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1.
J. Leroux P.-H. Vivier M. Ould Slimane E. Foulongne S. Abu-Amara J. Lechevallier J.-P. Flambart J. Bredin J. Griffet 《Motricité Cérébrale》2012
Introduction
Follow-up of motor impaired children is particularly complicated and difficult. The use of a computerized medical recording filing system specially designed for motor impaired children must improve completeness and reproducibility of clinical examination, ease data exchange between clinicians and help to appreciate the evolution of orthopaedic conditions.Material and methods
In order to ease a widespread use, it has been developed via the Access™ software included in Office™ (Microsoft), which is installed on computers of most care centers.Results
A record-card is created at every medical visit, surgical operation or botulinium toxin injection. It is possible to note data about clinical examination, treatment, rehabilitation, walking tools, botulinium toxin injections, surgery and X-rays. To improve completeness, record-cards are in the forms of checklists and menus. Record-cards are saved in a database installed on a computer network in such a way that every clinician can retrieve immediately the whole data from any computer. In cases of no access to computer networks, there is an option to export data easily. An included tool determines doses, the number of botulinium toxin vials and the cost of injections according to the botulinium toxin used. Integrated help and tutorial options improve reproducibility of clinical examination and are very useful for teaching.Conclusion
This computerized medical recording filing system specially designed for motor impaired children is an innovative tool. It improves follow-up, care and clinical research. In addition, it is a very useful teaching tool. 相似文献2.
Objective
The assessment of manual abilities in children is carried out in occupational therapy through the observation of fine motor skills without an object (repetitive and sequential tapping) and with an object (prehension, reaching). There was a lack of an assessment tool of the manual abilities with objects of everyday life for children older than 6 years old. The Man.OS was developed; a manipulation test of “stationary” tools such as erasers, rulers, scissors, etc associated to an analysis of this activity, dissociating the procedural components of the manipulation and the quality of the production itself.Method
One hundred and twenty children from grades CE1, CE2 and CM1 from Parisian schools were asked to display their skills on these manipulations.Results
In general, good manual abilities were observed with percentages of success always superior to 50%. Specific results for each tool are also given.Discussion
Further studies should include more items, older children and from other regions. 相似文献3.
I. Pulido-Valdeolivas D. Gómez-Andrés J.A. Martín-Gonzalo J. López-López E. Gómez-Barrena J.J. Sánchez Hernández E. Rausell 《Neurología (Barcelona, Spain)》2013
Introduction
Instrumental gait analysis is an emerging technology used increasingly to evaluate motor disorders in children. Normal reference data is necessary in order to evaluate patients, but there are few reference resources for the Spanish paediatric population.Objective
We aim to describe the values of 16 clinically relevant gait variables in healthy Spanish schoolchildren, and identify any linear associations or left-right asymmetries.Subjects and methods
The values of 16 gait variables were determined in schoolchildren (n = 27, aged 5-13 years) using instrumental gait analysis. We analysed asymmetries for each variable (Student's t-test for dependent samples) and calculated their confidence intervals (95% of the standardised difference in right and left means [SMD]). Values and associations between variables were represented using a heat map.Results
Our project presents normal values tables for 16 variables in the gait cycle. Significant asymmetries were detected in the mean values for minimum hip flexion (SMD: 0.25 95% CI, 0.11-0.39) and peak hip abduction in swing (SMD: −1.05 95% CI: −1.71- − 0.27). Functional associations among gait variables are present.Conclusions
We present a reference dataset for Spanish school-aged children in which left-right asymmetries and functional associations may be observed for different variables. 相似文献4.
Background
Musculo-skeletal disorders and hip deformity play a key role on future development of motor and adaptive functions in children with cerebral palsy (CP). Lateral migration of the femoral head increases on average of 7.7% per year and may progress to hip dislocation. Conservative preservation of muscle length and balance may prevent or reduce femoral head migration and acetabular dysplasia. A prospective comparative non randomized study was conducted to determine the effect of a siège moulé postural management, in association with a physiotherapy program, on the progression of hip displacement in children with CP. Thirty-five patients with bilateral CP and so-called hip at risk (migration percentage [MP] of over 10% but less than 40%) were included into the study and evaluated by neurofunctional assessment, Gross Motor Function Classification System (GMFCS), Tardieu scale and radiological measurements (MP by Reimers). Eighteen children were treated with therapeutic education and postural management 4 hours a day, and 17 children (control group) were treated with NDT alone.Results
A significant difference was found between MP values of case group and control group after 1 year (T1) and 2 years of treatment (T2) (p = 0,001). The rate of hip displacement was reduced by 5 % in the treatment group after the first year and by 7 % at second follow-up.Conclusion
Our data show a progressive reduction of MP values measured in the treated group confirming the significant benefit from combined non-surgical approach. The study supports the evidence that conservative management of hip deformity can be successful if implemented before the development of hip dysplasia. 相似文献5.
