concentric classical ratios, the eccentric isokinetic assessment of the muscle shoulder allows us to build some specific ratios. The mixed ratio combines the eccentric maximal contraction of ... [more ▼]

Besides the concentric classical ratios, the eccentric isokinetic assessment of the muscle shoulder allows us to build some specific ratios. The mixed ratio combines the eccentric maximal contraction of the external rotators (ER) and the concentric maximal strength of the internal rotators (IR). The mixed ratio is frequently decreased among overhead athletes. This imbalance could rise to shoulder tendinopathy, but seemed to be linked with field performance. The functional ratio corresponds to the balance between the ER in concentric mode and the IR in eccentric contraction. The unstable shoulder shows a trend to lower functional ratios, highlighting the weakness of the eccentric IR in that pathology. [less ▲]

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See detailIsokinetic assessment of the scapular muscles in serratus anterior dysfunction
Forthomme, Bénédicte ULg; Wang, François-Charles ULg; Crielaard, Jean-Michel ULg et al

in Journal of Rehabilitation Medicine Supplement (2008, June), 47

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See detailQuel protocole pour l’évaluation de la résistance à la fatigue du genou ?
Croisier, Jean-Louis ULg; Maquet, Didier ULg; Forthomme, Bénédicte ULg et al

in Abstract book de la 6ème Journée Belge d’Isocinétisme du GIBL (2008, March)

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