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See detailUsing platelet-rich plasma to treat jumper's knees: Exploring the effect of a second closely-timed infiltration
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Forthomme, Bénédicte ULg et al

in Journal of Science and Medicine in Sport (in press)

Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative administration may prove ... [more ▼]

Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of two or three successive infiltrations. The aim of this study was to evaluate whether two infiltrations of PRP proves more effective than a single treatment. DESIGN: Prospective, randomized and comparative study of level 2. METHODS: Twenty patients suffering from chronic proximal patellar tendinopathy were enrolled into the study and split into two randomized groups (one or two infiltrations of PRP, respectively). The 3-month follow-up evaluation consisted of VAS, IKDC and VISA-P scores, along with algometer, isokinetic and ultrasounds evaluations. After 1 year, subjects were contacted to define their functional evolution. RESULTS: The concentration of the PRP used for each infiltration was similar in both groups, and contained no red or white cells. Results revealed no difference in treatment efficacy between the groups. CONCLUSIONS: The comparison between one or two infiltrations of PRP did not reveal any difference between the two groups at short to mid term. A second closely-timed infiltration of PRP to treat proximal patellar tendinopathies is not necessary to improve the efficacy of this treatment in the short term. [less ▲]

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See detailExtraction of temporal gait parameters using a reduced number of wearable accelerometers
Boutaayamou, Mohamed ULg; Denoël, Vincent ULg; Bruls, Olivier ULg et al

in Proceedings of the 9th International Conference on Bio-inspired Systems and Signal Processing (2016)

Wearable inertial systems often require many sensing units in order to reach an accurate extraction of temporal gait parameters. Reconciling easy and fast handling in daily clinical use and accurate ... [more ▼]

Wearable inertial systems often require many sensing units in order to reach an accurate extraction of temporal gait parameters. Reconciling easy and fast handling in daily clinical use and accurate extraction of a substantial number of relevant gait parameters is a challenge. This paper describes the implementation of a new accelerometer-based method that accurately and precisely detects gait events/parameters from acceleration signals measured from only two accelerometers attached on the heels of the subject’s usual shoes. The first step of the proposed method uses a gait segmentation based on the continuous wavelet transform (CWT) that provides only a rough estimation of motionless periods defining relevant local acceleration signals. The second step uses the CWT and a novel piecewise-linear fitting technique to accurately extract, from these local acceleration signals, gait events, each labelled as heel strike (HS), toe strike (TS), heel-off (HO), toe-off (TO), or heel clearance (HC). A stride-by-stride validation of these extracted gait events was carried out by comparing the results with reference data provided by a kinematic 3D analysis system (used as gold standard) and a video camera. The temporal accuracy ± precision of the gait events were for HS: 7.2 ms ± 22.1 ms, TS: 0.7 ms ± 19.0 ms, HO: ‒3.4 ms ± 27.4 ms, TO: 2.2 ms ± 15.7 ms, and HC: 3.2 ms ± 17.9 ms. In addition, the occurrence times of right/left stance, swing, and stride phases were estimated with a mean error of ‒6 ms ± 15 ms, ‒5 ms ± 17 ms, and ‒6 ms ± 17 ms, respectively. The accuracy and precision achieved by the extraction algorithm for healthy subjects, the simplification of the hardware (through the reduction of the number of accelerometer units required), and the validation results obtained, convince us that the proposed accelerometer-based system could be extended for assessing pathological gait (e.g., for patients with Parkinson’s disease). [less ▲]

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See detailEvaluation isocinétique et fonctionnelle de la rupture de coiffe des rotateurs non opérée
Forthomme, Bénédicte ULg; Schwartz, Cédric ULg; MAHIEU, Xavier ULg et al

in Abstract book des XVIIèmes RENCONTRES ISOCINETIQUES DE MEDIMEX (2015, November)

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See detailPièges à considérer lors de l’évaluation isocinétique
Croisier, Jean-Louis ULg; Kaux, Jean-François ULg; Crielaard, Jean-Michel ULg et al

in Abstract book des XVIIèmes RENCONTRES ISOCINETIQUES DE MEDIMEX (2015, November)