A. Jaravel B. BayleM.-C. d’Anjou B. DohinD. Tardieu S. ChabrierV. Gautheron 《Motricité Cérébrale》2012
Introduction
The respite care meets a real need for families of children with multiple disabilities. The service of Physical Medicine and Paediatric Rehabilitation of the University Hospital of Saint-Etienne offers to accommodate a patient with multiple disabilities already known by the service for short periods to provide respite for his families. The objective of this study is to assess the value for patients.Method
It is a retrospective qualitative study, starting from an exhaustive review of medical records of 19 patients who were admitted in the department since the opening of beds in December 2004. The parents of these children answered to a telephone questionnaire and physicians and senior health care providers of the department were interviewed.Results
The vast majority of stays went well. Irrespective of the relief expected, they sometimes induced medical and paramedical acts such as changes in the treatment or equipment, the use of expert advice, requirements of additional tests… All children underwent a clinical examination for admission. There was also a secondary benefit with parents relaxed and reassured by the hospital.Conclusion/Discussion
This survey confirms the importance of these respite stays for children with multiple disabilities in this department but raises another question: is the role of the hospital there to compensate for the lack of temporary shelter bed? It also highlights the total lack of knowledge of these hospital admission opportunities from general practitioners and the public. 相似文献6.
Introduction
The aim of this study was to compare the real vocational and social outcome of a young adult CP population that was treated for 2 years at the Kerpape rehabilitation unit, with a retrospective insertion prognosis, taken from the analysis of their clinic record.Material and method
Investigators first evaluated functional independence, social autonomy, years of education, and vocational status through a phone survey. A second group of investigators (independent from the first one), studied the medical clinic record assessment in order to determine the clinical type of cerebral palsy (CP). The prediction was based on their clinical judgment, using information about the diagnosis, type of involvement, functional status. Out of 120 selected patients, 43 were eventually included in this study.Results
Type of CP: 36; 4% quadriplegia; 24.2, diplegia, 9.1% hemiplegia, 30.3% dyskinesia. Walking ability: 45.5 walking, 54.5% wheelchair. Complete independence: 36.4% for personal care, 18.2% for domestic life. Vocational assessment: 6.1% competitive employment, 6.1% sheltered, 78.8% unemployed, 3% studying. Social autonomy and vocational prediction was right in 72.7% of the cases.Discussion
The Intellectual Quotient is the most reliable predictive factor for social and vocational outcomes. On the other hand, the functional independence and walking ability are less predictive for social autonomy prediction. Thus, a greater number of CP adults who are dependent in their everyday life could reach social autonomy. A shortfall in social ability darkens social insertion prognostic, and reduces their quality of life. For CP children, it should be useful to develop specific programs to improve their social ability, in addition to motor rehabilitation, and specific education. 相似文献7.
M. Mpembi Nkosi S. Mampunza Ma Miezi V. Massamba Kubuta T. Matonda Ma Nzuzi V. Dubois M.-P. De Partz A. Peeters J. Macq E. Constant 《Revue neurologique》2014
Objectives
To describe the evolution of the clinical profile of post-stroke depression over a period of one year and to determine factors associated with changes in post-stroke depression.Methods
Prospective cohort study with a follow-up of 1 year including 30 consecutive eligible patients. The severity of depression was assessed with the patient health questionnaire (PHQ9).Results
The mean age was 55.87 ± 12.67 years. Seventy percent of patients were men. The two assessments for neurological status, perceived health status and test results of attention were not statistically different. The rate of depressive symptoms was 26.67% in 2011 and 20% in 2012. Disability and apathy were significantly improved. The average for disability increased from 2.77 ± 1.19 to 2.46 ± 2.19 (P = 0.002). From 66.7% in 2011, the proportion of patients able to walk without assistance rose to 93.3% in 2012 (P = 0.03). In addition, the proportion of patients apathetic decreased from 43.3% to 13.3% (P = 0.01). Greater age, female sex, sleep disorders and post-stroke apathy remained associated with DPAVC between the two assessments, with an increase in the strength of the association for apathy.Conclusions
The frequency of post-stroke depression is high and remains stable over time. Disability is the clinical feature that evolved more favorably. The association with apathy, present at the beginning, of the study was strengthened one year later. 相似文献8.
