Etude de l effet immédiat d une séance de Gait Trainer sur la symétrie de la marche chez l hémiplegique vasculaire en comparaison d une séance de rééducation à la marche conventionnelle

LIMOGES-BU Médecine pharmacie (870852108) / SudocSudocFranceF

Retrospective Study on the Pathway and the Outcome of Children Victims of Acquired Brain Injury Accompanied By a Mobile Unit of School Reintegration

International audienceObjectives: to retrace the care pathways and the academic pathways of brain-damaged children supported a Mobile Unit of School Reintegration (MUSR) and to identify factors associated with their long-term outcome. Patients and methods: Retrospective study from the medical files of 53 children followed by the MUSR, conducted between November 2018 and April 2019. Results: The cerebro-lesions were mainly caused by a craniocerebral trauma (83% of cases), with an average age of onset of 9.8 years. The duration of the initial hospitalization was 39 days on average. The mean length of follow-up was 37 months. Long-term medical outcome was marked by 18.5% of medical complications, 29.6% of behavioral disorders and 9.2% of judiciary complications. The factors associated with long-term behavioral disorders were the age of onset (p = 0.015), the initial Glasgow score (p = 0.025), a head trauma related to a traffic accident (p = 0.046), a poor therapeutic alliance with the parents (p <0.001), the absence of psychological follow-up (p = 0.040) and the existence of legal complications (p = 0.001). The factor associated with long-term legal complications was a poor therapeutic alliance with the parents (p = 0.017). All the children followed were reintegrated into school, after an average of 6.4 months. A school reorientation was necessary in 49.9% of cases, associated with initial complications (p = 0.035), the existence of secondary brain aggressions of systemic origin (p <0.001), the existence of antecedents (p = 0.040), and the autonomy level (p = 0.023). Conclusion: The MUSR offers multidisciplinary, integrative and mobile cares, based on coordination of the care pathway and the academic pathway of children victims of acquired brain injuries

Physical factors associated with fatigue after stroke: an exploratory study.

International audienceObjective: To look for a relationship between physical fatigue and physical parameters in patients at least 3 months post stroke. Methods: We conducted a prospective cross-sectional study of 32 poststroke patients (average duration of stroke 40 months) who were recruited among in- and outpatients followed by the Department of Physical and Rehabilitation Medicine of a university hospital. Fatigue was defi ned as a Fatigue Severity Scale (FSS) score of 4 or more. The parameters studied were age, sex, time since stroke, Demeurisse Motor Index, Barthel Index score, new Functional Ambulation Category, Berg Balance Scale, 10-meter walk test, 6-minute walk test, Dijon Physical Activity Score, Montgomery and Asberg Depression Rating Scale, Epworth Sleepiness Scale, presence of pain, and length and area of the center of pressure displacement obtained posturographically. Results: Two-thirds of patients (65.6%) were fatigued. The mean FSS score was 4.3 ± 1.8. Fatigue was not associated with the physical parameters studied; notably, there was no correlation with motor impairment, autonomy and walking capacity, or balance and physical activity. However, after multivariate analysis, we found an association between physical fatigue and time since the occurrence of stroke (P = .05). Conclusions: Our study revealed a relationship between pain and physical fatigue, as reported by 2 other studies. Poststroke fatigue management should include appropriate pain management. Further studies are necessary to determine the causes of physical fatigue after stroke

Evaluation of a multidisciplinary consultation of diabetic foot : [Évaluation d'une prise en charge multidisciplinaire préventive et curative du pied diabétique]

International audienceOBJECTIVES: To evaluate the effectiveness of a multidisciplinary consultation of diabetic foot in terms of ulcer healing rate and podiatric complications prevention. METHODS: A longitudinal observational study was conducted on 78 patients consulting multidisciplinary clinic of diabetic foot between the 1st January 2005 and the 31th December 2006. There were two evaluations: the first one in June 2008, the second one in January 2010, at a medium follow-up of 48 months. RESULTS: 30.8% of diabetic patients were addressed in primary prevention, 53.8% for treatment of foot ulcer, and 15.4% in secondary prevention. The global healing rate was 76.19% after a medium follow-up of 29 months, and the recurrence rate at a medium follow-up of 48 months was 9.52%. Healing was achieved in 63.6% of patients with off-loading shoes versus 81.8% of whom with fiberglass cast boot. CONCLUSION: Care and follow-up of diabetic patients with foot at risk in multidisciplinary consultation seem to be effective not only in curative treatment, but also in primary and secondary prevention. The economic benefits need to be evaluated