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See detailIndex de résistance à la fatigue: que garder?
Paulus, Julien ULg; Bosquet, Laurent; Forthomme, Bénédicte ULg

Conference (2015, October 10)

Objective Isokinetic tests regularly contribute to the assessment of muscle performance. However, to evaluate an athlete who mainly uses the lactic anaerobic metabolism to perform or in specific ... [more ▼]

Objective Isokinetic tests regularly contribute to the assessment of muscle performance. However, to evaluate an athlete who mainly uses the lactic anaerobic metabolism to perform or in specific pathological contexts, fatigue-resistance protocol could be complementary to short maximal strength evaluation. Although the reproducibility of the protocol has been demonstrated by Bosquet et al. (2010), what about the reproductibility of the measured parameters and various "fatigue index" proposed by dynamometers and used in the clinic and in the literature? Material & method Seventeen subjects, moderately active, performed 30 reciprocal maximal concentric contractions on three occasions with one 7-10 days recovery between each session. The peak torque (PT) and the maximal work (MW) of each repetition computed and subsequently use to compile eleven measured parameters and build forty-four index. The reproducibility of each parameter and index was evaluated through their ICC (2,1), SEM and respective MD. Results The ICC values of the measured parameters for the knee extensors are almost always higher than 0.8 while those for flexor range between 0.7 and 0.8. The ICC values for built "fatigue index" are less than 0.7 and 0.5 respectively for the extensors and flexors. No significant difference was observed between the reproducibility of PT and that of MW (whether for the extensors or flexors or for the measured parameters and "fatigue index"). Discussion In view of the values obtained in our population, it appears that no "fatigue index"or calculated quotient (quotient of the last x repetitions by the first x or accumulated repetitions by the best,...) seems sufficiently reproducible for clinical or scientific use! Only the measured parameters such as the best repetition, total or partial sum have a (very) high or excellent reproducibility and can therefore be used in clinical or research domain. References Bosquet, L., Maquet, D., Forthomme, B., Nowak, N., Lehance, C., & Croisier, J. L. (2010). Effect of the lengthening of the protocol on the reliability of muscle fatigue indicators. Int J Sports Med, 31(2), 82-88. [less ▲]

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See detailProgramme d'étirement appliqué à l'épaule raide : conséquences fonctionnelles
Forthomme, Bénédicte ULg; Croisier, Jean-Louis ULg; COLLIGNON, Pierre ULg et al

Conference (2015, October 09)

Les athlètes de lancer présentent une mobilité passive gléno-humérale de l’épaule dominante spécifique avec une majoration de la rotation externe et une limitation de la rotation interne. La limitation ... [more ▼]

Les athlètes de lancer présentent une mobilité passive gléno-humérale de l’épaule dominante spécifique avec une majoration de la rotation externe et une limitation de la rotation interne. La limitation interne semble liée à une raideur capsulo-musculaire postérieure, favorisant les pathologies de l’épaule sportive. Matériel et méthodes Vingt hommes, sportifs d’armer / lancer (volley-ball, handball) et pratiquant au moins 6 heures d’entraînement depuis plus de 5 années ont participé à cette étude. Ils présentaient tous une raideur des structures postérieures évaluée en clinique. Lors de l’inclusion dans l’étude, 10 athlètes (22,5 ± 4 ans) étaient asymptomatiques, 10 (24,8 ± 4 ans) présentaient une épaule dominante symptomatique (≥ 3/10 sur l’EVA). Les athlètes ont étiré chaque jour leur épaule dominante (sleeper stretch et cross body arm) pendant 4 semaines (5 x 30’'). Avant et après le programme d’étirement des structures postérieures, ils ont subi un test isocinétique de force maximale des rotateurs internes et externes ainsi qu’une analyse tridimensionnelle définissant la cinématique scapulaire. Résultats Après 4 semaines d’étirement des structures postérieures, tous les athlètes ont montré un gain significatif de mobilité en rotation interne passive. Nous n’observons aucune modification de la cinétique scapulaire lors de l’analyse 3D après les étirements chez les athlètes asymptomatiques ; les athlètes symptomatiques présentent une diminution du tilt antérieur scapulaire au repos après les 4 semaines. L’évaluation isocinétique des rotateurs d’épaules après les étirements montrent uniquement une légère réduction (- 4% ; p < 0,05) de la force des rotateurs internes à 60°/s en concentrique chez les athlètes asymptomatiques. Les sportifs qui décrivaient des douleurs avant les étirements sont significativement améliorés après le programme de 4 semaines ; cette diminution de la douleur est corrélée au gain en rotation interne passive. Discussion L’étirement pendant 4 semaines des structures postérieures de l’épaule raide sportive permet une augmentation de la mobilité passive. Ce gain de mobilité est corrélé à la diminution de la douleur chez les athlètes symptomatiques. [less ▲]

