ROLE OF CUTANEOUS AFFERENTS IN THE CONTROL OF FINE MOVEMENTS

An increase in the quantity of afferents has been observed to be less useful to normal individual, therefore to patients suffering from neurological problems. To determine the effect of reduction of cutaneous afferents in the control of fine movements.Sixty healthy individuals, age between 20 and 25 years, were randomized into 2 groups.Main outcome measures: The speed of movements was measured with a specific device constructed specially to this study, related to digital chronometer that detects 1/100 of the second. T-test was performed for outcome measure and to evaluate individual difference within groups in the presence of significance. The position at the edge of the support show an increase in the speed of the fine movement by 82% than the position completely on the support

EFFECT OF PULSED GALVANIC ELECTRO STIMULATION AND ULTRASUONBD ON BURN HEALING. A RANDOMIZED CLINICAL TRIALS

The goal of this study is to evaluate the effect of pulsed galvanic electro stimulation of high voltage and ultrasound on the healing of induced burn applied on rats. 48 rats (Sprague Dawley), mass between 300g and 400g, age between 3 months and 4 months. These rats are putted and the same experimental conditions of alimentation and hygiene. Rats are divided into 3 groups of 16 rats each. Each rat was induced to a uniform burn of second degree by a specific device fabricated specially to this study. Group ES undergoes a treatment of electro stimulation by a pulsed galvanic current of high voltage for 10 min daily during 2 weeks. Group US undergoes a treatment of pulsed ultrasound of 1w/cm² for 2 minutes daily during 2 weeks Group control GC undergoes placebo treatment. Measure are done by digital camera, results are analyzed by specific program (AutoCad) on computer. Wound healing between the three groups are different and statistical tests ( T-tests and ANOVA) done between the two groups US and GC show no significant difference in the reduction of the surface of healing between them (α˃0.05), whereas the comparison between ES group and the two others group was significant (α˂0.05). At the end of the second week of treatment, the best healing was presented in ES group where the wound was healed by 61.4 % whereas the groups GC and US were 11.9 % and 14.9 % respectively. Therefore the ES group have the best results between than others groups (GC and US)

CRITERIA FOR THE RETURN TO SPORT AFTER RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT (RACL)

Background: One of the objectives of the reconstruction of the anterior cruciate ligament (RACL) is the return of athletes to existing activity before the injury. Thus, it is essential to understand the variables that influence the return. Associations between the return to sport and the variables representing the strength of the quadriceps, instability and symmetry of the members, and the psychological state have not been studied in athletes following the RACL. Purpose: The purpose of this study is to summarize the literature relating to the proposed variables to be associated with the return to sport following a reconstruction of the anterior cruciate ligament. Method: During this study, we searched electronic databases, PubMed, Medline, Embase, and Cochrane Database to find the most recent articles about returning to the sport after the RACL criteria. Therefore, the articles included in this review meets these criteria: 1) patients who underwent a RACL; 2) reported at least one measurement of quadriceps strength, symmetry between members, and the psychological state; 3) the return to the sport identified by subjective measures or action to identify the level of sports participation of patients; and 4) any relationship analysis between the measures and the return to sport. Conclusion: Despite the fact that there are a number of important criteria influencing the return to sport, some have remained critical which have been considered and supported. By analyzing the items, the following results were obtained as described below: A quadriceps strength [IQ = 90%] and a motivating psychological state are the two criteria that ensures sport participation and reduction of the rate of re-injury or injury to the contralateral side. However, other criteria should not be neglected, with a view of their interaction with quadriceps strength and psychological status influence on the overall condition of the athlete wishing to return to the sport

ROLE OF CUTANEOUS AFFERENTS IN THE CONTROL OF FINE MOVEMENTS

An increase in the quantity of afferents has been observed to be less useful to normal individual, therefore to patients suffering from neurological problems. To determine the effect of reduction of cutaneous afferents in the control of fine movements.Sixty healthy individuals, age between 20 and 25 years, were randomized into 2 groups.Main outcome measures: The speed of movements was measured with a specific device constructed specially to this study, related to digital chronometer that detects 1/100 of the second. T-test was performed for outcome measure and to evaluate individual difference within groups in the presence of significance. The position at the edge of the support show an increase in the speed of the fine movement by 82% than the position completely on the support

