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Rousseau MC, Hully M, Milh M, Juzeau D, Pollez B, Peudenier S, Bahi Buisson N, Gautheron V, Chabrol B, Billette de Villemeur T. Clinical characteristics of COVID-19 infection in polyhandicapped persons in France. Arch Pediatr 2021; 28:374-380. [PMID: 33994267 PMCID: PMC8064873 DOI: 10.1016/j.arcped.2021.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/29/2021] [Accepted: 04/16/2021] [Indexed: 01/02/2023]
Abstract
Aim Little is known about the clinical profile of COVID-19 infection in polyhandicapped persons. This study aimed to describe the characteristics of this infection among individuals with polyhandicap. Method This was a retrospective observational study. Polyhandicap was defined by the combination of motor deficiency, profound mental retardation, and age at onset of cerebral lesion younger than 6 years. A positive COVID-19 status was considered for patients with a positive COVID-19 laboratory test result, or patients presenting with compatible symptoms and living in an institution or at home with other patients or relatives who had laboratory-confirmed COVID-19 infection. Data collection included sociodemographic data, clinical and paraclinical characteristics, as well as the management and treatment for COVID-19 infection. Results We collected 98 cases, with a sex ratio of 0.98 and a mean age of 38.5 years (3 months to 73 years). COVID-19 infection was paucisymptomatic in 46% of patients, 20.6% of patients presented with dyspnea, while the most frequent extra-respiratory symptoms were digestive (26.5%) and neurological changes (24.5%); 18 patients required hospital admission, four adults died. The mean duration of infection was longer for adults than for children, and the proportion of taste and smell disorders was higher in older patients. Conclusion These findings suggest that PLH persons often develop paucisymptomatic forms of COVID-19 infection, although they may also experience severe outcomes, including death. Clinicians should be aware that COVID-19 symptoms in PLH persons are often extra-respiratory signs, mostly digestive and neurologic, which may help in the earlier identification of COVID-19 infection in this particular population of patients.
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Affiliation(s)
- M-C Rousseau
- Service polyhandicap adultes, Hôpital San Salvadour (Assistance Publique Hôpitaux de Paris), BP 30 080, 83407 Hyères cedex, France.
| | - M Hully
- MD, Services de Neurologie et Rééducation Pédiatriques, Hôpital Necker Enfants Malades, APHP, 75015 Paris, France
| | - M Milh
- Service de Neuropédiatrie, Hôpital d'Enfants CHU Timone, 13005 Marseille, France
| | - D Juzeau
- Santé Publique, Co Fondatrice du réseau NeurodeV, 59000 Lille, France
| | | | - S Peudenier
- CRDI, Hôpital Morvan, CHRU Brest, 29200 Brest, France
| | - N Bahi Buisson
- Pediatric Neurology, Necker Enfants Malades University Hospital, Université de Paris, 75015 Paris, France; Institut Imagine, INSERM U 1163, Université de Paris, Paris, France
| | - V Gautheron
- Physical and Rehabilitation Medicine, Bellevue University Hospital, 42100 Saint-Étienne, France
| | | | - B Chabrol
- Service de Neuropédiatrie, Hôpital d'Enfants CHU Timone, 13005 Marseille, France
| | - T Billette de Villemeur
- Service de Neuropédiatrie, Pathologie du développement, hôpital Trousseau-La Roche Guyon, 95780 La Roche-Guyon, France
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Bodoria M, Gautheron V, Bérard E, Desguerre I, Toullet P, De La Cruz J, Brochard S. Unmet needs and expectations about motor rehabilitation reported by children, youth and adults with cerebral palsy and their families: A national survey in France, 2016–2017. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schreiber-Bontemps A, Brochard S, Fontaine-Carbonnel S, Chabrier S, Gautheron V, Peudenier S, Rippert P, Rauscent H, Rivier F, Andoni Urtizberea J, Fournier-Mehouas M, Mahé J, Tiffreau V, Lagrue E, Hamroun D, Poirot I, Ragot-Mandry S, Sacconi S, Puy Haubert B, Fafin C, Vuillerot C. Promoting the use of Motor Function Measure (MFM) as outcome measure in patients with Duchenne Muscular Dystrophy (DMD) treated by corticosteroids. Ann Phys Rehabil Med 2015. [DOI: 10.1016/j.rehab.2015.07.331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Darteyre S, Renaud C, Vuillerot C, Presles E, Kossorotoff M, Dinomais M, Lazaro L, Gautheron V, Chabrier S. Quality of life and functional outcome in early school-aged children after neonatal stroke: a prospective cohort study. Eur J Paediatr Neurol 2014; 18:347-53. [PMID: 24503061 DOI: 10.1016/j.ejpn.2014.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 01/09/2014] [Accepted: 01/19/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Quality of life (QoL) is recognized internationally as an efficient tool for evaluating health interventions. To our knowledge, QoL has not been specifically assessed in children after neonatal arterial ischemic stroke (AIS). AIM To study the QoL of early school-aged children who suffered from neonatal AIS, and QoL correlation to functional outcome. METHOD We conducted a multicenter prospective cohort study as part of a larger study in full-term newborns with symptomatic AIS. Participating families were sent anonymous QoL questionnaires (QUALIN). Functional outcome was measured using the Wee-FIM scale. Healthy controls in the same age range were recruited in public schools. Their primary caregivers filled in the QUALIN questionnaires anonymously. We used Student's t-test and a rank test to compare patients and controls' QoL and functional outcomes. RESULTS 84 children with neonatal AIS were included. The control group was composed of 74 children, of which ten were later excluded due to chronic conditions. Mean ages and QUALIN median scores did not differ between patients and controls. Median Wee-FIM scores were lower in hemiplegic children than in non-hemiplegic ones (p < 0.001). QoL scores did not seem correlated to functional outcome. INTERPRETATION Those results could support the presence of a "disability paradox" in young children following neonatal AIS.
