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See detailEpidemiological Review of Injuries in Rugby Union
Kaux, Jean-François ULg; Julia, Marc; Delvaux, François ULg et al

in Sports (2015), 3(1), 21-29

Rugby is a sport that is growing in popularity. A contact sport par excellence, it causes a significant number of injuries. In Rugby Union, there are 30 to 91 injuries per 1000 match hours. This ... [more ▼]

Rugby is a sport that is growing in popularity. A contact sport par excellence, it causes a significant number of injuries. In Rugby Union, there are 30 to 91 injuries per 1000 match hours. This epidemiological review of injuries incurred by rugby players mentions the position and type of injuries, the causes, time during the match and season in which they occur and the players’ positions as well as the length of players’ absences following the injury. [less ▲]

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See detailRetour au sport après plastie du ligament croisé antérieur : critères utilisés dans les cubs professionnels de football
Delvaux, François ULg; Rochcongar, P; Bruyère, Olivier ULg et al

in Science et Sports (2015), 30

Résumé Objectifs Analyser la démarche suivie par les médecins de clubs professionnels de football lorsqu’ils décident, en pratique quotidienne, d’autoriser le retour compétitif après plastie du ligament ... [more ▼]

Résumé Objectifs Analyser la démarche suivie par les médecins de clubs professionnels de football lorsqu’ils décident, en pratique quotidienne, d’autoriser le retour compétitif après plastie du ligament croisé antérieur chez un footballeur. Matériels et méthodes Trente-sept médecins responsables de clubs professionnels de football français et belges (Ligue 1, n = 15 ; Ligue 2, n = 14 ; Division 1 belge, n = 8) ont rempli un questionnaire à choix multiple concernant : (1) les critères utilisés afin de déterminer si un joueur est apte à reprendre la compétition après plastie du ligament croisé antérieur ; (2) l’importance relative de chacun de ces critères ; (3) le rôle éventuel d’intervenants spécifiques (kinésithérapeute…) dans cette décision. Résultats Plus de 80 % des médecins interrogés ont déclaré utiliser au moins huit critères (sur 17 proposés) afin d’évaluer la capacité d’un footballeur à reprendre la compétition après plastie du ligament croisé antérieur. Les trois critères considérés comme les plus déterminants étaient, par ordre d’importance : la stabilité dynamique du genou lors d’un exercice spécifique au football, la force musculaire et la récupération complète ou quasi complète d’amplitudes articulaires de flexion et d’extension de genou. Pour certains de ces critères (notamment la force musculaire), nous constatons cependant un manque de consensus sur les modalités pratiques d’évaluation, sur les paramètres ainsi que sur les valeurs-limites tolérées afin de garantir un retour sur terrain sécurisé. La prise en compte de l’avis du kinésithérapeute et du préparateur physique par une très nette majorité de médecins souligne l’importance d’un travail pluridisciplinaire. Conclusion L’utilisation de différents critères objectifs afin d’autoriser le retour compétitif après plastie du ligament croisé antérieur semble être une réalité dans le football professionnel. Des études supplémentaires devraient cependant contribuer à préciser les modalités des épreuves ainsi que des valeurs-seuils. ________________________________________ Summary Purpose To analyze how sport physicians decide, in their daily practice, when a professional soccer player with a reconstructed anterior cruciate ligament is able to get back to competitive activities. Materials and methods Thirty-seven physicians for professional French and Belgian soccer teams filled in a specific questionnaire dedicated to: (1) return-to-play criteria after anterior cruciate reconstruction; (2) the importance they assigned to each of these criteria in the return-to-play decision; (3) the potential role of professionals, such as physiotherapists or physical coaches in this decision. Results More than 80% of the respondents declared to use at least eight criteria in order to assess the player's ability to return to competitive soccer after anterior cruciate ligament reconstruction. The most important ones were (in order of importance): dynamic knee stability during a specific soccer exercise, muscle strength performance and normalization of knee flexion and extension ranges of motion. For most of these criteria (notably muscle strength), there was a lack of consensus about the choice of assessment parameters and the limit values allowing physicians to authorize or forbid the return-to-competition. A large majority of participants stated to take into consideration advices from physiotherapists or physical coaches for the return-to-play decision. Conclusion Sport physicians of professional soccer teams use relevant criteria to assess players’ ability to return to full sport after anterior cruciate ligament reconstruction. Further studies are required to determine the choice of assessment parameters and the limit values to assist physicians in return-to-play decisions. [less ▲]

