Vers une éducation en physiothérapie axée sur la durabilité des soins de santé

Contexte : L’amélioration continue des programmes de formation pour les professionnels de la santé est essentielle. Un aspect clé réside dans l’intégration des principes du développement durable et de la responsabilité sociale. Objectif : Cette communication explore l’intégration des perspectives environnementales et de durabilité dans la formation en physiothérapie. Développement : Des ressources sont disponibles pour l’intégration de la durabilité dans les programmes de formation. Cependant, la perception erronée que la durabilité n’est pas pertinente pour les soins de santé, le manque d’expertise des enseignants, les défis d’intégration dans des programmes chargés et le manque d’approches d’évaluation adéquates constituent des obstacles à cette intégration. Discussion : La responsabilité sociale des institutions de formation est mise en avant, insistant sur le rôle qu’elles jouent face aux enjeux environnementaux et de santé. Pour surmonter les obstacles, une collaboration entre différents acteurs – institutionnels, pédagogiques, politiques, communautaires, industriels ou issus du monde académique – est nécessaire, ainsi que l’implication d’experts en santé environnementale. Les facteurs clés du succès incluent l’engagement institutionnel, le développement d’une culture de durabilité, la création de partenariats étudiant-formateur et des lieux de stage offrant un environnement d’apprentissage où les principes de durabilité peuvent être intégrés et évalués. Conclusion : Une intégration continue de la durabilité dans la formation en physiothérapie est requise pour une transition efficace vers des pratiques durables. Cela nécessite une collaboration interdisciplinaire, la promotion de la recherche et le soutien des décideurs politiques pour favoriser l’échange d’idées et élaborer des politiques de santé durable et visant à améliorer la santé des générations présentes et futures

Mental practice for chronic pain in people with spinal cord injury ::a systematic review protocol

Review question/objective: The primary objective of this systematic review is to identify the effects of mental practice (MP) interventions on chronic neuropathic and nociceptive pain and motor function recovery in individuals after spinal cord injury (SCI). Where possible, this review will also describe the optimal type and dosage (i.e. frequency, intensity and duration) of MP interventions for patients with SCI

Traduction d'Evidence Summaries ::une coopération entre deux hautes écoles spécialisées

Dans le cadre d’un projet commun avec des étudiant·e·s, les cursus de physiothérapie de Bâle et de Lausanne ont traduit des Evidence Summaries anglais en français et en allemand.Die Physiotherapie-Studiengänge in Basel und Lausanne haben in einem gemeinsamen Projekt mit StudentInnen englische «Evidence Summaries» auf Deutsch und Französisch übersetzt

Motor imagery for pain and motor function after spinal cord injury ::a systematic review

Study design Systematic review. Objectives To evaluate the therapeutic benefits of motor imagery (MI) for the people with spinal cord injury (SCI). Setting International. Methods We searched electronic bibliographic databases, trial registers, and relevant reference lists. The review included experimental and quasi-experimental study designs as well as observational studies. For the critical appraisal of the 18 studies retrieved (three RCT, seven quasi-RCT, eight observational), we used instruments from the Joanna Briggs Institute. The primary outcome measure was pain. Secondary outcome measures included motor function and neurophysiological parameters. Adverse effects were extracted if reported in the included studies. Because of data heterogeneity, only a qualitative synthesis is offered. Results The included studies involved 282 patients. In most, results were an improvement in motor function and decreased pain; however, some reported no effect or an increase in pain. Although protocols of MI intervention were heterogeneous, sessions of 8–20 min were used for pain treatments, and of 30–60 min were used for motor function improvement. Neurophysiological measurements showed changes in brain region activation and excitability imposed by SCI, which were partially recovered by MI interventions. No serious adverse effects were reported. Conclusions High heterogeneity in the SCI population, MI interventions, and outcomes measured makes it difficult to judge the therapeutic effects and best MI intervention protocol, especially for people with SCI with neuropathic pain. Further clinical trials evaluating MI intervention as adjunct therapy for pain in SCI patients are warranted

Physical activity and endogenous pain modulation in older people ::a scoping review protocol

Objective: This scoping review aims to provide a systematic overview of the existing literature on physical activity and endogenous pain modulation (EPM), assessed using conditioned pain modulation (CPM), with a specific focus on older people with chronic pain. Introduction: Approximately 20% of the European population reports chronic pain, highlighting the problem of chronic pain in the general population. This prevalence increases to 50% in older people. Physical activity is one of the most frequently used treatments for pain management and relief. A possible mechanism underlying the positive effects of physical activity on pain may be related to its influence on EPM. The study will map (i) types of physical activity used to study its effect on EPM in older people; (ii) intervention protocols investigating physical activity and EMP, measured using CPM, in older people experiencing pain; and (iii) knowledge gaps requiring further research or interventions adapted to older people with pain. Inclusion criteria: This review will consider studies of people aged 60 years or older, using CPM to examine the ffect of physical activity on EPM. All types of care settings will be eligible. Methods: This review will be conducted in accordance with the JBI methodology for scoping reviews. The following databases will be searched: MEDLINE (Ovid), CINAHL (EBSCOhost), Embase, Cochrane Library, Web of Science, JBI Evidence Synthesis, PsycINFO, and PEDro

Exogenous and endogenous components of ultralate (C-fibre) evoked potentials following CO2 laser stimuli to tiny skin surface areas in healthy subjects.