Monika Trentowska Jennifer SvaldiBrunna Tuschen-Caffier 《Journal of behavior therapy and experimental psychiatry》2014
Background and objectives
Body exposure and cognitive restructuring are well known interventions in cognitive-behavioral therapies for patients with eating disorders. Though promising, little is known about the impact of body exposure on body dissatisfaction, overvaluation of weight and shape and other aspects of eating disorder psychopathology. Thus, the aim of the two studies presented here is to evaluate the efficacy of mirror exposure and video exposure on body dissatisfaction, weight and shape concerns and other aspects of eating disorder psychopathology.Method study 1
Fourteen women diagnosed with Eating Disorders Not Otherwise Specified (EDNOS; DSM-IV-TR) were treated in repeated mirror exposure sessions. Assessments were carried out before (baseline) and after body exposure.Results study 1
Measures of body dissatisfaction, shape concerns and eating disorder psychopathology were significantly improved at the post treatment assessment.Method study 2
Thirteen women with Bulimia Nervosa (BN; DSM-IV-TR) received repeated mirror and video exposure sessions. Measures were assessed before (baseline) and after body exposure.Results study 2
Body image dissatisfaction was significantly improved at post treatment assessment.Limitations
These preliminary results are based on subjective data from two small clinical samples. Comparisons between the studies are limited by design variations.Conclusions
The studies provide evidence that body exposure is a promising technique for treatment of body dissatisfaction in EDNOS and BN. Moreover, in EDNOS shape concern and aspects of eating disorder psychopathology were improved after body exposure. Reasons for the lack of change in shape and weight concern as well as in eating disorder psychopathology in BN are discussed. 相似文献9.
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11.
Victoria Heldestad Jan Linder Lisa Sellersjö Erik Nordh 《Clinical neurophysiology》2010,121(11):1878-1885
Objective
To evaluate the reproducibility of quantitative sensory testing (QST), performed with the method-of-limits (MLI) at different test intervals, by assessing the inter- and intra-individual variation of thermal cold (CT) and warm (WT) perception thresholds, and of thermal cold- (CPT) and heat pain (HPT) thresholds.Methods
QST with the MLI was performed in 38 healthy subjects in three repeated and pseudo-randomized test sessions, done at three occasions (days 1, 2 and 7).Results
At repeated testing, none of the thermal threshold estimates showed systematic significant differences, neither between days nor between sessions within the same day, when determined as first tests (FT), and for CT and WT also after thermal pain assessment (aTPA). However, when determined directly aTPA, both CT and WT were noted significantly higher. Also the coefficients of variation and repeatability showed increased values aTPA.Conclusions
The high reproducibility show that the MLI is a feasible method for thermal QST, with reproducible results both at shorter and longer test intervals, on condition that temperature thresholds are determined before any painful thermal stimuli are given, as the latter influence both CT and WT assessments.Significance
The findings show that QST with the MLI is a reliable tool for indirect evaluation of human small nerve fiber function. 相似文献12.