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Affiliation(s)
- S Darteyre
- CHU Saint-Etienne, Médecine physique et réadaptation pédiatrique, F-42055 Saint-Etienne, France; Université de Saint-Etienne, Groupe de recherche sur la thrombose EA3065, Saint-Etienne F-42023, France.
| | - C Renaud
- Inserm, CIC1408, F-42055 Saint-Etienne, France
| | - C Vuillerot
- CHU Lyon, l'Escale, Médecine physique et réadaptation pédiatrique, F-69677 Bron, France
| | - E Presles
- Université de Saint-Etienne, Groupe de recherche sur la thrombose EA3065, Saint-Etienne F-42023, France; Inserm, CIC1408, F-42055 Saint-Etienne, France
| | - M Kossorotoff
- APHP, Hôpital Necker-Enfants malades, Service de neuropédiatrie et maladies métaboliques, F-75015 Paris, France
| | - M Dinomais
- LUNAM, Université d'Angers, CHU Angers, Département de médecine physique et réadaptation, F-49933, France
| | - L Lazaro
- CH Côte-Basque, Service de pédiatrie, Bayonne F-64109, France
| | - V Gautheron
- CHU Saint-Etienne, Médecine physique et réadaptation pédiatrique, F-42055 Saint-Etienne, France
| | - S Chabrier
- CHU Saint-Etienne, Médecine physique et réadaptation pédiatrique, F-42055 Saint-Etienne, France; Université de Saint-Etienne, Groupe de recherche sur la thrombose EA3065, Saint-Etienne F-42023, France; Inserm, CIC1408, F-42055 Saint-Etienne, France
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Mietton C, Gautheron V, Poirot I, Nuti C, Dohin B, Fernandez B. Utilisation de la pompe à baclofène dans la paralysie cérébrale de l’enfant : enquête nationale de pratique. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.1299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mietton C, Gautheron V, Poirot I, Nuti C, Dohin B, Fernandez B. Utilisation de la pompe à baclofène dans la paralysie cérébrale de l’enfant : enquête nationale de pratique 2. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.1414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mietton C, Gautheron V, Poirot I, Nuti C, Dohin B, Fernandez B. Use of baclofen pump in the cerebral palsy of child: National survey of practice 2. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.1394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mietton C, Gautheron V, Poirot I, Nuti C, Dohin B, Fernandez B. Use of baclofen pump in the cerebral palsy of child: National survey of practice. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.1241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mietton C, Gautheron V, Dohin B, Nuti C, Fernandez B, Poirot I. Utilisation de la pompe à baclofène dans la paralysie cérébrale de l’enfant : enquête nationale de pratique. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.1024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mietton C, Gautheron V, Dohin B, Nuti C, Fernandez B, Poirot I. Use of baclofen pump in the cerebral palsy of child: National survey of practice. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bensoussan L, Viton JM, Lotito G, Calmels P, Pellas F, Gautheron V, Pelissier J, Delarque A. Effet sur le contrôle postural du traitement par toxine botulique du pied varus équin spastique chez des patients post-AVC : essai randomisé, contrôlé, multicentrique. Neurophysiol Clin 2012. [DOI: 10.1016/j.neucli.2012.09.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Roren A, Roby-Brami A, Fayad F, Gautheron V, Poiraudeau S, Revel M, Lefèvre-Colau M. Modified 3D scapular kinematic patterns for two activities of daily living in painful shoulders with restricted mobility: A comparison with contralateral unaffected shoulders. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Roren A, Roby-Brami A, Fayad F, Gautheron V, Poiraudeau S, Revel M, Lefèvre-Colau M. Modification de la cinématique scapulaire des épaules raides et douloureuses lors de deux gestes de la vie quotidienne : comparaison avec le membre controlatéral sain. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bensoussan L, Lotito G, Viton JM, Pellas F, Pelissier J, Calmels P, Gautheron V, Delarque A. Effet sur le contrôle postural du traitement par toxine botulique du pied varus équin spastique chez des patients post-AVC : essai randomisé, contrôlé, multicentrique. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bensoussan L, Lotito G, Viton JM, Pellas F, Pelissier J, Calmels P, Gautheron V, Delarque A. Effect on postural control of spastic equinovarus foot treatment with botulinum toxin in stroke patients: Randomized, controlled, multicenter trial. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Anselmetti A, D’anjou M, Leone C, Gautheron V. Prise en charge de l’achondroplasie en MPR : à propos de 3 cas. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Anselmetti A, D’anjou M, Leone C, Gautheron V. Achondroplasia in physical medicine and rehabilitation: A case report. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Anselmetti A, Perrin L, Bayle B, Gautheron M, Gautheron V. Traitement par traction d’une fracture diaphysaire humérale, dans les suites de l’exérèse chirurgicale d’un ostéochondrome, chez un enfant en état pauci relationnel. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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De Lattre C, Gautheron V, Tiffreau V, Yelnik A. Transition to adulthood for children with motor disability: Results of the 2010 public SOFMER'S conference. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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De Lattre C, Gautheron V, Tiffreau V, Yelnik A. Transition du jeune en situation de handicap moteur : de la pédiatrie au monde des adultes, enjeux sanitaires et médico-sociaux. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Marcucci A, Edouard P, Loustalet E, d'Anjou MC, Gautheron V, Degache F. Efficiency of flexible derotator in walking cerebral palsy children. Ann Phys Rehabil Med 2011; 54:337-47. [PMID: 21868301 DOI: 10.1016/j.rehab.2011.07.960] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 07/23/2011] [Accepted: 07/25/2011] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The flexible derotator is one of the therapeutic resources used to combat primary and secondary abnormalities in walking cerebral palsy children. It was developed to reduce abnormal femoral and tibial torsions and lessen the latter's negative functional impact. OBJECTIVE To determine the effect of wearing a flexible derotator on anatomic and functional parameters in walking cerebral palsy children. METHODS We performed a retrospective study of walking cerebral palsy children by gathering data on bone-related parameters (femoral and tibial torsion) and functional parameters (distance and speed gait, and the energy expenditure index (EEI)). Fifteen walking cerebral palsy children were treated with the flexible derotator for one year and 15 untreated walking cerebral palsy children were included as controls. The two groups were compared in terms of the various parameters' change over time between the initial examination (the last examination prior to the start of the study or prior to use of the flexible derotator) and the final examination (after one year of follow-up). RESULTS Right femoral anteversion and right and left external tibial torsion improved. There was a significant increase in distance and speed gait and a decrease in the EEI in walking cerebral palsy children. CONCLUSION Our retrospective study revealed a significant improvement in functional parameters in children with cerebral palsy, as a result of wearing the flexible derotator for at least 6 hours a day for a year. Bone parameters only improved slightly. Use of the flexible derotator could improve these children's quality of life.
