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Bougeard M, Hauret I, Pelletier-Visa M, Plan-Paquet A, Givron P, Badin M, Pereira B, Lanhers C, Coudeyre E. Use of immersive virtual reality for stress reduction during botulinum toxin injection for spasticity (RVTOX): a study protocol of a randomised control trial. BMJ Open 2023; 13:e066726. [PMID: 37903608 PMCID: PMC10619105 DOI: 10.1136/bmjopen-2022-066726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 08/17/2023] [Indexed: 11/01/2023] Open
Abstract
INTRODUCTION Botulinum toxin injection is a common way to help reduce spasticity in the body caused by central neurological damage such as cerebral stroke, multiple sclerosis or traumatic brain injury. The pain felt during the injection causes most patients to experience significant stress for further injections, the level of which is variable between patients.Immersive virtual reality is a digital technique that simulates the three-dimensional spatial and sound environment around a person said to be immersed in this virtualised world. The effectiveness of virtual reality comes from the intensity of this multisensory immersion, known as the feeling of presence (ie, subjective experience of being in one place or one environment, even when you are physically in another one).Only one research article in paediatrics has shown that immersive reality technique has a positive impact on the level of pain and agitation suffered during botulinum toxin injections. The purpose of this study is therefore to evaluate with sufficient assurance the following research hypothesis: virtual reality can help adults cope with the stress and pain of botulinum toxin treatment injection. METHODS AND ANALYSIS The research hypothesis will be tested using a randomised stepped-wedge method versus a non-invasive technique (headset with virtual reality session) to its control (headset with no image nor audio).The design leads to considering the injection as a statistical unit as all participants will undergo the standard condition, the control technique and virtual reality technique. ETHICS AND DISSEMINATION Patients will be fully and fairly informed in terms of their understanding of the objectives and constraints of the study and the possible risks involved. They will also be entitled to refuse the study and/or withdraw, and this refusal will have no impact on their follow-up as part of their pathology. Dissemination of the results of this study will be through peer-reviewed publications, and national and international conferences.Ethics were approved by the Comité de Protection des Personnes Nord-Ouest in January 2022. TRIAL REGISTRATION NUMBER NCT05364203.
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Affiliation(s)
- Marie Bougeard
- Physical Rehabilitation Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Isabelle Hauret
- Physical Rehabilitation Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Anne Plan-Paquet
- Physical Rehabilitation Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Pascale Givron
- Physical Rehabilitation Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Marin Badin
- Physical Rehabilitation Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Direction de la recherche clinique et de l'innovation, University Hospital CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Charlotte Lanhers
- Physical Rehabilitation Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Emmanuel Coudeyre
- Physical Rehabilitation Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Bouillon-Minois JB, Roux V, Pereira B, Flannery M, Pelissier C, Occelli C, Schmidt J, Navel V, Dutheil F. Stress among Emergency Health Care Workers on Nuclear or Radiation Disaster: A Preliminary State Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168384. [PMID: 34444134 PMCID: PMC8393601 DOI: 10.3390/ijerph18168384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The nuclear or radiation disaster risk within the French Auvergne-Rhone-Alpes state is low (but not absent) due to its proximity to four Nuclear Power Generation Centers and two regional cancer control centers. This study aims to compare subjective stress ratings for emergency health care workers regarding nuclear and radiation disasters between two locations: at work versus at home. MATERIALS AND METHODS We distributed an anonymous online questionnaire via RedCap® to all emergency health care workers who could be involved in patient care after a nuclear or radiation disaster. It comprised 18 questions divided into three parts-theoretical knowledge and practical assessment, stress assessment, and sociodemographic criteria. RESULTS We analyzed 107 responses. There was a significant 11-point increase in stress levels between work and home regarding nuclear or radiation disaster risks (p = 0.01). Less than 25% of emergency health care workers surveyed benefited from annual training. CONCLUSION The stress levels of emergency health care workers regarding nuclear or radiation disaster were higher at work than at home and increased without annual training. It is important to increase knowledge about these protocols and to mandate yearly training for all workers potentially involved in these disasters.
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Affiliation(s)
- Jean-Baptiste Bouillon-Minois
- Emergency Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
- Correspondence: ; Tel.: +33-6-74-36-04-23; Fax: +33-4-73-27-46-49
| | - Vincent Roux
- CNRS, LaPSCo, Université Clermont Auvergne, Physiological and Psychosocial Stress, 63000 Clermont-Ferrand, France; (V.R.); (F.D.)
| | - Bruno Pereira
- Clinical Research and Innovation Direction, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Mara Flannery
- Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York University Langone Health, New York, NY 10016, USA;
| | - Carole Pelissier
- Service de Santé au Travail, CHU de Saint-Étienne, Saint-Étienne, France. Univ Lyon 1, Univ St Etienne, 42005 Saint-Étienne, France;
| | - Céline Occelli
- CHU Nice, Emergency Department, Université Côte d’Azur, 06000 Nice, France;
| | - Jeannot Schmidt
- Emergency Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Valentin Navel
- Translational Approach to Epithelial Injury and Repair, Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, INSERM, GReD., 63000 Clermont-Ferrand, France;
- Ophthalmology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Frédéric Dutheil
- CNRS, LaPSCo, Université Clermont Auvergne, Physiological and Psychosocial Stress, 63000 Clermont-Ferrand, France; (V.R.); (F.D.)
