Table1_Robotic locomotor training for spasticity, pain, and quality of life in individuals with chronic SCI: A pilot randomized controlled trial.docx

ObjectiveThe prevention and treatment of secondary complications is a key priority for people with spinal cord injury and a fundamental goal of rehabilitation. Activity-based Training (ABT) and Robotic Locomotor Training (RLT) demonstrate promising results for reducing secondary complications associated with SCI. However, there is a need for increased evidence through randomized controlled trials. Therefore, we aimed to investigate the effect of RLT and ABT interventions on pain, spasticity, and quality of life in individuals with spinal cord injuries.MethodsParticipants with chronic motor incomplete tetraplegia (n = 16) were recruited. Each intervention involved 60-minute sessions, 3× per week, over 24-weeks. RLT involved walking in an Ekso GT exoskeleton. ABT involved a combination of resistance, cardiovascular and weight-bearing exercise. Outcomes of interest included the Modified Ashworth Scale, the International SCI Pain Basic Data Set Version 2, and the International SCI Quality of Life Basic Data Set.ResultsNeither intervention altered symptoms of spasticity. Pain intensity increased from pre-post intervention for both groups, with a mean increase of 1.55 [−0.82, 3.92] (p = 0.03) and 1.56 [−0.43, 3.55] (p = 0.02) points for the RLT and ABT group, respectively. The ABT group had an increase in pain interference scores of 100%, 50%, and 109% for the daily activity, mood, and sleep domain, respectively. The RLT group had an increase in pain interference scores of 86% and 69% for the daily activity and mood domain respectively, but no change in the sleep domain. The RLT group had increased perceptions of quality of life with changes of 2.37 [0.32, 4.41], 2.00 [0.43, 3.56] and 0.25 [−1.63, 2.13] points, p = 0.03, for the general, physical, and psychological domains, respectively. The ABT group had increased perceptions of general, physical and psychological quality of life with changes of 0.75 [−1.38, 2.88], 0.62 [−1.83, 3.07] and 0.63 [−1.87, 3.13] points, respectively.ConclusionsDespite increased pain ratings and no change in symptoms of spasticity, there was an increase in perceived quality of life for both groups over 24-weeks. This dichotomy warrants additional investigation in future large-scale randomized controlled trials.</p

Note sous Cour d'appel de Paris, troisième Chambre B, 16 juin 2006, Mme Cayrol et Tottger contre Mme de Galbert-Defforey

National audienceno abstrac

“A More Equitable Society”: The Politics of Global Fairness in Paralympic Sport

<div><p>The Paralympic Movement explicitly sets out to create a more equitable society and promote participation for all and fairness in disability sport. This is primarily achieved through the use of a range of interventions with less attention given to how economic factors may hinder access and achievement in Paralympic sport. We investigated how country-level economic variables influence the level of participation and achievement in the 2015 International Paralympic Committee (IPC) Athletics Championships held in Doha. We used multiple regression analysis to show how levels of participation and achievement in the Championships were significantly determined by economic factors independent of population size.</p><p>Our data show that in spite of the ideals of inclusion and fairness within the Paralympic Movement and the considerable effort expended on the use of technologies to achieve this, economic factors continue to exert a statistically significant influence on both the level of participation and achievement of Paralympic athletes. LMICs participate at lower levels and achieve fewer medals when compared to HICs. These differences are particularly marked in events that have a high cost of participation. Our findings raise questions regarding the use of current technologies and the level to which they are able to truly disrupt the politics of global inequality in sport.</p></div

Proportion of Countries by World Bank classification that participated in the Championships.

<p>Proportion of Countries by World Bank classification that participated in the Championships.</p

Level of achievement for HICs compared to LMICs for events which have a low cost of participation, moderate cost of participation and high cost of participation.

<p>Level of achievement for HICs compared to LMICs for events which have a low cost of participation, moderate cost of participation and high cost of participation.</p

Prehospital management of exertional heat stroke at sports competitions for Paralympic athletes

Objectives: To adapt key components of exertional heat stroke (EHS) prehospital management proposed by the International Olympic Committee (IOC) Adverse Weather Impact Expert Working Group for the Olympic Games Tokyo 2020 so that it is applicable for the Paralympic athletes.Methods: An expert working group representing members with research, clinical and lived sports experience from a Para sports perspective reviewed and revised the IOC consensus document of current best practice regarding the prehospital management of EHS.Results: Similar to Olympic competitions, Paralympic competitions are also scheduled under high environmental heat stress; thus, policies and procedures for EHS prehospital management should also be established and followed. For Olympic athletes, the basic principles of EHS prehospital care are: early recognition, early diagnosis, rapid, on-site cooling, and advanced clinical care. Although these principles also apply for Paralympic athletes, slight differences related to athlete physiology (e.g., autonomic dysfunction) and mechanisms for hands-on management (e.g., transferring the collapsed athlete or techniques for whole-body cooling) may require adaptation for care of the Paralympic athlete.Conclusions: Prehospital management of EHS in the Paralympic setting employs the same procedures as for Olympic athletes with some important alterations.</div