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See detailAdaptation interculturelle et validation du questionnaire VISA-P en français
Oppong-Kyei, Julian; Bruyère, Olivier ULg; Delvaux, François ULg et al

in 7ème Congrès National SFMES & SFTS 2014 (2014, September)

Introduction La tendinopathie patellaire est une affection musculo-squelettique très fréquentes chez le sportif et la plus fréquente au niveau du genou. Elle affecte le plus souvent des disciplines qui ... [more ▼]

Introduction La tendinopathie patellaire est une affection musculo-squelettique très fréquentes chez le sportif et la plus fréquente au niveau du genou. Elle affecte le plus souvent des disciplines qui nécessitent soit des impulsions et des sauts soit un travail important du quadriceps. Le Victorian Institute of Sports Assessment–Patellar (VISA-P) est un questionnaire permettant d’évaluer les symptômes et leurs retentissements sur les activités physiques quotidiennes et sportives de la tendinopathie patellaire (Jumper’s knee). Comme la plus part des questionnaires de ce type, le VISA-P fut originalement développé pour des patients anglophones et n'est donc pas adapté à une population francophone. En conséquence, l'objectif de cette étude sera de traduire, adapter et valider une version française fiable du VISA-P et d'en évaluer ses propriétés psychométriques. Matériel et méthode La traduction et l’adaptation interculturelle du VISA-P ont été réalisées selon les recommandations internationales (Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures). Ce processus s'est déroulé en 6 étapes : traductions initiales, synthèse des traductions, traduction de retour vers la langue d’origine, comité expert, test de la version pré-finale et approbation du comité expert. La version française finale obtenue fut ensuite l’objet d’une évaluation de certaines propriétés psychométriques telles que la fidélité test-retest, la cohérence interne, la validité de construit et les effets plancher et plafond. Nonante-deux sujets furent recruté au total afin de tester ces propriétés psychométriques. Trois groupes de sujets furent utilisés pour répondre conjointement aux VISA-P et à un questionnaire supplémentaire, le Medical Outcomes Survey Short Form 36 questionnaire (SF-36) pour la validité de construit : un groupe de sujets pathologiques principalement recrutés parmi les patients du Centre Hospitalier Universitaire de Liège (28), un groupe de sujets asymptomatiques (22) et un groupe de sportifs à risque recrutés dans divers clubs sportif (42). L'ensemble des participants ont été recrutés au sein de la province de Liège. Résultats Aucun sujet ne présenta de grosses difficultés à comprendre le questionnaire suite au test de la version pré-finale. Les différents membres du comité expert se montrèrent satisfait de la version finale et donnèrent donc leur approbation. La moyenne des scores obtenu est de 53 (± 17) pour le groupe pathologique, 99 (± 2) pour le groupe sain et 86 (± 14) pour le groupe à risque. Les corrélations entre le VISA-P et certaines mesures divergentes du SF-36 semblent donner des résultats faibles. Les coefficients de corrélation mesurés entre les scores du VISA-P et les items convergents du SF-36 paraissent être élevés. Aucun effet plancher ou plafond n'a pu être observer lors de l'évaluation des propriétés psychométriques du VISA-P dans le groupe pathologique. Conclusion La version française du VISA-P est donc être un questionnaire compréhensible, fiable et adapté aux patients francophones souffrant d'une tendinopathie patellaire supérieur. [less ▲]

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See detailAdaptation interculturelle et validation du questionnaire VISA-A en français
Oppong-Kyei, Julian; Bruyère, Olivier ULg; Delvaux, François ULg et al

in 7ème Congrès National SFMES & SFTS 2014 (2014, September)

Introduction La tendinopathie d’Achille, dont la discipline athlétique implique une grosse activité de course à pied, représente une source de douleurs et de handicap. Cette pathologie fait actuellement l ... [more ▼]