CRITERIA OF THE RETURN TO SPORT AFTER RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT

Background: Despite the progress of reconstruction techniques for the anterior cruciate ligament (LCA), the return to sport after this surgery remains a challenge. The absence of good knowledge in the measures of appropriate results after ACL rehabilitation can lead the patients to return to play prematurely, making them in front of a high risk of injury again later. Over one-third of athletes are unable to resume their sport at the same level and almost one fifth will suffer from new accident during this recovery, either on the operated knee or contralateral knee. While the fear of another accident remains the biggest obstacle to return to sport, persistent functional deficits is the leading cause of recurrence tear. Objective: to conduct an environmental study of clinical practice surgeons and physiotherapists decision making in the return to sport (RTS) after ACL ligament; and to gain a better understanding of how clinicians take the suitable decision to back to the sport. Participants: 34 physiotherapists and 11 orthopedic surgeons are included in this study. Interventions: Lebanese surgeons and physiotherapists completed distinct and validated questionnaires which consisted of 10 closed questions, each including a sections on demography, outcome measurement, treatment and procedures including the decisions of the RTS. Data collection: The main measures were the descriptive and subjective collected from orthopedic surgeons and physiotherapists. The use of measures of clinical outcomes by the two groups is qualitatively analyzed for similarities between the professions and criteria recently proposed consensus used to decide the RTS. The level of agreement for the definition of success for the RTS following a ligamentoplasty ACL was explored by the frequency of response for each item. Results: Analysis of the results show that 90% of participants consider that physiotherapists have a vital role in the decision making to return to sport after ACL reconstruction. In addition, several measurement scales are mostly used for evaluation of ACL as the jump test, Lachman test, pain ... while the analysis of the Pearson correlation between the number of patients taken by year and the criteria of success of the decision to return to ground shows a very weak correlation (P <0.452), which reflects the poor experience of Lebanese physiotherapists in the selection of the factors influencing the return to sport. Conclusion: The results show a lack of scientific knowledge in the participants on valid tests that can be used for clinical decision-making to return to sport after ACL reconstruction. Future studies are recommended to verify these results with a large number of participants

VALIDITY OF PROPRIOCEPTIVE REHABILITATION FOR ANKLE INSTABILITY BASED ON FREEMAN BOARD TRAINING

Background: Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. Objective: up to date, many studies have reported the effects of Proprioception training on ankle joint stability. But fewer who studied the validity of dynamic Proprioception on ankle instability. The purpose of this pilot study was to conduct the effects of a 4-week dynamic neuromuscular training program in addition to the rehabilitation treatment for ankle instability Methods: 26 sportive men were exposed to a progressive 4-week dynamic neuromuscular training program which incorporated postural stability, strengthening, plyometric. The following criteria were considered: Number of shaking of leg in a minute standing on freeman board (one minute stand), Time of balance on freeman board ( balance), Maximal resistance for ankle dorsal flexion, plantar flexion, Inversion and eversion,Muscle reaction for ankle dorsal flexion, plantar flexion, Inversion and eversion. Measurements were rated within 3 trials for each criterion before and after each session for the affected leg. For the non-affected leg same criteria were measured before and after session without applying the rehabilitation protocol Results: a high significant (p=.000<0.05) a progress is noted during rehabilitation protocol,. Results show high correlation between one minute stands and balance; one minute stand and muscle reaction; balance and maximal resistance was significant. Results show non-significance of correlation between muscle reaction and maximal resistance for ankle dorsal flexion, plantar flexion, Inversion and eversion. Moreover, we can notice that training period has had a slight effect on the non-affected side. Conclusions: The 4-week dynamic neuromuscular training program improves the parameters of ankle joint sensorimotor control in an athlete with CAI

