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See detailLe traitement médical conservateur des tendinopathies du genou
Kaux, Jean-François ULg; BAUVIR, Philippe ULg; Croisier, Jean-Louis ULg et al

in Ortho-Rhumato (2014), 12(1), 31-34

Les traitements «passifs» des tendinopathies sont généralement utilisés de manière empirique pour combattre la douleur mais ne modifient pas la structure histologique du tendon. Par contre, le travail ... [more ▼]

Les traitements «passifs» des tendinopathies sont généralement utilisés de manière empirique pour combattre la douleur mais ne modifient pas la structure histologique du tendon. Par contre, le travail excentrique a pour but de contrecarrer une théorie étiopathogénique proposant une insuffisance de résistance du tendon exposé à des charges externes qui peuvent progressivement entrainer des lésions. Les résultats cliniques suite à cette prise en charge montrent souvent une évolution favorable des douleurs. Les ondes de choc extra-corporelles demeurent une option thérapeutique non-invasives et présentent peu de complications. De plus, elles sont employées avec succès pour traiter des tendinopathies chroniques rebelles aux traitements conservateurs classiques. Le plasma riche en plaquettes (PRP) est obtenu par centrifugation de sang autologue afin d’obtenir une grande concentration plaquettaire dépendant de la technique employée. Malgré la preuve de l’efficacité du PRP sur la régénération tissulaire en laboratoire, il existe actuellement peu de preuves cliniques tangibles concernant le traitement des tendinopathies chroniques. Enfin, d’autres nouvelles options thérapeutiques (patches de dérivés nitrés, infiltrations de polidocanol, d’acide hyaluronique et de cellules souches) sont également abordées. [less ▲]

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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 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 detailSyndromes canalaires rares du membre supérieur - Apport des bilans électrophysiologiques
Kaux, Jean-François ULg; MASSART, Nicolas ULg; TINANT, France ULg et al

in 32ème Séminaire de Traumatologie du Sport de l'AMDTS (2013, May)

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See detailL’onde F dans tous ses états
WANG, François-Charles ULg; Massart, Nicolas ULg; Kaux, Jean-François ULg et al

in Revue Neurologique (2011), 167

F-waves result from the discharge of the motoneurons following their antidromic activa- tion. The F-wave appears, as an indirect (the F-wave latency decreases when the stimulation site moves away from the ... [more ▼]

F-waves result from the discharge of the motoneurons following their antidromic activa- tion. The F-wave appears, as an indirect (the F-wave latency decreases when the stimulation site moves away from the muscular detection) and late response (occurring after the M response). In practice, the most useful parameter is the F-wave minimal latency, provided that at least seven distinct F-waves are evoked. When the analysis is relative either to the controlateral side, or to a former examination, this parameter is one of most sensitive in electroneuromyography. F-wave evocation implies conduction along the entire peripheral nervous system, and particularly its proximal part, which is not investigated by nervous trunks conduction velocity studies. Thus, F wave study is the most useful in plexopathies and polyradiculonevritis. In the early phase of Guillain-Barre ́ syndrome, their absence may be the unique sign indicative of proximal conduction blocks. [less ▲]

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See detailL'onde F dans tous ses états
Wang, François-Charles ULg; Massart, Nicolas ULg; Kaux, Jean-François ULg et al

in Journées de la Société Francophone du Nerf Périphérique - Livre des Résumés (2011, January)

C’est Magladery et McDougal (1950) qui, les premiers, ont constaté l’existence des réponses F au niveau du pied (F pour foot) chez l’homme. Dawson et Merton (1956) ont ensuite démontré que celles-ci ne ... [more ▼]

C’est Magladery et McDougal (1950) qui, les premiers, ont constaté l’existence des réponses F au niveau du pied (F pour foot) chez l’homme. Dawson et Merton (1956) ont ensuite démontré que celles-ci ne résultent pas d’un réflexe, mais de la décharge des motoneurones suite à leur activation rétrograde par des volées d’influx centripètes. L’onde F se traduit au niveau musculaire, par une réponse indirecte (dont la latence diminue lorsque le site de stimulation nerveuse s’éloigne du site de détection musculaire), tardive (survenant après la réponse M), de longue latence. Lors d’une stimulation nerveuse supramaximale, une ou plusieurs unités motrices participent à la formation de la réponse F. Lorsque la stimulation nerveuse est répétée, les unités motrices, générant l’onde F, changent d’une stimulation à l’autre, induisant une variabilité en latence, durée, amplitude et forme de la réponse tardive. Cette variabilité est principalement liée au niveau d’excitabilité des motoneurones α. En clinique, le paramètre le plus utile est la latence minimale, à condition qu’au moins 7 ondes F distinctes soient évoquées. Lorsque l’analyse est relative soit au côté controlatéral, soit à un examen antérieur, ce paramètre est un des plus sensibles en électroneuromyographie. [less ▲]

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See detailLes psychoses delirantes chroniques.
Desseilles, Martin ULg; Massart, Nicolas ULg

in Revue Médicale de Liège (2009), 64(9), 464-7

The current Anglo-Saxon trend is to consider that schizophrenia includes all psychoses. However, far from being a uniform set, there is a lot of different clinical presentations of patients with psychosis ... [more ▼]

The current Anglo-Saxon trend is to consider that schizophrenia includes all psychoses. However, far from being a uniform set, there is a lot of different clinical presentations of patients with psychosis. Chronic delusional psychosis, as a paradigm, show that subtyping psychosis on a clinical basis is useful for therapeutic and prognosis purposes. [less ▲]

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See detailLes sacro-iliaques
Massart, Nicolas ULg

Conference (2009)

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See detailClinique du sujet et hyperspécialisation du soin en hôpital de jour: quand la réalité dépasse la fiction
Massart, Nicolas ULg; Conraads, Valérie; Argento, Gino et al

in Revue des Hôpitaux de Jour Psychiatriques et des Thérapies Institutionnelles (2007), 9

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See detailDépression et maladies coronariennes: quand les émotions nous brisent le coeur...
Massart, Nicolas ULg; Triffaux, Jean-Marc ULg

in Revue Médicale de Liège (2005), 60(12), 931-8

Depression and cardiovascular diseases represent a major public health problem worldwide. Recent studies have shown that depression is a risk factor for the development of coronary artery disease (CAD) in ... [more ▼]

Depression and cardiovascular diseases represent a major public health problem worldwide. Recent studies have shown that depression is a risk factor for the development of coronary artery disease (CAD) in healthy people and also increases morbidity and mortality in depressed patients with CAD. Others studies have shown that selective serotonin inhibitors (SSRIs) constitute a safe and effective treatment for depressed patients with heart disease. There are also data suggesting that treating depression with SSRIs has a protective role in myocardial infarction and may improve outcomes, including mortality. [less ▲]

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