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Affiliation(s)
- A Marcucci
- Service de médecine physique et de réadaptation, hôpital de Bellevue, CHU de Saint-Étienne, France.
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Casalonga A, Bourelle S, Chalencon F, De Oliviera L, Gautheron V, Cottalorda J. Tibial intercondylar eminence fractures in children: The long-term perspective. Orthop Traumatol Surg Res 2010; 96:525-30. [PMID: 20541992 DOI: 10.1016/j.otsr.2010.01.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2009] [Revised: 11/07/2009] [Accepted: 01/19/2010] [Indexed: 02/02/2023]
Abstract
PURPOSE OF THE STUDY To analyze objective and subjective results on medium-term follow-up of intercondylar fractures of the tibia in children. MATERIAL AND METHODS A retrospective, single-center study of 32 fractures (17 boys, 14 girls) was performed. Fractures were itemized on the Meyers and McKeever classification as modified by Zaricznyj: there were eight type-I, 17 type-II, five type-III and two type-IV fractures. Treatment was conservative for type-I and II fractures (with mild displacement) and for the others surgical. Seven patients were lost to follow-up and one had insufficient follow-up for inclusion. Thirteen patients were assessed on a KT 1000 arthrometer and a dynamometer, and on the IKDC and ARPEGE scoring systems. Ten patients chose to answer only the subjective IKDC questionnaire, by mail. RESULTS The mean IKDC score of subjects answering by mail was 91 and of those with clinical examination was 80. Mean ARPEGE score was 8.3. Subjective IKDC score classified four patients as A, four as B, four as C and one as D. Mean difference in tibial anterior translation between affected and unaffected knees was 0.88mm for type I fractures, 0.82mm for type II and 0.30mm for types III and IV together. DISCUSSION The mean difference in tibial anterior translation between affected and unaffected knees was greater in patients with conservative treatment (0.96mm for conservative vs. 0.29mm for surgical treatment). Seventy per cent of patients reported pain at follow-up. Only two had pathological knee laxity. Twelve out of thirteen had returned to sport activity, half of them at the same level as before injury. CONCLUSION The cases treated surgically had a better objective result than those treated conservatively. Nevertheless there was no correlation between subjective evaluation and degree of knee laxity. Overall, intercondylar fractures of the tibial eminence in children have good long-term prognosis, at least subjectively. This study shows that, in spite of a very satisfactory subjective result for most patients, results were not so good on objective measures. LEVEL OF EVIDENCE Level IV: retrospective study.
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Affiliation(s)
- A Casalonga
- Children's Surgery Department, Northern Hospital, 2055 Saint-Étienne cedex 2, France
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Gautheron V, Edouard P, Bayle B, d'Anjou MC, Tardieu D, Chabrier S, Cottalorda J, Dohin B. [Importance of relay between hospitalization in surgery department and return to home in severely handicapped children]. Arch Pediatr 2010; 17:640-1. [PMID: 20654819 DOI: 10.1016/s0929-693x(10)70037-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- V Gautheron
- Laboratoire de Physiologie de l'Exercice, Service de Médecine Physique et deRéadaptation, Hôpital Bellevue, CHU de Saint-Etienne, EA 4338, IFR 25, Université Jean-Monnet, Saint-Etienne.
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Degache F, Perrier M, Bayle B, D’Anjou MC, Gautheron V. Étude des relations entre le score de Gillette et la vitesse de marche chez les enfants paralysés cérébraux. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.motcer.2009.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Heitz S, Gautheron V, Lutz Y, Rodeau JL, Zanjani HS, Sugihara I, Bombarde G, Richard F, Fuchs JP, Vogel MW, Mariani J, Bailly Y. BCL-2 counteracts Doppel-induced apoptosis of prion-protein-deficient Purkinje cells in the Ngsk Prnp(0/0) mouse. Dev Neurobiol 2008; 68:332-48. [PMID: 18085563 DOI: 10.1002/dneu.20555] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The pro-apoptotic factor BAX has recently been shown to contribute to Purkinje cell (PC) apoptosis induced by the neurotoxic prion-like protein Doppel (Dpl) in the prion-protein-deficient Ngsk Prnp(0/0) (NP(0/0)) mouse. In view of cellular prion protein (PrP(c)) ability to counteract Dpl neurotoxicity and favor neuronal survival like BCL-2, we investigated the effects of the anti-apoptotic factor BCL-2 on Dpl neurotoxicity by studying the progression of PC death in aging NP(0/0)-Hu-bcl-2 double mutant mice overexpressing human BCL-2 (Hu-bcl-2). Quantitative analysis showed that significantly more PCs survived in NP(0/0)-Hu-bcl-2 double mutants compared with the NP(0/0) mutants. However, number of PCs remained inferior to wild-type levels and to the increased number of PCs observed in Hu-bcl-2 mutants. In the NP(0/0) mutants, Dpl-induced PC death occurred preferentially in the aldolase C-negative parasagittal compartments of the cerebellar cortex. Activation of glial cells exclusively in these compartments, which was abolished by the expression of Hu-bcl-2 in the double mutants, suggested that chronic inflammation is an indirect consequence of Dpl-induced PC death. This partial rescue of NP(0/0) PCs by Hu-bcl-2 expression was similar to that observed in NP(0/0):Bax(-/-) double mutants with bax deletion. Taken together, these data strongly support the involvement of BCL-2 family-dependent apoptotic pathways in Dpl neurotoxicity. The capacity of BCL-2 to compensate PrP(c) deficiency by rescuing PCs from Dpl-induced death suggests that the BCL-2-like property of PrP(c) may impair Dpl-like neurotoxic pathways in wild-type neurons.
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Affiliation(s)
- S Heitz
- Département Neurotransmission et Sécrétion Neuroendocrine, UMR7168-LC2 CNRS, France.