VALIDITY OF PROPRIOCEPTIVE REHABILITATION FOR ANKLE INSTABILITY BASED ON FREEMAN BOARD TRAINING

Background: Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. Objective: up to date, many studies have reported the effects of Proprioception training on ankle joint stability. But fewer who studied the validity of dynamic Proprioception on ankle instability. The purpose of this pilot study was to conduct the effects of a 4-week dynamic neuromuscular training program in addition to the rehabilitation treatment for ankle instability Methods: 26 sportive men were exposed to a progressive 4-week dynamic neuromuscular training program which incorporated postural stability, strengthening, plyometric. The following criteria were considered: Number of shaking of leg in a minute standing on freeman board (one minute stand), Time of balance on freeman board ( balance), Maximal resistance for ankle dorsal flexion, plantar flexion, Inversion and eversion,Muscle reaction for ankle dorsal flexion, plantar flexion, Inversion and eversion. Measurements were rated within 3 trials for each criterion before and after each session for the affected leg. For the non-affected leg same criteria were measured before and after session without applying the rehabilitation protocol Results: a high significant (p=.000<0.05) a progress is noted during rehabilitation protocol,. Results show high correlation between one minute stands and balance; one minute stand and muscle reaction; balance and maximal resistance was significant. Results show non-significance of correlation between muscle reaction and maximal resistance for ankle dorsal flexion, plantar flexion, Inversion and eversion. Moreover, we can notice that training period has had a slight effect on the non-affected side. Conclusions: The 4-week dynamic neuromuscular training program improves the parameters of ankle joint sensorimotor control in an athlete with CAI

Evaluation of the accuracy of new modalities in the assessment and classification of lumbar lordosis: A comparison to Cobb's angle measurement

Background: Because of the association of lumbar lordosis with some clinical conditions such as low back pain, the chiropractic field has emphasized the significance of evaluating the lumbar lordotic status, by measuring Cobb's angle, regarded as the radiological gold standard, for the assessment of lumbar lordosis, on lateral radiographs. However, research has shown that this technique has some considerable drawbacks, mostly in terms of low accuracy and high variability between clinicians when compared with other radiological modalities. The main objective was to compare the diagnostic accuracy of newly established radiological measurements with one of Cobb's angle methods, for the characterization of lumbar lordosis status in a sample of Lebanese patients aged 15 and above. Material and methods: This retrospective single-center study consisted of measuring Cobb's L1-S1 and Cobb's L1-L5 angles, along with the novel established measurements which are the derivative and the normalized surface area, on 134 lateral radiographs of the lumbar spine of Lebanese patients aged fifteen years old and above, gotten from the Radiology department at Zahra'a’s Hospital in Beirut, performed by two observers using MATLAB. Inter-rater agreement was assessed by calculating the Intra-class correlation coefficients. Spearman correlation was analyzed between both Cobb's angle methods and with the derivative and normalized area respectively. 54 patients of the sample were diagnosed by two radiologists, according to their LL status. ROC curve analysis was performed to compare the diagnostic accuracy of the four techniques used. Data were analyzed with IBM SPSS Statistics 23.0 (NY, USA); P < 0.05 was considered statistically significant. Results: According to the ROC curve analysis the new methods, which are the derivative and the normalized surface area, displayed lower diagnostic accuracy (AUCderivative = 0.818 and 0.677, AUCsurface area = 0.796 and 0.828) than Cobb's L1-L5 (AUCL1-L5 = 0.924 and 0.929 values) and L1-S1 (AUCL1-S1 = 0.971 and 0.955) angles, in the characterization of hypo and hyperlordotic patients, respectively, in our Lebanese sample consisting of patients aged 15 and above, because of their lower area under the curve's values compared to the traditional Cobb's techniques. The Cobb's L1-S1 has shown to have the highest diagnostic accuracy among the four methods to characterize normal patients from hypo and hyperlordotic ones, by referring to its highest area under the curve's values. However, the sensitivity of Cobb's L1-L5 angle in characterizing hyperlordotic patients was similar to the one of the normalized surface area with a value of 100%.Conclusion: among the four modalities, the new methods didn't show a better diagnostic accuracy compared to the traditional modalities. Cobb's L1-S1 displayed the highest diagnostic accuracy despite its drawbacks. Further prospective studies are needed to validate the cut-offs obtained for Cobb's L1-S1 angle in our sample