Effets d'une division d'attention pendant le contournement d'obstacles fixes ou mobiles chez des sujets ayant subi un traumatisme craniocérébral

L'objectif général de cette thèse était de comparer les effets d'une division de l'attention sur la combinaison de la locomotion en contournant des obstacles fixes et mobiles entre des participants ayant un traumatisme craniocerebral (TCC) et des participants sains. Une approche biomécanique a été utilisée pour analyser les altérations fonctionnelles qui ont été soulevées chez des adultes ayant un TCC de grade modéré ou sévère et des athlètes d'élite présentant un TCC de grade léger (TCCL). Des enfants sains ont aussi été étudiés afin de mieux comprendre les altérations fonctionnelles présentes à la suite d'une division d'attention dans des environnements complexes mais écologiques. Les adultes ayant un TCC ont démontré des temps de réaction de réponse plus longs, ont fait plus d'erreurs dans la réponse à la tâche d'interférence, avaient une vitesse moyenne de marche plus lente, une vitesse maximale de marche plus lente et démontraient aussi plus de dégagement minimal face aux obstacles que les adultes sains du groupe-contrôle. Ils ont également plus de difficulté à effectuer deux tâches ou plus simultanément. Il semble aussi que les déficits des fonctions executives, plus particulièrement au niveau de la planification, sont évidents chez des adultes avec un TCC modéré ou sévère mais aussi chez les athlètes ayant un TCCL. La planification et la navigation sont deux aspects importants dans le sport et pour les athlètes qui ont déjà eu un TCCL Cet aspect est primordial pour éviter de se mettre dans des situations à risque potentiel d'autres blessures à la tête. De plus, il a été démontré que même si les athlètes ne présentaient aucun symptôme et que leur résultats aux tests neuropsychologiques étaient revenus au niveau d'avant leur blessure, ils présentaient tout de même des altérations fonctionnelles plus de 30 jours suivant cette blessure. Une partie de cette thèse a été faite auprès d'enfants sains pratiquant le hockey sur glace. La vitesse maximale de patinage a diminué avec l'ajout de la tâche d'interférence visuelle et plus d'erreurs ont été commises lors de l'ajout du maniement du bâton

Cervicovestibular rehabilitation in adult with mild traumatic brain injury: a randomised controlled trial protocol

Mild traumatic brain injury (mTBI) is an acknowledged public health problem. Up to 25% of adult with mTBI present persistent symptoms. Headache, dizziness, nausea and neck pain are the most commonly reported symptoms and are frequently associated with cervical spine and vestibular impairments. The most recent international consensus statement (2017 Berlin consensus) recommends the addition of an individualized rehabilitation approach for mTBI with persistent symptoms. The addition of an individualized rehabilitation approach including the evaluation and treatment of cervical and vestibular impairments leading to symptoms such as neck pain, headache and dizziness is, however, recommended based only on limited scientific evidence. The benefit of such intervention should therefore be further investigated

Cervical Spine Involvement in Mild Traumatic Brain Injury: A Review

Background. There is a lack of scientific evidence in the literature on the involvement of the cervical spine in mTBI however, its involvement is clinically accepted. Objective. This paper reviews evidence for the involvement of the cervical spine in mTBI symptoms, the mechanisms of injury, and the efficacy of therapy for cervical spine with concussion-related symptoms. Methods. A keyword search was conducted on PubMed, ICL, SportDiscus, PEDro, CINAHL, and Cochrane Library databases for articles published since 1990. The reference lists of articles meeting the criteria (original data articles, literature reviews, and clinical guidelines) were also searched in the same databases. Results. 4,854 records were screened and 43 articles were retained. Those articles were used to describe different subjects such as mTBI’s signs and symptoms, mechanisms of injury, and treatments of the cervical spine. Conclusions. The hypothesis of cervical spine involvement in post-mTBI symptoms and in PCS (postconcussion syndrome) is supported by increasing evidence and is widely accepted clinically. For the management and treatment of mTBIs, few articles were available in the literature, and relevant studies showed interesting results about manual therapy and exercises as efficient tools for health care practitioners