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Fayad F, Roby-Brami A, Gautheron V, Lefevre-Colau MM, Hanneton S, Fermanian J, Poiraudeau S, Revel M. Relationship of glenohumeral elevation and 3-dimensional scapular kinematics with disability in patients with shoulder disorders. J Rehabil Med 2008; 40:456-60. [DOI: 10.2340/16501977-0199] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Edouard P, Gautheron V, D'Anjou MC, Pupier L, Devillard X. Training programs for children: literature review. ACTA ACUST UNITED AC 2007; 50:510-9, 499-509. [PMID: 17532521 DOI: 10.1016/j.annrmp.2007.04.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 04/16/2007] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Training programs are increasingly being prescribed for occupational therapy for adults affected by chronic illness and/or handicap, but their use is more recent for children and teenagers. OBJECTIVE A review of the literature to synthesize information concerning training programs for children, whether healthy or with disease or handicap, considering the target population, methodology, the results and limitations. METHODS We searched the Medline database with use of the key words retraining, training, training programs, physical activity, physical training, fitness program, sport, children, disability, and handicap. We also searched references of the selected articles for appropriate studies. DISCUSSION/CONCLUSION Physical activity seems to be a good means of primary preventing adverse health in the healthy child and secondary prevention in children with chronic disease or handicap. Thus, training programs could be adapted and integrated into the global treatment of sick or handicapped children in the health care situation or in the home. These programs are feasible and do not undermine children's health, but few studies have shown clear data on the methods of the programs. The suggested training programs, not always validated, included two to five sessions from 30 to 60 min/week, for 6-16 weeks, of variable activity and intensity, adapted to the condition and the objectives of therapy. Training programs adapted to children should be validated to allow their accessibility by health care professionals dealing with children with chronic disease and/or handicap.
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Affiliation(s)
- P Edouard
- Service médecine physique et réadaptation, unité PPEH EA 3062, faculté de médecine Jacques-Lisfranc, université Jean-Monnet, CHU de Saint-Etienne, hôpital Bellevue, 42055 Saint-Etienne cedex 02, France.
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Heitz S, Lutz Y, Rodeau JL, Zanjani H, Gautheron V, Bombarde G, Richard F, Fuchs JP, Vogel MW, Mariani J, Bailly Y. BAX contributes to Doppel-induced apoptosis of prion-protein-deficient Purkinje cells. Dev Neurobiol 2007; 67:670-86. [PMID: 17443816 DOI: 10.1002/dneu.20366] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Research efforts to deduce the function of the prion protein (PrPc) in knock-out mouse mutants have revealed that large deletions in the PrPc genome result in the ectopic neuronal expression of the prion-like protein Doppel (Dpl). In our analysis of one such line of mutant mice, Ngsk Prnp0/0 (NP0/0), we demonstrate that the ectopic expression of Dpl in brain neurons induces significant levels of cerebellar Purkinje cell (PC) death as early as six months after birth. To investigate the involvement of the mitochondrial proapoptotic factor BAX in the Dpl-induced apoptosis of PCs, we have analyzed the progression of PC death in aging NP0/0:Bax-/- double knockout mutants. Quantitative analysis of cell numbers showed that significantly more PCs survived in NP0/0:Bax-/- double mutants than in the NP0/0:Bax+/+ mutants. However, PC numbers were not restored to wildtype levels or to the increased number of PCs observed in Bax-/- mutants. The partial rescue of NP0/0 PCs suggests that the ectopic expression of Dpl induces both BAX-dependent and BAX-independent pathways of cell death. The activation of glial cells that is shown to be associated topographically with Dpl-induced PC death in the NP0/0:Bax+/+ mutants is abolished by the loss of Bax expression in the double mutant mice, suggesting that chronic inflammation is an indirect consequence of Dpl-induced PC death.
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Affiliation(s)
- S Heitz
- Département Neurotransmission et Sécrétion Neuroendocrine, Institut des Neurosciences Cellulaires et Intégratives (UMR7168-LC2), CNRS/Université Louis Pasteur, IFR 37 des Neurosciences de Strasbourg, and APHP, Hôpital Charles Foix, Ivry/Seine, France
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Diop M, Rahmani A, Belli A, Gautheron V, Geyssant A, Cottalorda J. Influence of Speed Variation and Age on Ground Reaction Forces and Stride Parameters of Children's Normal Gait. Int J Sports Med 2005; 26:682-7. [PMID: 16158375 DOI: 10.1055/s-2004-830382] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this study was to assess the influence of both age and speed on ground reaction forces and temporal parameters during normal gait in children. Fifteen children aged 4-6 years (group 1), 16 aged 6-8 years (group 2), and 16 aged 8-10 years (group 3) walked at 2.7 km/h, 3.6 km/h, and 4.5 km/h on a treadmill. For each child thirty successive steps were recorded. The influence of speed and age on normalized gait parameters was examined with two-way analysis of variance. The first vertical peak force (Fz1) and all the antero-posterior forces of group 1 were higher than those of the other groups for the three speeds. The minimum vertical force (Fz2), the second vertical peak force (Fz3), and the duration of stride and stance were significantly higher in groups 2 and 3. For all the groups, Fz1 and all the antero-posterior forces increased with the speed while Fz2, stride, stance, and double-stance duration decreased. Fz3 was not influenced by speed variation. The results of this study show that age and walking speed influence ground reaction forces and stride time parameters in 4- to 10-year-old children.
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Affiliation(s)
- M Diop
- Physiology Department - GIP Exercice Sport Santé, University School of Medicine, Saint-Etienne, France
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Calmels P, Degache F, Fayolle-Minon I, Condemine A, Courbon A, Ramas J, Richard R, Roche F, Degache A, Girardin N, Gautheron V, Devillard X. [Hemiplegia and a hiking tour of Mont Blanc: from hope to reality]. Ann Readapt Med Phys 2005; 48:180-6. [PMID: 15848260 DOI: 10.1016/j.annrmp.2004.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2004] [Accepted: 10/26/2004] [Indexed: 05/02/2023]
Abstract
INTRODUCTION At the end of an endurance training program for stroke patients with hemiplegia, we offered a hiking tour around the Mont Blanc Pedestrian Tour. We found no publication describing a similar experience and no scientific data in the literature to determine the physiological characteristics required for this performance, particularly regarding cardiac and vascular capacities, level of impairment, and functional abilities. OBJECTIVE To complete a part of the Mont Blanc Pedestrian Tour over six days, with a group of adults with hemiparesis and aphasia due to stroke. POPULATION Seven of 20 subjects with right hemiparesis and aphasia were selected on the basis of results of physiological tests, after an endurance training program and two tests hikes at medium altitude. Mean age was 51.71 +/- 7.13 years, mean VO(2max) 19.76 +/- 3.46 ml.g(-1).mm(-1), mean P(max) 90 +/- 22.68 and mean walking speed 3.60 +/- 1.30 km/hour. ORGANIZATION Organization involved setting up the itinerary, recruiting accompanying personnel (9 people), and arranging security. No specific adaptations for accessibility were available, and no specific equipment was used, except for standard walking sticks. RESULTS During this pedestrian tour, the subjects demonstrated strong motivation, as well as exceptional physical and functional performance, despite significant changes in elevation (up to 1500 m per day) and long walking times (from 5 to 9 hours per day). DISCUSSION This experience has enriched our reflection about the medical, functional, and psychological conditions required for this type of physical effort, both from patients and accompanying personnel. In the absence of reports on similar experiences with this patient population, we thought it interesting, six months after this challenge, to present our observations as well as the patients' point of view. This may encourage other rehabilitation teams to offer intensive walking activities for stroke patients.