Background
Technology is omnipresent in our world today and mental disorders are examined using modern genetic, biological, neurophysiological and functional brain imaging exploratory techniques. Conversion is not just external, it can also be glimpsed at in images that look at brain functioning.Objectives
Do modern biological and radiological investigation elements discuss classic psychopathological conceptions of conversion and hence offer a new definition?Methods
Recently published neuroscientific studies have re-evaluated our traditional ideas of hysterical conversion with a critical eye.Results
Freud had the intelligence of differentiating conversion and simulation as two nosological frameworks that could not be superimposed: neurobiology scientifically confirmed the intervention of distinct brain mechanisms. Freud had the merit of defining conversion using a positive psychopathological diagnostic strategy, and not just by simply eliminating the organicity: with the same positive ethics, a distinction between somatic illnesses and conversive disorders can be established with imaging techniques. Furthermore, the possibility of conversive attacks caused by a psychotraumatic mnemic determination has found an echo in very recent studies which have objectified, in the conversive physiopathology, the intervention of cerebral structures involved in emotional memories. Finally, research looking at neurofunctional mechanisms that determine dissociative and conversive disorders confirm their close relationship.Discussion
The most recent neuroimaging studies validate the hypothesis of a biological carrier of conversive phenomena. If this new data should incite us to redefine conversion, it is also the definition of the signifier “psychogenic” which has evolved due to the advances in neuroimaging techniques. Is any psychological or somatic manifestation not also of neuronal and signified origin?Conclusion
These studies show that science can validate or specify some of our classical psychopathological paradigms. 相似文献13.
A. Vélez-van-Meerbeke I.P. ZamoraG. Guzmán B. FigueroaC.A. López Cabra C. Talero-Gutiérrez 《Neurología (Barcelona, Spain)》2013
Objective
To identify impairment of executive functions (EF) in children with attention deficit hyperactivity disorder (ADHD).Subjects and methods
A case-control study was performed on a sample of schoolchildren with low socioeconomic levels in Bogota, Colombia. ADHD was diagnosed using the DSM IV checklist and the Behavior Assessment System for Children scale. Children with cognitive deficits were excluded. We evaluated scores from six measurements of executive function (EF). We conducted a bivariate statistical analysis to compare the variables, a multivariate study controlled by sex and age, and a logistic regression analysis.Results
The study sample included 119 children with ADHD and 85 controls, all aged between 6 and 12 years. Controlling by sex, age, and type of school showed that EF measurements in children with ADHD were significantly more impaired than in controls, especially for measurements of verbal and graphic fluency, Rey-Osterrieth Complex Figure, and cognitive flexibility. Comparison of ADHD subgroups showed that results in children with multiple deficits were similar to those in the global ADHD group. Graphic fluency impairment was the sole impairment in cases with only attention deficit or only hyperactivity-impulsivity manifestations.Conclusions
EF measures in children with ADHD revealed more problems, particularly those having to do within planning, inhibition, working memory and cognitive control. Age and sex may affect the degree of EF impairment. 相似文献14.
Introduction
During the first days of incarceration, the “shock prison” may encourage the appearance of symptomatology reaction with the presence of depressive disorders. Several studies in prisons showed the presence of certain socio-demographic characteristics, psychological and legal in this population life course singular susceptible to weaken against the event that represents an incarceration.Objective
The present study is twofold. This is firstly to assess depression, life events, impulsivity and locus of control in a newly incarcerated population and secondly to compare the results with depressed people those do not show depression.Method
Maintenance of semi-structured research was proposed to 46 inmates in the unit of outpatient consultations in a prison in 2010. This interview was completed by placing two questionnaires (Beck Depression Questionnaire, Eysenck Impulsivity Questionnaire) and scale (Multidimensional locus of control scale of Levenson).Results
Of the forty four inmates incarcerated for less than 10 days, who participated in the study twenty-six had a depression, a significant number of incarceration, psychiatric history, certain life events (personal and maternal abuse, parental alcoholism), as well as significantly higher scores with regard to empathy and external locus of control type “powerful character”.Conclusion
Home maintenance is a systematic critical time. Newly incarcerated population, with a depression score above the standard psychological characteristics show support from the idea of a unique formation of the personality associated with the presence of life events and highlights particularly difficult childhood susceptible to weaken, especially to cope with the event that is incarceration. 相似文献15.
Introduction
Forty to sixty percent of patients with obsessive compulsive disorder (OCD) are resistant to well conducted treatment with selective serotonin reuptake inhibitors (SSRIs) over 8 weeks. The data concerning effectiveness of the addition of antipsychotics in this indication is controversial.Aims of the study
To synthesize the neurobiological mechanisms at work in order to understand the action of pharmacological treatments in this disease and to propose a systematic review of the literature on effectiveness of different antipsychotic drugs according to their pharmacological profiles, in monotherapy or in combination with SSRIs in OCD.Method
We conducted a systematic review of the literature using the criteria according to the PRISMA research paradigm “obsessive compulsive disorder AND antipsychotic agents”. Research bases MEDLINE, Cochrane and Web of science have been explored.Results
Unlike the classical serotonergic hypothesis, OCD may result from striatal dopaminergic hyperactivity, modulated in some patients by an underlying serotonergic hypoactivity. Most studies report effectiveness of first-generation antipsychotics (amisulpride and haloperidol) and some second-generation antipsychotics (risperidone, olanzapine, aripiprazole, quetiapine) in combination with an SSRI in the treatment of resistant OCD. Recrudescence or onset of OCD in patients with schizophrenia have been described in a relay from first generation antipsychotic to olanzapine, risperidone, aripiprazole or clozapine in case reports, but not amisulpride and quetiapine. 相似文献16.