Influences of a yoga intervention on the postural skills of the Italian short track speed skating team

Introduction: In preparation for a short track speed skating season, eight men and seven women were given yoga sessions during an 8-week high volume training cycle. The sessions were planned according to the postural aspects specific to short track speed skating technical requirements. Three specific goals were selected for the intervention: 1) to observe whether the practice of yoga as postural training could improve the efficiency and the athlete's repertoire along the muscular synergies solicited in the short track speed skating specific technique 2) to enhance and diversify the motor time-on-task of athletes without changing the prescription of other training stimulus and 3) to lower the risk of injury during periods with high volumes of training. Methods: A total of 36 sessions of yoga were given. Three postural tests were administered before and after the intervention with 14 angles analyzed. Non-parametric Wilcoxon test was used to compare angles' variations. Results: The 36 yoga sessions totalized 986 minutes of motor time-on-task, registering a proportion of 30% of the global motor time-on-task of the training cycle. Improvements were found in eleven of the 14 angles measured when comparing pre- and post-postural tests (P-value from 0.01 to 0.005). During the 8 weeks, excepting traumatic injuries due to short track speed skating accidents, no skaters suffered injuries linked to the high volume of training. Following the intervention, coaches noticed, following their on-ice feedbacks, an adjustment in the efficiency of the skating technique, in particular regarding hip dissociation. Conclusion: These results suggest that yoga could be inserted into out-of-season training cycles, even in a high volume training cycle. Planned with the decision training tools, it allows athletes to diversify their motor time-on-task by integrating a new functional range of generic movements with the solicitation of neuromuscular synergies related to the specificity of their sport. Keywords: conditioning, motor time-on-task, physical literacy, athletic development, decision trainin

(Homo)glutathione Deficiency Impairs Root-knot Nematode Development in Medicago truncatula

Root-knot nematodes (RKN) are obligatory plant parasitic worms that establish and maintain an intimate relationship with their host plants. During a compatible interaction, RKN induce the redifferentiation of root cells into multinucleate and hypertrophied giant cells essential for nematode growth and reproduction. These metabolically active feeding cells constitute the exclusive source of nutrients for the nematode. Detailed analysis of glutathione (GSH) and homoglutathione (hGSH) metabolism demonstrated the importance of these compounds for the success of nematode infection in Medicago truncatula. We reported quantification of GSH and hGSH and gene expression analysis showing that (h)GSH metabolism in neoformed gall organs differs from that in uninfected roots. Depletion of (h)GSH content impaired nematode egg mass formation and modified the sex ratio. In addition, gene expression and metabolomic analyses showed a substantial modification of starch and γ-aminobutyrate metabolism and of malate and glucose content in (h)GSH-depleted galls. Interestingly, these modifications did not occur in (h)GSH-depleted roots. These various results suggest that (h)GSH have a key role in the regulation of giant cell metabolism. The discovery of these specific plant regulatory elements could lead to the development of new pest management strategies against nematodes

Effet d'un programme personnalisé d'exercices correctifs de la posture sur les douleurs dorsolombaires et sur la posture chez des hockeyeurs masculins d'âge junior