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Affiliation(s)
- P Calmels
- Service de médecine physique et de réadaptation, centre hospitalier universitaire de Saint-Etienne, France.
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Abstract
STUDY DESIGN Single-subject case (a quadriplegic female, 56 years). OBJECTIVES To describe a new case of eosinophilic pleural effusion induced by dantrolene chronic administration. SETTING Physical medicine and rehabilitation unit in a teaching hospital, France. METHODS Diagnosis of an eosinophilic pleural effusion induced by dantrolene without any respiratory symptoms, except a decrease of breath sounds on the right lung base. RESULTS Chest radiograph revealed a right-sided pleural effusion, and blood cell count a significant peripheral eosinophilia. Thoracenthesis contained 85% of eosinophils. The other explorations eliminated other causes of pleural effusion. The diagnosis of drug-induced effusion was almost sure and led us to discontinue the dantrolene. After 3 months, she had completely recovered. These characteristics, similar to the eight other cases described in the literature, are essential for the diagnosis of pleural effusion induced by dantrolene. CONCLUSION Dantrolene, a long-acting skeletal muscle relaxant, is well known to induce liver side effects but it can also induce pleural pericarditis. The pathogenesis is still not clearly identified, but similarities of chemical structures of dantrolene and nitrofurantoine make us think that it could be the same mechanism. The association between dantrolene and nitrofurantoine may have contributed to the expression of the pleural effusion.
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Affiliation(s)
- B Lê-Quang
- 1Service de Médecine Physique et de Réadaptation, Hôpital Bellevue, CHU de Saint-Etienne, Saint-Etienne, France
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Abstract
Of 23 children (35 feet) with cerebral palsy who had undergone a Grice extra-articular subtalar arthrodesis for a valgus hindfoot between 1976 and 1981, we reviewed 17 (26 feet), at a mean of 20 years (17 years 3 months to 22 years 4 months) after operation. Seven were quadriplegic, eight spastic diplegic, and two hemiplegic. They were all able to walk at the time of operation. Thirteen patients (20 feet) were pleased with the Grice procedure, 13 had no pain and 15 (23 feet) were still able to walk. The clinical results were satisfactory for most feet. Radiography showed that the results had been maintained over time but 14 feet developed a mean ankle valgus of 11° (6 to 18) with a compensatory hindfoot varus in 12 feet. No deformity of the talus or arthritis of adjacent joints was noted. The Grice procedure gives good long-term results in children with cerebral palsy.
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Affiliation(s)
- S Bourelle
- Medical School of Medicine, Saint-Etienne, France
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Elmhandi L, Féasson L, Camdessanche JP, Calmels P, Gautheron V. Évaluation isocinétique de la force musculaire de patients atteints de polyradiculonévrite aiguë. ACTA ACUST UNITED AC 2004; 47:209-16. [PMID: 15183258 DOI: 10.1016/j.annrmp.2004.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2003] [Accepted: 02/16/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the feasibility and the interest of isokinetic measures tests in subjects with inflammatory demyelinating polyradiculoneuropathy or Guillain-Barré syndromes (GBS). METHODS Nine patients with GBS are tested at the beginning and after 6 months of recovery stage. They benefit from (1) isokinetic assessment of muscular strength of knee, elbow, ankle: flexion/extension and shoulder abduction/adduction ranging 30 per s at 180 per s angular velocity; (2) isometric assessment of the same muscular groups; (3) manual muscle testing; (4) functional independence measure. RESULTS Isokinetic tests were tolerated at 60 and 120 per s. Fatigability appears since the third second of isometric test. The relationships between isokinetic, manual tests and isometric tests are variables (0.29 < r < 0.97). The evaluation after 6 months of recovery showed a good sensibility of isokinetic test. CONCLUSION The continuation of this motor isokinetic evaluation, in a large population, will permit to establish longitudinal and evolutive profile of each patient and will facilitate to chose the rehabilitation program.
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Affiliation(s)
- L Elmhandi
- Service de médecine physique et de réadaptation, unité PPEH-GIP E2S EA 3062, faculté de médecine Jacques-Lisfranc, CHU de Saint-Etienne, hôpital Bellevue, université Jean-Monnet, 42055 Saint-Etienne 02, France.
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Abstract
Back pain has become a real public health concern both for adults and children. In general, patients complain of moderate pain. While the topic was long ignored by the scientific community, the number of publications has increased over the last three Years. We reviewed the literature to separate real evidence from speculations. Recognized risk factors for spinal pain are: female gender, poor general status, family history of back pain, particular psychological patterns, time spent sitting watching television, history of spinal trauma, intense physical activity, practicing competition sports, and age (more frequent in adolescents than children). Several recent papers have drawn attention to the role of the weight of the school backpack in children, particularly when its weight exceeds 20% of the child's body weight. Many children carry heavy backpacks which for some may weigh 30% to 40% of their body weight. Several groups have estimated that the maximum should be 10% of the body weight. It appears that time spent carrying the backpack as well as its weight is an important factor favoring back pain. Backpacks can injury the head or face, as well as the hands, the elbow, the wrist, the shoulder, the foot and the ankle. Back trauma is observed as the sixth most common injury. The 'weak point' is the shoulder and not the back. A poorly positioned backpack can modify posture and gait. Carrying the backpack with two shoulder straps affects posture and gait less than carrying it on one shoulder. The posture of the spine changes when the weight of the backpack increases. This is probably one of the reasons why many parents who consult believe that there is a relationship between the weight of the backpack and scoliosis or kyphosis, observed in many of their children. It is proven that adolescents who suffer from back pain will probably have chronic back pain as adults, but there is not evidence to our knowledge demonstrating a relationship between the development of spinal deviation and the weight of the backpack. Recent studies have been conducted to design backpacks allowing a better weight distribution and comfort. This type of backpack appears to have a limited benefit. Furthermore, the question of mode must not be ignored for children and adolescents. Backpacks with one sack in front and one in back certainly provide better weight distribution but are they acceptable for children and adolescents?