S. Gronier X. Ayrignac C. Lamy J. Honnorat P. Thomas C. Lebrun-Frenay P. Labauge 《Revue neurologique》2013
Introduction
Perivascular spaces, known as Virchow-Robin spaces (VRS), may become massively enlarged but are usually an incidental finding. However, a few reports on patients with unusually large VRS have mentioned association with neurological symptoms. We report a series of three symptomatic patients with extremely wide Virchow-Robin spaces documented on brain magnetic resonance imaging (MRI).Methods
We retrospectively analyzed the medical records and brain MRI of three symptomatic patients, who had been diagnosed with VRS widening.Case reports
In all three patients, the unusual widening of the VRS was located within the subcortical white matter with asymmetric distribution. Their neurological symptoms were epilepsy and neurological deficits which correlated well with the lesions seen on the MRI. Two patients had associated white matter hyperintensities: in the first case associated gliosis and in the second case, with vascular leukoencephalopathy.Conclusions
Enlarged symptomatic VRS are rare. The underlying pathophysiological mechanisms remain uncertain. We report three cases with symptomatic giant dilatation of the Virchow-Robin spaces. 相似文献17.
Background
Patients with severe functional (psychogenic) neurological symptoms such as paralysis and fixed dystonia present a therapeutic challenge, particularly if no movement is possible during physiotherapy. Sedation has been discussed as a treatment for functional neurological symptoms for 100 years but technique, use of video and outcome has not been systematically described.Methods
Therapeutic sedation of patients with severe functional neurological symptoms with propofol and follow up at a neuroscience centre.Results
Of eleven patients (median duration 14 months), five were cured or had major improvement with sedation. At follow up (median 30 months) four were asymptomatic, two were significantly improved and one had minor improvements. We describe a standardized anesthetic and physician technique, refined over consecutive treatments.Conclusion
In carefully chosen patients, therapeutic sedation with propofol can be a useful adjunctive treatment for patients with severe functional neurological symptoms. The treatment deserves randomized evaluation. 相似文献18.
19.
H. Mokri F. Matharan K. Pérès J. Bouisson J.-F. Dartigues H. Amieva B. Dubois 《Revue neurologique》2013
Introduction
Most current tools exploring visuospatial memory abilities are poorly adapted to the elderly population. The Goblets test allows a brief evaluation of visuospatial memory abilities through an encoding phase in which the participant has to learn a particular sequence and a further delayed recall phase. The aim of the present work was to produce normative scores for this test and to study its properties in the detection of dementia.Methods
Data were collected in a sample of 1002 agricultural retirees aged 65 years and over included in the AMI study, a population-based cohort study conducted in Gironde (southwestern France). The sample analyzed to establish normative data included 795 non-institutionalized and non-demented participants. Regarding the validity study, the sample analyzed included 912 participants of whom 76 subjects with a diagnosis of Alzheimer's disease.Results
Normative scores were calculated according to age (65–74 years and 75 years and over) and educational level (primary school level not validated by a diploma, primary school level validated by a diploma and more than a primary school level). The normative scores of the learning phase were described using the percentiles while rates of success were reported for the delayed recall. Regarding the properties of the test, the Goblets test seemed to be more specific than sensitive and presented high negative predictive values. The Youden index showed that the better cut-off score was two trials (with 75.0% sensitivity and 83.0% specificity).Conclusion
The Goblets test can be a helpful tool in screening for dementia. Nevertheless, like many other simple and quick cognitive tests, it cannot be used alone to establish the diagnosis of dementia. This test has the advantage to be easy to administer in clinical situations; the normative scores presented in this study could be used as an aid to interpret a patient's performance. 相似文献20.