The interest of gait markers in the identification of subgroups among fibromyalgia patients

<p>Abstract</p> <p>Background</p> <p>Fibromyalgia (FM) is a heterogeneous syndrome and its classification into subgroups calls for broad-based discussion. FM subgrouping, which aims to adapt treatment according to different subgroups, relies in part, on psychological and cognitive dysfunctions. Since motor control of gait is closely related to cognitive function, we hypothesized that gait markers could be of interest in the identification of FM patients' subgroups. This controlled study aimed at characterizing gait disorders in FM, and subgrouping FM patients according to gait markers such as stride frequency (SF), stride regularity (SR), and cranio-caudal power (CCP) which measures kinesia.</p> <p>Methods</p> <p>A multicentre, observational open trial enrolled patients with primary FM (44.1 ± 8.1 y), and matched controls (44.1 ± 7.3 y). Outcome measurements and gait analyses were available for 52 pairs. A 3-step statistical analysis was carried out. A preliminary single blind analysis using k-means cluster was performed as an initial validation of gait markers. Then in order to quantify FM patients according to psychometric and gait variables an open descriptive analysis comparing patients and controls were made, and correlations between gait variables and main outcomes were calculated. Finally using cluster analysis, we described subgroups for each gait variable and looked for significant differences in self-reported assessments.</p> <p>Results</p> <p>SF was the most discriminating gait variable (73% of patients and controls). SF, SR, and CCP were different between patients and controls. There was a non-significant association between SF, FIQ and physical components from Short-Form 36 (p = 0.06). SR was correlated to FIQ (p = 0.01) and catastrophizing (p = 0.05) while CCP was correlated to pain (p = 0.01). The SF cluster identified 3 subgroups with a particular one characterized by normal SF, low pain, high activity and hyperkinesia. The SR cluster identified 2 distinct subgroups: the one with a reduced SR was distinguished by high FIQ, poor coping and altered affective status.</p> <p>Conclusion</p> <p>Gait analysis may provide additional information in the identification of subgroups among fibromyalgia patients. Gait analysis provided relevant information about physical and cognitive status, and pain behavior. Further studies are needed to better understand gait analysis implications in FM.</p

Legal Writing: Why is a Legal Memorandum Like an Onion?-A Student\u27s Guide to Reviewing and Editing

If you are a student working on a legal memorandum, you may think the answer to the question posed by the title of this Article is that they can both make you cry. This Article may help you avoid tears by giving you a way to review your work. The legal memorandum is like an onion because it is a whole made up of many layers. These layers cover each other in levels that can be cross-sectioned and examined in place without losing the sense of the whole. The guidelines offered for that examination follow the priorities of your legal reader. These guidelines should help you with the complex task of editing your memorandum, while guarding against straying from the core purpose of your memorandum- the presentation of your legal analysis

Les changements d'affectation et l'amélioration des logements de 1962 à 1967

[spa] Cambios de afectación y mejora de la vivienda de 1962 a 1967 por Jean-Louis BODIN y Nicole SEUGMANN . A favor de una série de encuestas realizadas sobre una muestra permanente de viviendas, se pudieron medir entre 1962 y 1967, probabil idades de desafectación de residencias habituales y la reafectación de viviendas vacantes asi como la tasa de mejora en materia de equipamiento de las viviendas. . Como se podia esperar, la desafectación es un fenómeno selectivo : el 10% del parque inicial de residencias habituales ha sido desafectado en un plazo de cinco anos, pero este porcentaje alcanza un 12,5 % en el medio rural y excede un 15 % en lo que se refiere a las viviendas que carecen de comod idades. A la inversa, las reafectaciones son más frecuentes en zona urbanao en lo que se refiere a viviendas proveidas de todas las comodidades. . La mejora intervenida en el parque inmobiliario ha sido harto rápido (180 000 viviendas al ano con respecto a instalación de agua corriente, 190 000 por lo que se refiere a instalaciones de retretes o de aseo). La parte de las mejoras intervenidas al nivel de equipamiento del parque que existia en 1967 no es nada despreciable. El aumento del nivel de comodidades en la vivienda deberá de acarrear una modificación de las estructuras de renovación. [fre] Grâce à une série d'enquêtes effectuées auprès d'un échantillon permanent de logements, on a pu mesurer de 1962 à 1967 des probabilités de désaffectation des résidences principales et de réaffectation des logements inoccupés ainsi que des taux d'amélioration de l'équipement des logements.. Comme on pouvait s'y attendre, la désaffectation est un phénomène sélectif : 10% du parc initial des résidences principales a été désaffecté en cinq ans, mais ce pourcentage atteint 12,5 % en milieu rural et dépasse 15 % pour les logements sans confort. En sens inverse, les réaffectations sont plus fréquentes en zone urbaine ou pour des logements confortables. . L'amélioration du parc immobilier a été assez rapide (180 000 logements par an en ce qui concerne l'installation de l'eau courante, 190 000 en ce qui concerne celle desW.C. ou des installations sanitaires). La part de l'amélioration dans le niveau d'équipement du parc existant en 1967 est loin d'être négligeable. L'augmentation du niveau de confort des logements devra entraîner une modification des structures du renouvellement. [eng] Affectation changes and housing improvement from 1962 up to 1967 Jean-Louis BODIN and Nicole SEL1GMANN . Owing to a series of surveys carried out on a permanent sample of housing units, it became possible to evaluate between 1962 and 1967 the probabilities of putting to other purposes principal residences and reappropriating vacant dwellings as well as measuring improvement rates of housing equipment. . As it might be expected, the putting to other purposes is a selective phenomenon : 10% of the initial housing stock of principal residences were put to other purposes in five years, but this percentage reaches 12,5% in rural areas and goes beyond 15% for dwellings with no housing amenities. On the contrary, new assignments are more frequent in urban areas or for dwellings provided with housing amenities. . The improvement in immovable property was rather fast (180 000 housing units per annum concerning water supply, 190 000 concerning water closet and sanitary equipment). The part of improvement in the equipment rate of the existing stock of dwellings in 1967 is far from being negligible. The increase in housing amenities rate should lead to a change in the renovation structure.