Cette étude avait pour but de déterminer si un programme d'exercices correctifs personnalisés de la posture influence (i) la posture du hockeyeur et (ii) les douleurs dorsolombaires qu'il pourrait ressentir lors de la pratique de son sport. La production de résultats significatifs a réussi à démontrer que le programme personnalisé d'exercices correctifs de la posture atténue de façon significative la posture en flexion du hockeyeur ainsi que la durée et l'intensité des douleurs dorsolombaires, mais sans toutefois affecter le nombre d'épisodes. Au début de l'étude, les connaissances fondamentales multidisciplinaires sur lesquelles reposent les mécanismes lésionnels attribuables à la posture ont été évaluées de façon méticuleuse. En seconde étape, une évaluation posturale statique accompagnée d'un programme d'exercices personnalisés a été mise en place tout en surveillant les douleurs dorsolombaires donnant lieu à une étude quasi-expérimentale composée de 49 sujets masculins divisés en deux groupes. Celle-ci comprenait une évaluation posturale servant à l'élaboration d'un programme d'exercices spécifiques pour les 24 sujets du groupe expérimental, suivi d'une deuxième évaluation posturale dix semaines plus tard. Les 25 sujets du groupe contrôle ont eu une évaluation posturale suivi d'une autre dix semaines plus tard. Aucun exercice spécifique ne leur était prescrit. Tous les participants du groupe expérimental faisaient partie d'une équipe distincte de celle des participants du groupe contrôle, et ce pour toute la durée de l'étude. Au plan de l'évaluation des douleurs dorsolombaires, tous les hockeyeurs avaient à remplir deux questionnaires, le premier récoltant des données démographiques et le second étant le Questionnaire québécois sur les maux de dos de Kopec. Le questionnaire de Kopec devait être rempli chaque fois qu'une douleur dorsolombaire était ressentie par le hockeyeur. Une échelle analogique d'évaluation de la douleur, graduée de 1 à 10, était aussi utilisée pour essayer de quantifier les douleurs dorsolombaires

Efficiency of an Active Rehabilitation Intervention in a Slow-to-Recover Paediatric Population following Mild Traumatic Brain Injury: A Pilot Study

Objective. The aim of this study was to identify whether the addition of an individualised Active Rehabilitation Intervention to standard care influences recovery of young patients who are slow-to-recover following a mTBI. Methods. Fifteen participants aged 15±2 years received standard care and an individualised Active Rehabilitation Intervention which included (1) low- to high-intensity aerobic training; (2) sport-specific coordination exercises; and (3) therapeutic balance exercises. The following criteria were used to measure the resolution of signs and symptoms of mTBI: (1) absence of postconcussion symptoms for more than 7 consecutive days; (2) cognitive function corresponding to normative data; and (3) absence of deficits in coordination and balance. Results. The Active Rehabilitation Intervention lasted 49±17 days. The duration of the intervention was correlated with self-reported participation (x-=84.64±19.63%, r=-0.792, p<0.001). The average postconcussion symptom inventory (PCSI) score went from a total of 36.85±23.21 points to 4.31±5.04 points after the intervention (Z=-3.18, p=0.001). Conclusion. A progressive submaximal Active Rehabilitation Intervention may represent an important asset in the recovery of young patients who are slow-to-recover following a mTBI

Training driving ability in a traumatic brain-injured individual using a driving simulator: a case report

Background: Traumatic brain injury (TBI) causes functional deficits that may significantly interfere with numerous activities of daily living such as driving. We report the case of a 20-year-old woman having lost her driver’s license after sustaining a moderate TBI. Objective: We aimed to evaluate the effectiveness of an in-simulator training program with automated feedback on driving performance in a TBI individual. Methods: The participant underwent an initial and a final in-simulator driving assessment and 11 in-simulator training sessions with driving-specific automated feedbacks. Driving performance (simulation duration, speed regulation and lateral positioning) was measured in the driving simulator. Results: Speeding duration decreased during training sessions from 1.50 ± 0.80 min (4.16 ± 2.22%) to 0.45 ± 0.15 min (0.44 ± 0.42%) but returned to initial duration after removal of feedbacks for the final assessment. Proper lateral positioning improved with training and was maintained at the final assessment. Time spent in an incorrect lateral position decreased from 18.85 min (53.61%) in the initial assessment to 1.51 min (4.64%) on the final assessment. Conclusion: Driving simulators represent an interesting therapeutic avenue. Considerable research efforts are needed to confirm the effectiveness of this method for driving rehabilitation of individuals who have sustained a TBI