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See detailCross-Cultural Adaptation And Validation Of The VISA-A Questionnaire In French
Kaux, Jean-François ULg; DELVAUX, François ULg; Oppong-Kyei, Julian et al

Poster (2015, October 08)

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See detailVISA-PF: A Cross-Cultural Adaptation And Validation Of The VISA-P Questionnaire In French
Kaux, Jean-François ULg; Delvaux, François ULg; Oppong-Kyei, Julian et al

Poster (2015, October 08)

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See detailNouveaux traitements conservateurs des tendinopathies chroniques
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Forthomme, Bénédicte ULg et al

in Revue Médicale de Liège (2015), 70(10), 507-510

The pathophysiological mechanisms of tendinopathies integrate various intrinsic and extrinsic factors. Classic «passive» therapeutics have a limited action. Because of a better pathophysiological ... [more ▼]

The pathophysiological mechanisms of tendinopathies integrate various intrinsic and extrinsic factors. Classic «passive» therapeutics have a limited action. Because of a better pathophysiological understanding of tendinopathies, more recent treatments (injections of various compounds, infiltrations of platelet-rich plasma, stem cells) would lead to a longterm healing. In case of failure of conservative managements and depending on the anatomical site, a surgical approach may be considered. [less ▲]

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See detailCross-cultural adaptation and validation of the VISA-P questionnaire in French
Kaux, Jean-François ULg; Delvaux, François ULg; Oppong-Kyei, Julian et al

in European Journal of Sports Medicine (2015, September), 3(Suppl 1), 112

Introduction: The Victorian Institute of Sports Assessment–Patellar (VISA-P), originally developed for English-speaking patients, assesses the severity of patellar tendinopathy symptoms. Although this ... [more ▼]

Introduction: The Victorian Institute of Sports Assessment–Patellar (VISA-P), originally developed for English-speaking patients, assesses the severity of patellar tendinopathy symptoms. Although this questionnaire has already been translated into different languages, it has never been adapted for French-speaking patients, which is surprising. Indeed, French is not only spoken by most than 275 millions of people all around the world. The aim of our study was to validate a French version and verify its psychometric properties. Materials and Methods: The translation and cultural adaptation were performed according to international recommendations in six steps: initial translation, translation merging, back translation to the original language, expert committee review to test the pre-final version, and expert committee appraisal. Once the final French version (VISA-PF) was obtained, certain psychometric properties were assessed in 92 subjects were included and divided into three groups: pathological subjects (n = 28), asymptomatic subjects (n = 22) and sports-risk subjects (n = 42). Results: The different members of the expert committee agreed with the final version. The average scores of the VISA-PF obtained were 53 (± 17) for the pathological group, 99 (± 2) for the healthy group and 86 (± 14) for the sports-risk group. The test-retest reliability of the VISA-PF was excellent with an intra-class correlation coefficient of 0.99 and good internal consistency (α = 0.9). Correlations between the VISA-PF and diverging measures of the SF-36 were low and the correlation coefficient values measured between the VISA-PF scores and converged items of the SF-36 were higher. Conclusion: The VISA-PF is understandable, reliable and suitable for French-speaking patients with patellar tendinopathy. [less ▲]