- Occupational and Environmental Medicine, CHU Clermont-Ferrand, WittyFit, 63000 Clermont-Ferrand, France
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Picard M, Tauveron I, Magdasy S, Benichou T, Bagheri R, Ugbolue UC, Navel V, Dutheil F. Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis. PLoS One 2021; 16:e0251863. [PMID: 33999947 PMCID: PMC8128270 DOI: 10.1371/journal.pone.0251863] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cardiac autonomic neuropathy is a common complication of type 2 diabetes mellitus (T2DM), that can be measured through heart rate variability (HRV)–known to be decreased in T2DM. Physical exercise can improve HRV in healthy population, however results are under debate in T2DM. We conducted a systemic review and meta-analysis to assess the effects of physical exercise on HRV in T2DM patients. Method PubMed, Cochrane, Embase, and ScienceDirect databases were searched for all studies reporting HRV parameters in T2DM patients before and after exercise training, until September 20th 2020, without limitation to specific years. We conducted random-effects meta-analysis stratified by type of exercise for each of the HRV parameters: RR–intervals (or Normal to Normal intervals–NN), standard deviation of RR intervals (SDNN), percentage of adjacent NN intervals varying by more than 50 milliseconds (pNN50), root mean square of successive RR-intervals differences (RMSSD), total power, Low Frequency (LF), High Frequency (HF) and LF/HF ratio. Sensitivity analyses were computed on studies with the highest quality. Results We included 21 studies (9 were randomized) for a total of 523 T2DM patients: 472 had an exercise training and 151 were controls (no exercise). Intervention was endurance (14 studies), resistance (2 studies), endurance combined with resistance (4 studies), and high intensity interval training (HIIT) (4 studies). After exercise training, all HRV parameters improved i.e. an increase in SDNN (effect size = 0.59, 95%CI 0.26 to 0.93), RMSSD (0.62, 0.28 to 0.95), pNN50 (0.62, 0.23 to 1.00), HF (0.58, -0.16 to 0.99), and a decrease in LF (-0.37, -0.69 to -0.05) and LF/HF (-0.52, -0.79 to -0.24). There were no changes in controls. Stratification by type of exercise showed an improvement in most HRV parameters (SDNN, RMSSD, pNN50, LF, HF, LF/HF) after endurance training, whereas mostly LF/HF was improved after both resistance training and HIIT. Supervised training improved most HRV parameters. Duration and frequency of training did not influence the benefits on HRV. Conclusion Exercise training improved HRV parameters in T2DM patients which may reflect an improvement in the activity of the autonomic nervous system. The level of proof is the highest for endurance training. Supervised training seemed beneficial.
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Affiliation(s)
- Mathilde Picard
- Endocrinology Diabetology and Metabolic Diseases, CHU Clermont–Ferrand, University Hospital of Clermont–Ferrand, Clermont-Ferrand, France
| | - Igor Tauveron
- Endocrinology Diabetology and Metabolic Diseases, Université Clermont Auvergne, GReD, CNRS, INSERM, CHU Clermont–Ferrand, University Hospital of Clermont–Ferrand, Clermont–Ferrand, France
| | - Salwan Magdasy
- Endocrinology Diabetology and Metabolic Diseases, Université Clermont Auvergne, GReD, CNRS, INSERM, CHU Clermont–Ferrand, University Hospital of Clermont–Ferrand, Clermont–Ferrand, France
| | - Thomas Benichou
- Endocrinology Diabetology and Metabolic Diseases, CHU Clermont–Ferrand, University Hospital of Clermont–Ferrand, Clermont-Ferrand, France
| | - Reza Bagheri
- Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Ukadike C. Ugbolue
- Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Valentin Navel
- Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, Université Clermont Auvergne, CNRS, INSERM, GReD, University Hospital of Clermont-Ferrand, Ophthalmology, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont–Ferrand, CHU Clermont–Ferrand, Occupational and Environmental Medicine, WittyFit, Clermont–Ferrand, France
- * E-mail:
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Amadéo S, Nguyen NL, Teai T, Favro P, Mulet A, Colin-Fagotin N, Rereao M, Malogne A, Simone MD, Rioche G, Gassion V, Pere P, Prokop A, Bernis F, Dufour P, Tuheiava A, Vanquin G, Vilhem S, Gokalsing E, Spodenkiewicz M, Pradem M, Seguin M, Beauchamp G, Thomas P, Vaiva G, Jehel L. Supportive effect of body contact care with ylang ylang aromatherapy and mobile intervention team for suicide prevention: A pilot study. J Int Med Res 2020; 48:300060520946237. [PMID: 32883150 PMCID: PMC7479860 DOI: 10.1177/0300060520946237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 07/07/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To assess understudied, alternative suicide prevention modalities in a mental health care setting. METHODS This was a prospective study of patients (n = 140, 68 cases and 72 controls) who were admitted to hospital or who contacted an SOS suicide crisis line for suicidal ideation or attempts. Psychiatric diagnoses (Mini-International Neuropsychiatric Interview) and intensity of anxiety/depression/suicidality (Hamilton Anxiety Rating Scale, Montgomery-Åsberg Depression Rating Scale, and Beck Scale for Suicidal Ideation) were assessed. All intervention group subjects received a crisis card with a crisis line number, interviews with psychologists or volunteers and a telephone call on days 10 to 21, then 6 months later. These subjects also had a choice between two further 4-month interventions: body contact care or mobile intervention team visits. RESULTS The interventions significantly reduced the number of suicide attempts and suicide (3%) at 6 months compared with the control condition (12%). There were fewer losses to follow-up in the intervention group (7.35%) than in the control group (9.72%). CONCLUSIONS The results favour the implementation of integrated care and maintaining contact in suicide prevention.
