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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 detailEccentric training improves tendon biomechanical properties: a rat model
Kaux, Jean-François ULg; Drion, Pierre ULg; Libertiaux, Vincent et al

in British Journal of Sports Medicine (2014, April), 48(7), 155

Background: Even if eccentric exercises appear favourable in primary prevention of tendons lesions and, especially, in secondary prevention after tendinopathy, the biomechanical changes to the tissue are ... [more ▼]

Background: Even if eccentric exercises appear favourable in primary prevention of tendons lesions and, especially, in secondary prevention after tendinopathy, the biomechanical changes to the tissue are not yet clear. Objective: We aimed to better define the biomechanical changes that affect healthy tendon after eccentric and concentric training. Design: Randomised controlled trial. Participants: Eighteen Sprague-Dawley rats of 2 months. Interventions: The six rats in the control group (U) were not subjected to physical exercise. The 12 remaining rats (6 in each group) ran on a treadmill set at a +15° incline for concentric training (C) or a -15° incline for eccentric training (E), at a speed of 17 m/min for 1 h, three times per week for 5 weeks. Main Outcome Measurements: The tricipital, patellar and Achilles tendons were subsequently removed to perform a traction test until rupture, and a histological analysis was performed. Results: There was a significant improvement in the rupture force of the patellar and tricipital tendons between the U and E groups. The tricipital tendons in the control group presented a significantly smaller cross-section than the E- and C-trained groups, but none between E and C groups. No significant difference was observed for the mechanical stress at rupture per surface unit between the three groups for all three tendons. However, a tendency towards improvement these values was observed between the trained and the U groups for the patellar tendon. Histological studies demonstrated the tendency of the development of a greater number of blood vessels and a larger quantity of collagen in the eccentric group. Conclusions: The mechanical properties of tendons in rats improve after specific training, especially following eccentric training. Our results partly explained how mechanical loading, especially in eccentric mode, could improve the tendon structure. [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 detailExperimental Study of the Human Ability to Deliberately Excite a Flexible Floor
Schwartz, Cédric ULg; Berger, Alexis; Bruls, Olivier ULg et al

in Zingoni, Alphose (Ed.) Proceedings of the 5th International Conference on Structural Engineering, Mechanics and Computation (2014)

Human-structure interactions are not completely understood yet. This paper presents an experimental study focusing on the interaction between a human and a flexible support, with a major aim to better ... [more ▼]

Human-structure interactions are not completely understood yet. This paper presents an experimental study focusing on the interaction between a human and a flexible support, with a major aim to better understand how the behavior of a human subject, bouncing on a flexible structure, adapts to the support motion. Exploratory experiments are undertaken with a 7m-span timber footbridge tested in the Human Motion Analysis Laboratory of the University of Liege. The movements of the coupled system composed of the subject and the footbridge are recorded by Motion Capture technology; the subject\textquoteright{}s 3-D body motion is defined by three important angles: ankle, knee and hip. The interaction between the subject and the footbridge is also quantified by means of force platform measurements. The experiments indicate an influence of the support amplitude and natural frequency on the phase shift between the oscillatory floor motion and the three angles characterizing the motion. [less ▲]

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See detail3D analysis of gait using accelerometer measurements
Boutaayamou, Mohamed ULg; Schwartz, Cédric ULg; Stamatakis, Julien et al

Scientific conference (2013, November 07)

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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 detailLe mode excentrique appliqué aux rotateurs d'épaule
Forthomme, Bénédicte ULg; Kaux, Jean-François ULg; Crielaard, Jean-Michel ULg et al

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

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See detailActualités thérapeutiques dans la prise en charge des tendinopathies
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Forthomme, Bénédicte ULg et al

in Annals of Physical and Rehabilitation Medicine (2013, October), 56(Sup 1), 050-003

“Conventional” treatments of tendinopathies are generally employed empirically to fight pain and inflammation but they do not modify the histological structure of the tendon. However, these treatments are ... [more ▼]

“Conventional” treatments of tendinopathies are generally employed empirically to fight pain and inflammation but they do not modify the histological structure of the tendon. However, these treatments are not completely satisfactory and the recurrence of symptoms is common. In contrast to the passive pattern of many therapies dedicated to tendon disorders, some authors have promoted an eccentric training mode. Such active eccentric training programs are aimed at thwarting an aetiopathogenic theory proposing insufficient tensile strength of the tendon exposed to external loads which could progressively damage it. Though the literature remains incomplete on tendon architecture remodelling and real histological adaptations following an adapted eccentric training, clinical results following such therapy appear promising. Due to its noninvasiveness, low complication rate and high applicability combined with good results, extracorporeal shock wave therapy has become a well known option within the therapeutic spectrum for many tendinopathies. More specifically, it has been successfully applied in chronic tendinopathy resistant to a conservative training program including eccentric exercises. Platelets release different cytokines and growth factors that could promote angiogenesis, tissue remodelling (bone, skin etc.), and wound healing. Platelet-rich plasma (PRP) is obtained by centrifuging autologous blood to have a high concentration of platelets depending on the isolation method. For this reason, different PRP preparation techniques cannot provide a consistently identical final product, but there is currently no international consensus on this issue. Despite the proven efficacy of PRP tissue regeneration in labs, there is currently little tangible clinical evidence for chronic tendon disorders. The few studies that have been performed appear unlikely to be comparable. Up to now, randomised controlled studies with appropriate placebo groups are needed to determine the real effectiveness of PRP for treating chronic tendon conditions. However, this therapeutic option remains very popular in sports, and many top athletes are using it in case of musculoskeletal conditions. What is more, it has been removed from the doping lost of the World AntiDoping Agency. Other new therapeutic options (infiltrations of polidocanol, hyaluronic acid, botulinum toxin, patches of derivatives Nitro...) for treating tendinopathies are also discussed in this review. [less ▲]

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See detailShoulder and handball
Gleizes Cervera, S.; Croisier, Jean-Louis ULg; Kaux, Jean-François ULg et al

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

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See detailPhysiological interpretation of the slope during an isokinetic fatigue test of the knee
Bosquet, L.; Gouadec, K.; Berryman, N. et al

in European Journal of Sports Medicine (2013, September), 1(1), 151

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See detailInfluence of game playing on the muscular profile of shoulder rotators of handball players
Ucay, O.; Gasq, D.; Forthomme, Bénédicte ULg et al

in European Journal of Sports Medicine (2013, September), 1(1), 105

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See detailEffect of the lengthening of the protocol on the reliability of knee muscle fatigue indicators
Bosquet, L.; Maquet, Didier ULg; Forthomme, Bénédicte ULg et al

in European Journal of Sports Medicine (2013, September), 1(1), 150

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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 detailReference populations for shoulder studies should be selected carefully
Schwartz, Cédric ULg; Denoël, Vincent ULg; Bruls, Olivier ULg et al

Conference (2013, August 06)

To assess various shoulder pathologies / treatments, non pathological populations are often used as references. However, some factors may influence significantly the scapular kinematics within a healthy ... [more ▼]

To assess various shoulder pathologies / treatments, non pathological populations are often used as references. However, some factors may influence significantly the scapular kinematics within a healthy population and consequently alter the final kinematic evaluation. Results of 3D shoulder assessment found in this study show that small (≈5°) but significant differences exist between gender and between the dominant and non-dominant arms. Therefore the populations used for referential data should be selected carefully. [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 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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