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Affiliation(s)
- J Cottalorda
- Equipe d'accueil EA E2S 3062, Laboratoire de Physiologie et Physiopathologie de l'Exercice et du Handicap, Saint-Etienne.
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Diop M, Rahmani A, Calmels P, Gautheron V, Belli A, Geyssant A, Cottalorda J. Influence de la vitesse et de l’âge sur la variabilité intrasujet des forces de réaction et des paramètres spatiotemporels de la marche de l’enfant sain. ACTA ACUST UNITED AC 2004; 47:72-80. [PMID: 15013601 DOI: 10.1016/j.annrmp.2003.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2003] [Accepted: 09/18/2003] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the effect of age and speed on the variability of ground reaction forces (GRF) and stride parameters of gait in normal children. MATERIAL AND METHOD Forty-seven children aged 4-10 years were split into three age groups. Each child walked at three constant speeds on a treadmill. Thirty consecutive steps of each leg were recorded. For each child, the mean parameters of the 30 steps were calculated. The mean parameter of each child was taken to calculate the mean parameters of the group. The variability was evaluated by the coefficient of variation (CV). The influence of both age and speed on the variability was examined with a to-way analysis of variance. RESULTS The cross effect of age and speed on the variability was not significant. The variability of the parameters decreased significantly with age between 4 and 8 years. The variability of vertical forces increased significantly with speed (between 2.7 and 4.5 km/h), while the variability of antero-posterior forces, the stride and the stance decreased between 2.7 and 3.6 km/h. However, the variability of double stance was not influenced by walking speed between 2.7 and 4.5 km/h. Except the time of production of the vertical force of propulsion (Tz3), the variability of temporal vertical parameters decreased significantly with speed between 2.7 and 4.5 km/h and the variability of temporal antero-posterior parameters decreased significantly between 2.7 and 3.6 km/h. DISCUSSION-CONCLUSION The variability of the GRF and spatio-temporal parameters in children was influenced by age between 4 and 8 years old and by speed between 2.7 and 3.6 km/h. Moreover, the effect of age on the GRF persists up to 8 years. The variabilities of the time of production of the antero-posterior force of propulsion (Ty2) and stance duration were lower than the variabilities of the others parameters. These two variables could be the most reliable parameters when assessing gait in children aged 4-10 years, walking at speeds between 2.7 and 4.5 km/h.
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Affiliation(s)
- M Diop
- Equipe d'accueil EA E2S 3062, laboratoire de physiologie et physiopathologie de l'exercice et du handicap, Saint-Etienne, France
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Richard P, Calmels P, Fayolle-Minon I, Giraux P, Baptiste S, Gautheron V. [Prevention of thromboembolic risk in spinal cord injury: results of a questionnaire concerning short- and long-term treatment]. Ann Readapt Med Phys 2002; 45:224-31. [PMID: 12020990 DOI: 10.1016/s0168-6054(02)00206-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The use of medications to prevent thromboembolic risk is recommended in spinal cord injury patients during the early phase, but there is no consensus on treatment duration and modalities. Differences in practice include choice of medication (heparin, low molecular weight heparin, inhibitors of platelet aggregation), treatment duration (three to six months or more), and criteria for discontinuation of treatment. GOALS To determine usual practice modalities for prophylaxis of deep vein thrombosis in spinal cord injury patients, and to identify determinant criteria. METHODS Postal survey of physiatrists taking care of spinal cord injury patients. The questionnaire asks the physician about his usual practice modalities (choice of treatments, paraclinical tests, use of compressive stockings, during and after the first six months and criteria for discontinuation of treatments). RESULTS Forty-two questionnaires were suitable for analysis. Results show that usual practice modalities combine venous doppler testing only in the setting of suggestive clinical signs, treatment with low molecular weight heparin during three to six months, and combination with compressive stockings. DISCUSSION Despite the absence of consensus on this question, our results are consistent with data from the literature, which identify acute spinal cord lesions as a factor of high risk for deep vein thrombosis. The risk decreases during the chronic phase. Adjuvant techniques include mobilisation, elastic compression, and standing. A study of long-term treatment modalities after deep vein thrombosis would be needed.
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Affiliation(s)
- P Richard
- Service de médecine physique et réadaptation et GIP exercice-sport-santé, université Jean Monnet, CHU, 42055, Saint-Etienne, France
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Devillard X, Calmels P, Sauvignet B, Belli A, Denis C, Simard C, Gautheron V. Validation of a new ergometer adapted to all types of manual wheelchair. Eur J Appl Physiol 2001; 85:479-85. [PMID: 11606018 DOI: 10.1007/s004210100407] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Research concerning the physiological and biomechanical parameters of wheelchair propulsion requires the use of an accurate and reproducible protocol. Although some research comparing different ergometers has been conducted, it is not easy to fulfil the requirements of the realistic simulation of propulsion together with the careful analysis of metabolic and biomechanical parameters of performance. The VP100H ergometer has been validated for this purpose by comparing the values of power output (W) and force exerted to accelerate the wheels (F) with the same measures obtained using a two-dimensional force transducer (platform). The reproducibility of the power was verified during a test re-test procedure. Ten sportsmen performed an incremental exercise. Maximal aerobic power (Waer,max), maximum oxygen uptake (VO2max), maximum heart rate (fcmax), % Waer,max/%VO2max relationship (aV) and %Waer,max/%fcmax relationship (aH) were calculated. Results indicated no significant differences (P > 0.05) in VP100H versus platform measurements for F and W. Errors of measured Fand W ranged from 0.89% to 7.56% and from 0.41% to 6.74%, respectively, depending upon the trunk muscles that participate in the propulsion. This corresponded to a maximum error of 4.9 W for W. No significant differences (P > 0.05) were observed during the test re-test procedure for Waer,max, VO2max, fcmax, aH and aV. The coefficient of variation of these values ranged from 1.4 to 9.5, and the correlation coefficient from 0.68 to 0.98. We conclude that the VP100H is valid for measuring W, and F, and that these values are reproducible (when tested 10 days later).