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Affiliation(s)
- Stéphane Amadéo
- Centre hospitalier de Polynésie française (CHPF), & Maison
des Sciences de l'Homme du Pacifique (USR 2003, UPF / CNRS) Tahiti, Polynésie
française (SA), Tahiti, Polynésie française, France
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
- Inserm, Équipe Moods-IPSOM, CESP, 94807, Villejuif, France
| | - Ngoc Lam Nguyen
- Centre hospitalier de Polynésie française (CHPF), & Maison
des Sciences de l'Homme du Pacifique (USR 2003, UPF / CNRS) Tahiti, Polynésie
française (SA), Tahiti, Polynésie française, France
- Direction de la santé publique de la Polynésie française,
Tahiti, Polynésie française, France
| | - Taivini Teai
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
- Université de Polynésie française (UPF), Tahiti, Polynésie
française, France
| | - Patrick Favro
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
- Université de Polynésie française (UPF), Tahiti, Polynésie
française, France
| | - Aurélia Mulet
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Nathalie Colin-Fagotin
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Moerani Rereao
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Aurélia Malogne
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Michel De Simone
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Géraldine Rioche
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Virginie Gassion
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Paul Pere
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Alban Prokop
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Fabienne Bernis
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Pierre Dufour
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Annie Tuheiava
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Germaine Vanquin
- Centre de prévention du suicide (SPC), SOS Suicide NGO, Tahiti,
Polynésie française, France
| | - Steve Vilhem
- Service universitaire de psychiatrie de l’enfant et de
l’adolescent (SUPEA), centre hospitalier universitaire Vaudois (CHUV), Lausanne,
Switzerland
| | - Erick Gokalsing
- Inserm, Équipe Moods-IPSOM, CESP, 94807, Villejuif, France
- CUMP Océan Indien/VigilanS Océan Indien Etablissement Public de
Santé Mentale, La Réunion, France
| | - Michel Spodenkiewicz
- Inserm, Équipe Moods-IPSOM, CESP, 94807, Villejuif, France
- Pôle de Santé Mentale, CIC-EC 1410, CHU de la Réunion,
Saint-Pierre, France
| | | | - Monique Seguin
- Groupe McGill d'Étude sur le Suicide. Réseau québécois de
recherche sur le suicide, la dépression et les troubles associés (Rqsdta),
Université McGill -- Institut Universitaire en Santé Mentale de l’Hôpital
Douglas, Canada
| | - Guy Beauchamp
- Groupe McGill d'Étude sur le Suicide. Réseau québécois de
recherche sur le suicide, la dépression et les troubles associés (Rqsdta),
Université McGill -- Institut Universitaire en Santé Mentale de l’Hôpital
Douglas, Canada
| | - Pierre Thomas
- Université de Lille, Inserm, CHU Lille, U1172 -- Lille
Neuroscience & Cognition et Centre National de Ressource et Résilience pour
les psychotraumatismes (Cn2r Lille Paris), F-59000 Lille, France
| | - Guillaume Vaiva
- Université de Lille, Inserm, CHU Lille, U1172 -- Lille
Neuroscience & Cognition et Centre National de Ressource et Résilience pour
les psychotraumatismes (Cn2r Lille Paris), F-59000 Lille, France
| | - Louis Jehel
- Inserm, Équipe Moods-IPSOM, CESP, 94807, Villejuif, France
- Université des Antilles, Campus de Schoelcher, BP 7029, 97275
Schoelcher. Université Paris-Saclay, UVSQ & Université Paris-Sud. Centre
Hospitalier Universitaire de Martinique, BP632, 97261 Cedex Fort de France
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