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See detailValidation of the French translation of the VISA-A
Kaux, Jean-François ULg; Delvaux, François ULg; Oppong-Kyei, Julian et al

in European Journal of Sports Medicine (2015, September), 3(Suppl 1), 112-113

Introduction : The Victorian Institute of Sports Assessment– Achilles (VISA-A) was designed to evaluate the clinical severity of Achilles tendinopathy. It has been developed in English and therefore is ... [more ▼]

Introduction : The Victorian Institute of Sports Assessment– Achilles (VISA-A) was designed to evaluate the clinical severity of Achilles tendinopathy. It has been developed in English and therefore is not adapted for French-speaking patients. Although this questionnaire has already been translated into different languages but not in French. French is spoken by most than 275 millions of people and is one of the 2 official languages of the International Olympic Committee, and one of the 6 official languages and one of the 2 working languages of the United Nation Organisation. The aim of this study was to translate this questionnaires into French and to study its reliability and validity. Methods : The questionnaire was translated into French (VISA-AF) according to the "guidelines for the process of cross-cultural adaptation of self-report measures" using six steps: translation, synthesis, back translation, expert committee review, pretesting, and appraisal of the adaptation process by the expert committee. Once the final versions obtained, several psychometric proprieties such as test-retest fidelity, internal coherence, construct validity and floor and ceiling effects were evaluated. We recruited 116 subjects who were distributed in 3 groups: pathological patients (n=31), at risk athletes (n=63), healthy people (n=22). Results : The questionnaire was approved by the expert committee after the pre-final version test. On a scale ranging from 0 (theoretical minimum) to 100 (asymptomatic subject), the average scores of the VISA-PF obtained were 59 (± 18) for the pathological group, 99 (± 1) for the healthy group and 94 (± 7) for the sports-risk group. The VISA-A-F shows excellent reliability. The VISA-AF shows low correlations with the divergent sub-scales of the SF-36 and moderate correlations with the convergent sub-scales of the SF-36. No floor and ceiling effects were detected during the evaluation of the two questionnaires. Conclusion : The French versions of the VISA-A is equivalent to its original version and is reliable and valid questionnaire for French speaking patients with Achilles tendinopathy. [less ▲]

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See detailOne injection of platelet-rich plasma associated to a submaximal eccentric protocol to treat chronic jumper's knee
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Bruyère, Olivier ULg et al

in The Journal of sports medicine and physical fitness (2015), 55(9), 953-61

INTRODUCTION: Jumper's knee is a frequent chronic overuse syndrome of the upper part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons ... [more ▼]

INTRODUCTION: Jumper's knee is a frequent chronic overuse syndrome of the upper part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons. METHODS: Twenty patients with chronic upper patellar tendinopathy were enrolled. Assessments were made before infiltration of PRP, and 6 weeks and 3 months after the infiltration, using a 10--point Visual Analogic Scale, clinical examinations with a pressure algometer, algofunctional scores (IKDC and VISA--P), functional assessments (isokinetic and optojump evaluations) and imagery (ultrasounds and MRI). The PRP was obtained with an apheresis system (COM.TEC, Fresenius). Six millilitres of PRP were injected without local anaesthetic. One week after infiltration, patients started a standardised sub--maximal eccentric reeducation. RESULTS: Pain during daily activities significantly decreased with time. During functional evaluation, it decreased as well, but without significant functional improvement. No improvements in the imagery measurements were observed. Younger patients seemed to be more susceptible to have an improvement of pain by the PRP infiltration. CONCLUSION: This study demonstrates that a local infiltration of PRP associated with a submaximal eccentric protocol can improve symptoms of chronic jumper's knee in patients non--responsive to classical conservative treatments. [less ▲]

