Le certificat médical de non contre-indication au premier saut en parachute (la place du médecin généraliste)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Entorse du ligament collatéral de la cheville révélatrice d'une atteinte neurogène périphérique

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Traumatologie sportive aux urgences

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Le Contrôle de la posture et du mouvement chez les sujets cérébrolésés adultes

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

KINEMATIC AND KINETIC ASYMMETRIES IN HEMIPLEGIC PATIENTS’ GAIT INITIATION PATTERNS

International audienc

Asymmetry of gait initiation in patients with unilateral knee arthritis

International audienc

Satisfaction and long-term use of orthopedic shoes in people with chronic stroke

International audienceno abstrac

Knee-ankle-foot orthoses for treating posterior knee pain resulting from genu recurvatum: Efficiency, patients' tolerance and satisfaction

Objective: To assess the efficiency of knee-ankle-foot orthoses for treating painful genu recurvatum, and to determine users’ tolerance and satisfaction. Patients: Patients included in the study had a genu recurvatum during the stance phase, confirmed by a medical doctor on physical examination. A total of 27 patients with 31 knee-ankle-foot orthoses were included. Methods: The main outcome was scored on a verbal numerical rating scale (VNRS) before and at least 3 months after a knee-ankle-foot orthosis was fitted, and scored on a verbal numerical pain rating scale (VRS). Secondary outcomes were rated with the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST). Results: After fitting the knee-ankle-foot orthosis, the median VNRS pain score decreased from 85/100 to 25/100 (p ≤ 0.001) and the description of pain on the VRS decreased from “extreme” to “mild” (p ≤ 0.001). The QUEST total score was 4.0. Conclusion: Treating a painful genu recurvatum with a knee-ankle-foot orthosis reduced the pain efficiently whatever the patients’ diagnosis, and high scores were obtained for patients’ satisfaction

Plastic changes in spinal synaptic transmission following botulinum toxin A in patients with post stroke spasticity

International audienceObjective: The therapeutic effects of intramuscular injections of botulinum toxin-type A on spasticity can largely be explained by its blocking action at the neuromuscular junction. Botulinum toxin-type A is also thought to have a central action on the functional organization of the central nervous system. This study assessed the action of botulinum toxin-type A on spinal motor networks by investigating post-activation depression of the soleus H-reflex in post-stroke patients. Post-activation depression, a presynaptic mechanism controlling the synaptic efficacy of Ia-motoneuron transmission , is involved in the pathophysiology of spasticity. Patients: Eight patients with chronic hemiplegia post-stroke presenting with lower limb spasticity and requiring botuli-num toxin-type A injection in the ankle extensor muscle. Methods: Post-activation depression of soleus H-reflex assessed as frequency-related depression of H-reflex was investigated before and 3, 6 and 12 weeks after botulinum toxin-type A injections in the triceps surae. Post-activation depression was quantified as the ratio between H-reflex amplitude at 0.5 and 0.1 Hz. Results: Post-activation depression of soleus H-reflex, which is reduced on the paretic leg, was affected 3 weeks after botulinum toxin-type A injection. Depending on the residual motor capacity of the post-stroke patients, post-activation depression was either restored in patients with preserved voluntary motor control or further reduced in patients with no residual voluntary control. Conclusion: Botulinum toxin treatment induces synaptic plasticity at the Ia-motoneuron synapse in post-stroke pa-retic patients, which suggests that the effectiveness of bot-ulinum toxin-type A in post-stroke rehabilitation might be partly due to its central effects