Physiotherapy Intervention for Joint Hypermobility in Three Cases with Heritable Connective Tissue Disorders

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 ▲]

Programme excentrique dans la pathologie du coude : tendinopathie épicondylienne

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 ▲]

Dysphagie soudaine chez un patient âgé tétraparétique

in Annales de Réadaptation et de Médecine Physique (2009), 52(1), 59-62

Cas clinique. - Nous rapportons le cas d'un patient tétraparétique de 92 ans qui a présenté subitement des troubles majeurs de la déglutition dans les suites d'une contusion cervicale. L'examen ... [more ▼]

Cas clinique. - Nous rapportons le cas d'un patient tétraparétique de 92 ans qui a présenté subitement des troubles majeurs de la déglutition dans les suites d'une contusion cervicale. L'examen électrophysiologique en fibre unique au niveau du muscle extenseur commun des doigts a suggéré le diagnostic de myasthénie. Celui-ci a finalement été retenu au vu de l'absence de récidive après de six mois de traitement par pyridostigmine. Discussion. - Nous avons rappelé les différentes caractéristiques de la myasthénie ainsi que la prise en charge de toute dysphagie. Conclusion. - Il est important d'être attentif à tout signe direct et/ou indirect de dysphagie et de toujours les explorer afin de pouvoir en déterminer l'étiologie exacte pour instaurer la prise en charge et le traitement adéquats. [less ▲]

Imagerie médicale et appareil locomoteur : les membres inférieurs (cases report)

Conference (2008, April 14)

An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy

in British Journal of Sports Medicine (2007), 41(4), 269-275

Background: Lateral epicondylitis represents a frequent overuse injury. In spite of many conservative treatment procedures, prolonged symptoms and relapse are frequently observed. Objective: To compare ... [more ▼]

Background: Lateral epicondylitis represents a frequent overuse injury. In spite of many conservative treatment procedures, prolonged symptoms and relapse are frequently observed. Objective: To compare the outcome of patients performing an isokinetic eccentric training with that of age-, gender-, activity-matched patients receiving a non-strengthening classical rehabilitation. Methods: Ninety-two patients with unilateral chronic lateral epicondylar tendinopathy (mean duration of symptoms 8 +/- 3 months) were assigned either to a control group (n = 46) or to an eccentrically trained group (n = 46). The control group underwent a passive standardised rehabilitation programme that excluded strengthening exercises. In addition to this programme, the trained group also performed eccentric exercises based on the repetitive lengthening of the active musculo-tendinous unit. The latter exercises started with submaximal contraction intensity and slow speed movement. Modalities were progressively intensified (increase in intensity contraction and speed movement) over a long priod of treatment. Programme effectiveness was assessed through pain score evaluation, a disability questionnaire, muscle strength measurement and ultrasonographic examination. Results: Compared to the non-strengthening control group, the following observations were made in the eccentrically trained group: (1) a significantly more marked reduction of pain intensity, mainly after one month of treatment; (2) an absence of strength deficit on the involved side through bilateral comparison for the forearm supinator and wrist extensor muscles; (3) an improvement of the tendon image as demonstrated by decreasing thickness and a recovered homogenous tendon structure; and (4) a more marked improvement in disability status during occupational, spare time and sports activities. Conclusion: These results highlight the relevance of implementing isokinetic adapted eccentric training in the management of chronic lateral epicondylar tendinopathy. [less ▲]

Intérêt d’un programme excentrique dans le traitement de l’épicondylite

in Hérisson, C.; Rodineau, J. (Eds.) Le coude microtraumatique (2006)

Intérêt de l’exercice excentrique dans le traitement de l’épicondylite chronique

in Abstract book de la 5ème Journée Belge d’Isocinétisme du GIBL (2005, December)

Cinematic and electromyographic analysis of a basic athletic test: the walkover in well trained and beginners young female gymnasts

in Computer Methods in Biomechanics & Biomedical Engineering (2005, September), 8(Supp 1), 027

Protocole excentrique adapté au traitement des épicondylites chroniques

in Annales de Réadaptation et de Médecine Physique (2004, October), 47(7), 502-503

Travail excentrique sous-maximal sur dynamomètre isocinétique et traitement des épicondylites chroniques

in Actes du Congrès de la Société Royale Belge de Médecine Physique et de Réhabilitation (2002, November)