CO2 laser stimulation of tiny skin surface areas on the hand dorsum generate ultralate laser evoked potentials (LEPs) with a major positivity maximal at the vertex at a latency of about 1 s. These potentials follow selective and direct activation of C-fibres in the superficial layers of the skin. To identify the endogenous P3 component in ultralate LEPs, we used a 2-stimulus oddball paradigm (20% probability of targets). Ultralate LEPs were recorded in eight healthy subjects with 19 channels EEG and EOG. Laser stimuli (n = 200/subject, < 0.5 mm diameter, 5 ms duration, 9.4 mJ/mm2 energy density) were applied in a pseudo-random order to the proximal phalanx of either middle finger (target) or index (non-target) of the left hand. Vigilance was maintained during recording sessions. Subject's task was to press a button to any kind of sensation perceived at the target zone. We observed a negative-positive (N965-P1139) complex maximal at Cz for all stimulus conditions. This complex was of significantly larger amplitude for rare events. For the target responses, a second distinct positive peak was observed with a mean latency of 1343 +/- 103.5 ms with maximum amplitude at Pz. This latest peak may represent an endogenous P3-like component as it is linked to the subject's detection of the target stimulus (rare events)

Physiological effects of Therapeutic Body Wraps in healthy volunteers ::an observational study

Introduction The clinical management of severe anxiety is challenging. Along with specific medication, several nonpharmacological treatments exist, among which the Therapeutic Body Wraps (TBW). While TBW is clinically known to be efficient, the absence of objective physiological measurements raised some debates about its harmlessness. Aims This observational study investigated TBW in healthy volunteers. Methods Measurements were done in 26 participants, who experienced TBW, which consisted of tightly wrapping the body in one layer of wet cold sheets and several warm blankets. These were compared to 13 participants, who rested in supine position. Results Our results showed increase in the trunk skin temperature by the end of TBW similar to rest. Somatosensory perception as assessed with quantitative sensory testing was stable after both TBW and rest. The heart and breath rates decreased both during TBW and rest. It was accompanied by increase in heart rate variability parameters and decrease in salivary cortisol levels. Discussion Our data indicate anxiolytic effect of TBW in healthy participants. Implications for practice The TBW is harmless and might be used in patients, who are unable to relax by themselves and/or without anxiolytic medication. Further studies are necessary to investigate physiological response to TBW in clinical population

The predictive value of subsets of the orebro musculoskeletal pain screening questionnaire for return to work in chronic low back pain

BACKGROUND: Studies have shown that positive recovery expectations are associated with positive health outcomes in patients with chronic low back pain (CLBP) such as return to work (RTW) and the time to RTW. AIM: To compare the predictive value for RTW in CLBP using different subsets of the Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ). DESIGN: Longitudinal cohort study. SETTING: Rehabilitation center. POPULATION: Ninety-eight inpatients with CLBP (>3 months). METHODS: The OMPSQ at baseline was used to predict RTW three months after discharge from the rehabilitation clinic. The area under the ROC-curve was calculated based on a logistic regression model. Cox-regression was used to analyze time to RTW with C statistics for the original full (25-items) version of the OMPSQ, the 10-item version as well as for the two items about self-expected RTW and self-expected recovery. RESULTS: The area under the curve (AUC) for the overall score of the full version OMPSQ was 0.82 (95% CI: 0.73 to 0.90), the AUC for the short version was 0.79 (95% CI: 0.70 to 0.88), the AUC for the item about self-expected recovery (#15) was 0.67 (95% CI: 0.57 to 0.78), and the AUC for the item about self-expected RTRTW (#16) was 0.76 (95% CI CI: 0.66 to 0.85). Harrell's C for the full version was 0.74 (95% CI: 0.66 to 0.81), for the short version the C was 0.71 (95% CI: 0.64 to 0.79), for item #15 the C was 0.62 (95% CI: 0.53 to 0.72), and for item #16 the C was 0.71 (95% CI: 0.64 to 0.78). CONCLUSIONS: Two items about expectations from the OMPSQ showed similar predictive value for RTRTW compared to the short and full original versions, and could be used as first screening questions. CLINICAL REHABILITATION IMPACT: Clinicians may make an informed choice whether they use the full or the short version of the OMPSQ for screening of psychosocial problems, or whether they use the two single items about expectations. Knowledge about patient's expectations provides a base for discussion between health professionals and the patient