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

peer reviewedIntroduction: 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

Relevance of adding a triangular dynamic cushion on a traditional chair: A 3D-analysis of seated schoolchildren

Background: Low back pain is highly prevalent in the general population and is even reported as early as at primary school. A poor sitting position has been suggested as an etiologic factor. This study analysed, in primary schoolchildren, the influence of a triangular dynamic cushion that aims to help children maintain their physiological lumbar lordosis and to induce movement to reduce the static effect of the sitting position. Methods: Thirty 8-year-old children took part in this study. A 3D analysis combined with electromyography was used to evaluate the biomechanics and the related muscle activation in two sitting positions (with and without a triangular cushion on a horizontal stool) during a 15-minute working task. In addition, the force of the feet on the ground was assessed with a force plate. Findings: The cushion improved the trunk–thighs angle, lumbar lordosis, anterior pelvis tilt, and feet support on the ground (p < 0.0001). In addition, sitting on the cushion appeared to be more dynamic (p < 0.05) and induced a decrease of the lumbar paravertebral muscle activity (p < 0.01). Interpretation: Sitting on a dynamic triangular cushion tends to favour the “ideal” siting position usually described in the literature and to decrease the level of paravertebral muscle recruitment. Seeing that sitting position is a risk factor to develop low back pain, the cushion could be a solution to prevent it

Influence of the laboratory context and the size of the markers set on the tennis serve evaluation

The purpose of this study was to identify the influence on the tennis serve evaluation of 1/ the test environment and 2/ the number of the markers placed of the player. Two different studies were performed. The first compared a 4 vs. 28 marker set in a laboratory the same day. The second compared a 4 markers test in a laboratory with a 4 markers test on an official tennis court one week apart. We observed similar results between the different tests of both studies.Thèse de doctorat - Facteurs de performance du service en tenni

Isocinétisme et pathologie musculaire traumatique

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ISOKINETIC STRENGTH PROFILE OF SUBJECTS WITH PROXIMAL PATELLAR TENDINOPATHY

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Cross-cultural adaptation and validation of the Patient-Rated Tennis Elbow Evaluation Questionnaire on lateral elbow tendinopathy for French-speaking patients

peer reviewedIntroduction: The lateral elbow tendinopathy is a common injury in tennis players and physical workers. The Patient- Rated Tennis Elbow Evaluation (PRTEE) Questionnaire was specifically designed to measure pain and functional limitations in patients with lateral epicondylitis. The aims were to adapt the PRTEE questionnaire into French (PRTEE-F) and to evaluate the reliability and validity of this translated version of the questionnaire . Methods: The PRTEE was translated and cross-culturally adapted into French according to international guidelines. To assess the reliability and validity of the PRTEE-F, 115 participants were asked twice to fill in the PRTEE-F, and once the DASH and the SF-36. Internal consistency (using Cronbach’s alpha), test-retest reliability (using intraclass correlation coefficient (ICC), standard error of measurement and minimal detectable change), and convergent and divergent validity (using the Spearman’s correlation coefficients respectively with the DASH and with some subscales of the SF-36) were assessed. Results: The PRTEE was translated into French without any problems. PRTEE-F showed a good test-retest reliability for the overall score (ICC 0.86) and for each item (ICC 0.8-0.96) and a high internal consistency (Cronbach’s alpha 1⁄4 0.98). The correlation analyses revealed high correlation coefficients between PRTEE-F and DASH (convergent validity) and, as expected, a low or moderate correlation with the divergent subscales of the SF-36 (discriminant validity). There was no floor or ceiling effect. Discussion and Conclusions: The PRTEE questionnaire was successfully cross-culturally adapted into French. The PRTEE-F is reliable and valid for evaluating French-speaking patients with lateral elbow tendinopathy

EFFECT OF A STRETCHING PROGRAM ON OVERHEAD ATHLETES WITH A STIFF AND PAINFUL SHOULDER

Overhead athletes are more at risk of suffering shoulder injuries or/and developing shoulder pain. Stretching programs have been shown to successfully reduce pain for this population. However no study has provided a global overview of the effects of stretching. The present study evaluated the evolution of the pain, the strength of the shoulder muscles, potential instabilities or lesion of the shoulder as well as the 3D scapular kinematics of 10 overhead athletes having a painful and stiff dominant shoulder. Our results show a significant decrease of the pain and of the positive impingement syndrome tests. The kinematics of the scapula reveals a more upward rotation of the scapula after the stretching, which may reduce the risk of sub-acromial conflicts. The strength of the internal and external rotators of the shoulder is not modified by the program

Validity and reliability of the French translation of the VISA-A questionnaire

peer reviewedIntroduction: The Victorian Institute of Sport Assessment – Achilles tendinopathy questionnaire (VISA-A) evaluates the clinical severity of Achilles tendinopathy. The aim of this study was to translate the VISA-A into French and to study the reliability and validity of this French version, the VISA-AF.Method: The VISA-A was translated into French to produce the VISA-AF using a validated methodology in six steps. Thereafter, several psychometric properties of this French version such as test–retest reliability, internal consistency, construct validity and floor and ceiling effects were evaluated. Therefore, we recruited 116 subjects, distributed into 3 groups: pathological patients (n=31), at-risk athletes (n=63) and healthy people (n=22). Results: The final version of the VISA-AF was approved by an expert committee. On a scale ranging from 0 to 100, the average scores of the VISA-AF obtained were 59 (± 18) for the pathological group, 99 (± 1) for the healthy group and 94 (± 7) for the at-risk group. The VISA-AF shows excellent reliability, low correlations with the discriminant subscales of the SF-36 and moderate correlations with the convergent subscales of the SF-36. Conclusions: The French version of the VISA-A is equivalent to its original version and is a reliable and valid questionnaire for French- speaking patients with Achilles tendinopathy

Translation and Validation of the VISA-P Questionnaire for French-Speaking Patients

peer reviewedBackground: The Victorian Institute of Sport Assessment-Patella (VISA-P), originally developed in English, assesses the severity of patellar tendinopathy symptoms. To date, no French version of the questionnaire exists. Objectives: The aim of our study was to translate the VISA-P into French and verify its psychometric properties. Methods: The translation and cultural adaptation were performed according to international recommendations in 6 steps: initial translation, translation merging, back translation to the original language, use of an expert committee to reach a prefinal version, test of the prefinal version, and expert committee appraisal of a final version. Afterward, the psychometric properties of the final French version (VISA-PF) were assessed in 92 subjects, divided into 3 groups: pathological subjects (n = 28), asymptomatic subjects (n = 22), and sports-risk subjects (n = 42). Results: All members of the expert committee agreed with the final version. On a scale ranging from 0 to 100, with 100 representing an asymptomatic subject, the average SD scores on the VISA-PF 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 good internal consistency. Correlations between the VISA-PF and divergent validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (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, valid, and suitable for French-speaking patients with patellar tendinopathy