Introduction La tendinopathie d’Achille, dont la discipline athlétique implique une grosse activité de course à pied, représente une source de douleurs et de handicap. Cette pathologie fait actuellement l'objet de nouvelles découvertes sur le plan de la physiopathologie permettant l'exploration de nouvelles pistes thérapeutiques. Dans le cadre de telles études, des échelles d’évaluation sont utilisées afin d'évaluer des phénomènes subjectifs ou complexes tels la douleur, la qualité de vie, le handicap, etc. Elles sont généralement composées de plusieurs items dont la cotation est combinée en un score global ou des sous scores dimensionnels. La majorité des échelles algo-fonctionnelles sont développés dans des pays anglophones et sont par conséquence uniquement pertinents pour des sujets parlant l’anglais. Ceci est la cas pour le Victorian Institute of Sports Assessment–Achilles (VISA-A), un questionnaire développé dans le but d'évaluer la sévérité des symptômes de la tendinopathie achilléenne. L’intérêt de ce mémoire est donc de valider une version française fiable de ce questionnaire. Matériel et méthode La traduction et l’adaptation interculturelle du VISA-A ont été réalisées selon les recommandations internationales (Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures). Ce processus s'est déroulé en 6 étapes : traductions initiales, synthèse des traductions, traduction de retour vers la langue d’origine, comité expert, test de la version pré-finale et approbation du comité expert. La version française finale obtenue fut ensuite l’objet d’une évaluation de certaines propriétés psychométriques telles que la fidélité test-retest, la cohérence interne, la validité de construit et les effets plancher et plafond. Pour ces évaluations, 116 sujets furent recruté et répartis en 3 groupes : un groupe de sujets pathologiques principalement recrutés parmi les patients du Centre Hospitalier Universitaire de Liège (31), un groupe de sujets asymptomatiques (22) et un groupe de sportifs à risque (63). Tous ces sujets durent également répondre à un questionnaire supplémentaire, le Medical Outcomes Survey Short Form 36 questionnaire (SF-36) pour la validité de construit. L'ensemble des participants ont été recrutés au sein de la province de Liège. Résultats Aucun sujets ne présenta de difficultés à comprendre le questionnaire suite au test de la version pré-finale. Les différents membres du comité expert se montrèrent satisfait de la version finale et donnèrent donc leur approbation. La moyenne des scores obtenus dans le groupe pathologique est de 59 (± 18), celle du groupe sain est de 99 (± 1) et celle du groupe à risque est de 94 (± 7). Aucun effet plancher ou plafond n'a pu être observer lors de l'évaluation des propriétés psychométriques du VISA-A (dans le groupe pathologique). Les corrélations entre le VISA-A et certaines mesures divergentes du SF-36 semblent être faibles. Les coefficients de corrélation mesurés entre les scores du VISA-A et les items convergents du SF-36 paraissent être élevé. Conclusion La version française du VISA-A est donc être un questionnaire compréhensible, fiable et adapté aux patients francophones souffrant d'une tendinopathie d'Achille. [less ▲]

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See detailImportance of quantitative return-to-field criteria
Schwartz, Cédric ULg; Cordonnier, Caroline ULg; Lehance, Cédric ULg et al

Conference (2014, July 04)

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See detailDescription of a standardized rehabilitation program based on sub-maximal eccentric following a platelet-rich plasma infiltration for jumper’s knee.
Kaux, Jean-François ULg; Forthomme, Bénédicte ULg; NAMUROIS, Marie-Hélène ULg et al

in Muscles, Ligaments and Tendons Journal (2014), 4(1 (eCollection 2014 Jan)), 85-89

Introduction: Different series emphasized the necessity of rehabilitation program after infiltration of platelet-rich plasma (PRP) in case of tendinopathy. However, most of them describe only briefly the ... [more ▼]

Introduction: Different series emphasized the necessity of rehabilitation program after infiltration of platelet-rich plasma (PRP) in case of tendinopathy. However, most of them describe only briefly the reeducation protocol and these programs vary. Our aim was to extensively describe a specific standardized rehabilitation program. Methods: After a review of literature of post-PRP infiltration protocols, we had developed a standardized rehabilitation protocol. This protocol was evaluated by 30 subjects with chronic jumper’s knee who. A a standardised progressive sub-maximal eccentric program supervised by a physical therapist for 6 weeks was started 1 week post-infiltration. The patient benefited also from electromyostimulation, isometric strengthening and stretching of the quadriceps, cycloergometer and cryotherapy. After the supervised program, the patient had to make an auto-reeducation added to the reathletisation protocol for 6 more weeks which was followed by maintenance exercises up to 1 year. The assessments were made using a VAS, IKDC and VISA-P scores. Results: The VAS , IKDC and VISA-P scores decreased very significantly with time. The compliance to auto-reeducation was good. Conclusion: We proposed a simple and efficient protocol based on sub-maximal eccentric reeducation to add to PRP infiltrations in case of patellar tendinopathy. [less ▲]

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See detailEccentric training for elbow hypermobility
Kaux, Jean-François ULg; Delvaux, François ULg; Forthomme, Bénédicte ULg et al

in British Journal of Sports Medicine (2014, April), 48(7), 154

Background: Patients with hypermobility suffer from joints problems and chronic pain is the most frequently reported symptom. Objective: Eccentric muscle strengthening could be very important to protect ... [more ▼]