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See detailExploring the effect of a second closely-timed infiltration of PRP to treat proximal patellar tendinopathy
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Forthomme, Bénédicte ULg et al

in European Journal of Sports Medicine (2015, September), 3(Suppl 1), 54

Introduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative ... [more ▼]

Introduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of 2 or 3 successive infiltrations. The aim of this study was to evaluate whether 2 infiltrations of PRP proves more effective than a single treatment. Material and methods: Twenty patients suffering from chronic proximal patellar tendinopathy were enrolled into the study and split into two randomized groups (1 or 2 infiltrations of PRP, respectively). The 3-month follow-up evaluation consisted of VAS, IKDC and VISA-P scores, along with algometer, isokinetic and ultrasounds evaluations. After 1 year, subjects were contacted to define their functional evolution. Results: The concentration of the PRP used for each infiltration was similar in both groups, and contained no red or white cells. Results revealed no difference in treatment efficacy between the groups. Discussion and conclusion: The comparison between 1 or 2 infiltrations of PRP did not reveal any difference between the 2 groups at short to mid term. A second closely-timed infiltration of PRP to treat chronic proximal patellar tendinopathy is not necessary to improve the efficacy of this treatment in the short term. [less ▲]

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See detailOne-year follow-up of platelet-rich plasma infiltration to treat chronic proximal patellar tendinopathies
Kaux, Jean-François ULg; Bruyère, Olivier ULg; Croisier, Jean-Louis ULg et al

in European Journal of Sports Medicine (2015, September), 3(Suppl 1), 113

Introduction: Infiltration of Platelet-Rich Plasma (PRP) may be considered as a recent therapeutic option for chronic tendinopathies. The aim of this study is to evaluate the clinical status and the ... [more ▼]

Introduction: Infiltration of Platelet-Rich Plasma (PRP) may be considered as a recent therapeutic option for chronic tendinopathies. The aim of this study is to evaluate the clinical status and the return to sports activities in patients with chronic upper patellar tendinopathies. Material and methods : Twenty subjects with chronic upper patellar tendinopathy benefited from 1 infiltration of PRP. The follow-up (up to 1 year) was assessed by means of a Visual Anologue Scale (VAS), the International Knee Documentation Committee (IKDC) form and the Victorian Institute of Sport Assessment (VISA-P) score. Moreover, subjects had to answer an information questionnaire concerning their life and sports activities. Results : Seventy percents of the patients reported a favourable evolution with decrease of pain, and returned to sports activities. With time, VAS dropped significantly and both IKDC and VISA-P scores improved also significantly. Conclusion : This study confirms that a local injection of PRP coupled with a program of eccentric rehabilitation for treating a chronic jumper's knee, improves pain symptoms and the functionalities of the subjects’ knee up to 1 year after injection. [less ▲]

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See detailAnalyse critique des traitements conservateurs classiques des tendinopathies
KAUX, Jean-François ULg; Croisier, Jean-Louis ULg; Forthomme, Bénédicte ULg et al

in Revue Médicale de Liège (2015), 70(9), 456-460

Les thérapeutiques «passives» classiques (anti-inflammatoires, infiltrations de corticoïdes…) des tendinopathies, utilisées de manière relativement empirique, réduisent la douleur et l’inflammation, sans ... [more ▼]

Les thérapeutiques «passives» classiques (anti-inflammatoires, infiltrations de corticoïdes…) des tendinopathies, utilisées de manière relativement empirique, réduisent la douleur et l’inflammation, sans modifier fondamentalement la structure du tendon, expliquant leur vocable et caractère «passif». La rééducation excentrique a été appliquée aux tendinopathies chroniques, non seulement de par l’échec des traitements classiques, mais aussi en raison d’une meilleure compréhension physiopathologique des tendinopathies. Diverses études soulignent l’efficacité de la rééducation excentrique qui, après 20-30 séances, entraîne la guérison et surtout prévient le risque de chronicité. Les ondes de choc, modifiant la structure tendineuse, permettraient une guérison à plus long terme. [less ▲]

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