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Affiliation(s)
- X Devillard
- Département de Médecine Physique et Réadaptation-GIP Exercise, CHU de Saint Etienne, Hĵpital de Bellevue, France.
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Gautheron V. [Urination disorders and neurological disease except for o obvious medullary pathology: perinatal brain lesions with mental handicap]. Arch Pediatr 2000; 4 Suppl 1:37s-40s. [PMID: 9181009 DOI: 10.1016/s0929-693x(97)86441-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Children with mental retardation often present urinary incontinence because they are unable to control micturition. Constipation and/or encopresis are often associated. Careful assessment of the upper urinary tract and renal function is indicated. Urinary infections are frequent, however, bladder dysfunction complications of the upper urinary tract are uncommon. The cause of wetting could be explained by urodynamic findings: small capacity bladder with uninhibited contractions, hypertonic sphincter, or incomplete emptying secondary to detrusor-sphincter dyssynergia. Treatment of urinary incontinence should be adapted to the type of incontinence and be apart of the global training.
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Affiliation(s)
- V Gautheron
- Service de médecine physique et de réadaptation, hôpital Bellevue, Saint-Etienne, France
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Cottalorda J, Bourelle S, Gautheron V, Metton G, Charmet E. Place de la chirurgie dans la prise en charge des hanches spastiques chez l'enfant infirme moteur cérébral. ACTA ACUST UNITED AC 2000. [DOI: 10.1016/s0168-6054(00)88990-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cottalorda J, Gautheron V, Metton G, Charmet E, Chavrier Y. Toe-walking in children younger than six years with cerebral palsy. The contribution of serial corrective casts. J Bone Joint Surg Br 2000; 82:541-4. [PMID: 10855878 DOI: 10.1302/0301-620x.82b4.10188] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Our aim in this retrospective study was to analyse the value of serial corrective casts in the management of toe-walking in children aged less than six years with cerebral palsy. A total of 20 children (10 hemiplegic and 10 diplegic) had elongation of the triceps surae by serial casting at a mean age of four years and one month. The mean passive dorsiflexion of the foot with the knee in extension was 3 degrees (-10 to +5) and 12 degrees (0 to +15) with the knee in flexion. After removal of the cast passive dorsiflexion was 20 degrees (+10 to +30) with the knee in extension, and 28 (+10 to +35) with the knee in flexion. At a mean follow-up of 3.08 years (2.08 to 4.92), passive dorsiflexion was 9 degrees (-10 to +20) with the knee in extension and 18 degrees (0 to +30) with the knee in flexion. Serial corrective casts are useful for the treatment of equinus in young children as the procedure is simple and the results are at least equal to those of other non-operative techniques. It is a safe alternative to surgical procedures especially in young children. If the equinus recurs operation can be undertaken on a tendon which is not scarred.
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Affiliation(s)
- J Cottalorda
- Orthopaedic Paediatric Surgery Department, University of Medicine, Saint-Etienne, France
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Abstract
Our aim in this retrospective study was to analyse the value of serial corrective casts in the management of toe-walking in children aged less than six years with cerebral palsy. A total of 20 children (10 hemiplegic and 10 diplegic) had elongation of the triceps surae by serial casting at a mean age of four years and one month. The mean passive dorsiflexion of the foot with the knee in extension was 3° (−10 to +5) and 12° (0 to +15) with the knee in flexion. After removal of the cast passive dorsiflexion was 20° (+10 to +30) with the knee in extension, and 28° (+10 to +35) with the knee in flexion. At a mean follow-up of 3.08 years (2.08 to 4.92), passive dorsiflexion was 9° (−10 to +20) with the knee in extension and 18° (0 to +30) with the knee in flexion. Serial corrective casts are useful for the treatment of equinus in young children as the procedure is simple and the results are at least equal to those of other non-operative techniques. It is a safe alternative to surgical procedures especially in young children. If the equinus recurs operation can be undertaken on a tendon which is not scarred.
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Affiliation(s)
| | - V. Gautheron
- Physical Medecine and Rehabilitation Department, University of Medicine, Saint-Étienne, France
| | - G. Metton
- Physical Medecine and Rehabilitation Department, University of Medicine, Saint-Étienne, France
| | - E. Charmet
- Physical Medecine and Rehabilitation Department, University of Medicine, Saint-Étienne, France
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Cottalorda J, Durst C, Aubail R, Belli A, Gautheron V, Geyssant A. Consommation énergétique à la vitesse de confort au sol et sur tapis roulant. ACTA ACUST UNITED AC 2000. [DOI: 10.1016/s0168-6054(00)87939-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Cottalorda J, Ebermeyer E, Bui P, Reijnen JA, Gautheron V, Geyssant A. [Gait analysis of 57 healthy children by measurement of ground reaction forces on an Adal treadmill]. Rev Chir Orthop Reparatrice Appar Mot 1999; 85:146-55. [PMID: 10392415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
PURPOSE OF THE STUDY The purpose of this study was to present a new treadmill proposed for evaluating gait in children. We analysed differences in ground reaction forces between boys and girls, and we calculated the symmetry index in healthy children. MATERIAL AND METHOD Time and ground reaction forces of about 30 steps were measured using a new treadmill. The apparatus consists of 2 walking belts which function as two independent treadmills placed side by side, separated by 4 mm. The 2 treadmills were mechanically separated in order to allow independent measurement of the ground reaction forces induced by each lower limb during stance phase. The children (28 boys and 29 girls), all clinically healthy, were divided into three groups according to their height (between 105 and 150 cm). They walked at three different velocities (2.7 km/h, 3.6 km/h and 4.5 km/h according to their height). The graphs representing the subject's measurements were composed of fore-aft, medial-lateral, and vertical parameters. The analysis of these graphs considered stride, stance, double stance and nine specific points. We also calculated the symmetry index of each child. RESULTS We determined the values of the symmetry index in healthy children. We did not find any significant difference in gait between girls and boys, except for Fz3 at 2.7 kg/h, where Fz3 was higher in girls than in boys. DISCUSSION We compared our results with those reported in the literature and found that ADAL has a very important advantage in gait analysis in children because it is simple and easily accepted by children.