Background: Patients with hypermobility suffer from joints problems and chronic pain is the most frequently reported symptom. Objective: Eccentric muscle strengthening could be very important to protect hypermobile joints. Design: Case report. Patient: A girl (16 y.o.) affected by an Ehler-Danlos syndrome presented pain in the right elbow and the right wrist after a season of tennis. Interventions: Her training 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 within a limited range of motion in flexion and extension, on an isokinetic device after an evaluation. She was also given an orthesis restricting the joint range of motion of the wrist. Main outcome measurements: The evaluation was made by isokinetic evaluation, visual analog scale and MOS-SF36 questionnaire before and after training. Results: 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 a significant improvement in maximal torque in flexion-extension muscles of the right elbow. She was also given individualized home exercises. Conclusions: The goal of this eccentric training 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 and prevent pain during practicing tennis. [less ▲]

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See detailThe eccentric intervention for prevention: muscle and tendon aspects
Kaux, Jean-François ULg; Hody, Stéphanie ULg; Delvaux, François ULg et al

in European Journal of Sports Medicine (2014), 1(2), 37-46

The muscle-tendon pathologies remain very common in sport as well as to manual workers. An action of primary and secondary prevention is crucial if we are to prevent the occurrence of these pathologies ... [more ▼]

The muscle-tendon pathologies remain very common in sport as well as to manual workers. An action of primary and secondary prevention is crucial if we are to prevent the occurrence of these pathologies and prevent recurrence. The eccentric contractions marked by the removal of muscle insertions, gives them certain preventive and rehabilitative characteristics. It is now clearly shown that the eccentric work applied to the muscle-tendon complex, leads to progressive structural changes. These adaptations allow the muscles and tendons to better suit external stresses under which they are subjected and thereby reduce the lesion risk but also to prevent recurrence. Finally, it is also accepted that only the sub maximal eccentric exercise gradually increased helped protect (up to 1 year) of Delayed Onset Muscle Soreness in case of severe and unusual eccentric work. [less ▲]

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See detailRevue épidémiologique des blessures lors de la pratique du rugby à XV
Kaux, Jean-François ULg; Julia, Marc; Chupin, Marie et al

in Journal de Traumatologie du Sport (2014), 31(1), 49-53

Rugby is an increasingly popular sport. Full contact being a major characteristic of rugby, injuries are not uncommon. The incidence of injury in Rugby Union reaches 30–91 per 1,000 hours of game time ... [more ▼]

Rugby is an increasingly popular sport. Full contact being a major characteristic of rugby, injuries are not uncommon. The incidence of injury in Rugby Union reaches 30–91 per 1,000 hours of game time. This epidemiological review of injuries in rugby players reports their localization, nature, causes, moment of occurrence in matches and seasonal trends as well as the influence of the player’s position, field conditions, and duration of off time after injury. [less ▲]

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

in Kinésithérapie Scientifique (2014), 550

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See detailReturn-to-play critera after hamstring injury: actual medicine practice professional soccer teams
Delvaux, François ULg; Rochcongar, p; Bruyère, Olivier ULg et al

in Journal of Sports Science & Medicine (2014), 13

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See detailLes Facteurs de risques de rupture du ligament croisé antérieur du genou : l’état neuro-musculaire
Kaux, Jean-François ULg; Delvaux, François ULg; Forthomme, Bénédicte ULg et al

in Journal de Traumatologie du Sport (2013), 30(4), 248-252

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See detailLa qualité de force relative : paramètre sous-exploité ?
Croisier, Jean-Louis ULg; Delvaux, François ULg; Cordonnier, Caroline ULg et al

in Livret des interventions - XVèmes Rencontres Médimex - "Isocinétisme - Actualités et Controverses" (2013, November)

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See detailRééducation des plasties du LCA : quels pièges ?
Croisier, Jean-Louis ULg; BAUVIR, Philippe ULg; NAMUROIS, Marie-Hélène ULg et al

in Abstract Book du Symposium d'Axxon - Actualité en Kinésithérapie (2013, November)

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See detailCritères de retour sur le terrain après plastie LCA chez le footballeur professionnel
Croisier, Jean-Louis ULg; Rochcongar, Pierre; Bruyère, Olivier ULg et al

in European Journal of Sports Medicine (2013, September), 1(1),

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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 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 ▲]

Detailed reference viewed: 94 (14 ULg)