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Affiliation(s)
- J Cottalorda
- Service de Chirurgie infantile, C.H.U. de Saint-Etienne, France
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Abstract
To evaluate the influence of time on the quality of life of hemiplegic stroke patients living at home, we analyzed a sample of 45 outpatients. The sample was divided into two groups, according to the delay between the discharge time from hospital and the assessment (Group 1, fewer than 6 mo; Group 2, more than 6 mo after discharge). We hypothesized that patients in Group 2 would have a lower level of quality of life than patients in Group 1. Disability was assessed with the Functional Independence Measure, and the quality of life was assessed with the Reintegration to Normal Living Index. Both groups were comparable with regard to demographic and stroke characteristics. There was no statistically significant difference in Functional Independence Measure scores (global and subscales). Reintegration to Normal Living Index-perception of self subscale scores were significantly lower in Group 2. At the item level, quality of life scores were also significantly lower in Group 2 for indoor mobility (Mann-Whitney U test; P = 0.001), self-care needs (P = 0.005), personal relationships (P = 0.02), and the handling of life events (P = 0.05). These results confirm our hypothesis and suggest that quality of life may deteriorate in some domains over time, even when the disability level is unchanged, but these results need to be replicated in prospective studies with larger samples of stroke survivors.
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Affiliation(s)
- F Béthoux
- Service de Médecine Physique et de Réadaptation-GIP Exercice, CHU Bellevue, Université Jean Monnet, Saint Etienne, France
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Abstract
This study reviewed 57 hips in 30 children (18 girls and 12 boys) with cerebral palsy who had undergone an adductor tenotomy alone or in combination with an anterior obturator neurectomy (23 hips). Results were evaluated by the Reimers migration percentage (MP). The hips were split into three groups: group A (12 hips) a preoperative MP of less than 20%, group B (25 hips) between 20 and 40%, and group C (20 hips) more than 40%. The mean age at the time of surgery was 6 years and 1 month (range: 2.5-13 years). The mean period of review was 6 years and 3 months (2-20 years). The results were considered as "good" when radiographs at the longest follow-up showed a decrease of > 10% of the MP, as "bad" when they showed an increase of > 10%, and as "stable" when the MPs varied less than 10%. At the latest review of group A, 11 were stable (92%) and 1 was bad. In group B, 12 were stable (48%), 7 were good (28%), and 6 were bad (24%). In group C, 7 were stable (35%), and 13 were bad (65%). The preoperative migration percentage provided to be the only predictor of outcome. Age at the time of surgery had no constant significant effect on the outcome, neither had the addition of an anterior neurectomy.
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Affiliation(s)
- J Cottalorda
- Orthopaedic Pediatric Surgery Department, University Hospital of Saint-Etienne, France
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Cottalorda J, Gautheron V, Charmet E, Chavrier Y. [Muscular lengthening of the triceps by successive casts in children with cerebral palsy]. Rev Chir Orthop Reparatrice Appar Mot 1997; 83:368-371. [PMID: 9452811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
PURPOSE OF THE STUDY Twenty children with cerebral palsy who underwent elongation of the triceps surae using successive plaster-casts (28 short triceps) were reviewed. This study was retrospective. MATERIAL AND METHODS Among the eighteen children, 10 were hemiplegic, 8 were diplegic and 2 were spastic quadriparetic. All of them except one were ambulatory children. The authors describe their elongation technique by plaster-casts and the treatment they lead. The mean age at time of elongation was 4 years and 6 months (range 2 years 4 months to 8 years). The passive dorsiflexion of the foot before elongation was of 0 degree (range -20 degrees to +10 degrees) knee in extension, and of 5 degrees (range -15 degrees to +15 degrees) knee in flexion. RESULTS The passive dorsiflexion of the foot after elongation was of 23 degrees (range +10 degrees to +30 degrees) knee in extension, and of 27 degrees (range +10 degrees to +35 degrees) knee in flexion. One major complication was noted: the persistence of a varus foot in child after elongation. 24 elongations were reviewed with a mean follow-up of 21 months (range 12 months to 30 months). The passive dorsiflexion of the foot was of 10 degrees (range 0 degree to +20 degrees) knee in extension and of 17 degrees (range -5 degrees to +25 degrees) knee in flexion. DISCUSSION Compared to different procedures (surgical lengthening, botulinum-A toxin) elongation by successive plaster-casts is a quick, safe, complication-free, and simple technique, whose results are equivalent. Even if recurrence of equinus is probable, a surgical procedure of lengthening could be made on an operative-free tendon. CONCLUSION Elongation of the triceps surae muscle by successive plaster-casts constitutes a safe alternative technique compared to surgical procedure.
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Affiliation(s)
- J Cottalorda
- Service de Chirurgie Infantile, Hôpital Nord, Saint-Etienne
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Abstract
To study the global quality of life (QOL) of spouses of chronic stroke patients, and to determine its most pertinent factors, we assessed nine stroke patients and their spouses, using the Barthel index, the Functional Independence Measure (FIM), the Montgomery and Asberg Depression Rating Scale (MADRS), the Reintegration to Normal Living Index (RNLI), and a 10-cm visual analogue scale (VAS) to evaluate spouses' QOL. Correlation analysis was performed with the Spearman rank correlation analysis. Mean age of spouses was 53.6 +/- 11.3 years (male:female ratio, 8:1). The mean interval from stroke was 17.6 +/- 10.6 months. The spouses' median QOL score was 4.9, with a significant correlation between spouses' QOL scores and patients Barthel index scores, FIM global scores, and FIM locomotion scores. Spouses complained of the physical burden, but psychological, social, economic and marital consequences of the stroke were also reported. This study confirms the constant impact of stroke on the QOL of the spouses, and demonstrates the role of patients' physical disability. However, the VAS allows only a global approach. A self-administered composite index, exploring the consequences of the stroke on the spouses' daily life, would be a useful complement.
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Affiliation(s)
- F Béthoux
- Department of Physical Medicine and Rehabilitation-GIP Exercise, CHU Bellevue Hospital, Jean Monnet University, Saint Etienne, France
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Damon G, Richard O, Jacquet C, Gautheron V. Paraparésie et surdité rapportées à une maladie de Lyme. Arch Pediatr 1996. [DOI: 10.1016/0929-693x(96)87650-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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