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Rehabilitation's importance in cervico brachial neuralgia management
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Osteoarticular rehabilitation / Annals of Physical and Rehabilitation Medicine 60S (2017) e28–e32
Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2017.07.193 P056
Chronic disability in walking: Results of a school survey Salifou Gandema CHU Sourô Sanou, médecine physique, Bobo-Dioulasso, Burkina Faso E-mail address: [email protected] Introduction Walking disorder is a frequent reason for consultation in pediatric rehabilitation. It is most often a lameness that imposes a precise etiologic diagnosis for an appropriate treatment. Objectives Establish the epidemiological and diagnostic profile of chronic disability in school-based walking in Bobo-Dioulasso. Material/patients and methods This was a cross-sectional study conducted in Bobo-Dioulasso primary schools from January to May 2014. It involved 10 schools from a simple random draw. Sampling was exhaustive. The diagnosis of the cases was based on clinical and paraclinical examination. Only students with a walking disorder who have been living for more than six months have been selected. Results A total of 4336 students were examined. Of these, 62 had a chronic walking disability, giving a prevalence of 14.3‰. The main causes of chronic walking disability were axial deviations of the lower limbs (37.3%), followed by aseptic necrosis of the femoral head (30.65%) and iatrogenic paralysis of the sciatic nerve (11.3%). No cases of poliomyelitis were found. Discussion – conclusion Chronic walking disability occupies a modest place in childhood pathology in Burkina Faso. An epidemiological transition is under way with the disappearance of poliomyelitis sequelae in the infant population. Keywords Epidemiology; Disability; Walking; Poliomyelitis Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2017.07.194 P070
Therapeutic algorithm for native septic arthritis rehabilitation of the knee Aurore Chabaud 1,∗ , Morgane Tetard 1 , Stephane Descamps 1 , Christelle Nguyen 2 , Sylvie Aubreton 1 , Anne Plan-Paquet 1 , Franc¸ois Rannou 2 , Anne Tournadre 3 , Olivier Lesens 4 , Emmanuel Coudeyre 1 1 CHU de Clermont-Ferrand, MPR, Clermont-Ferrand, France 2 Hôpital Cochin, université Paris Descartes, MPR, Paris, France 3 CHU de Clermont-Ferrand, rhumatologie, Clermont-Ferrand, France 4 CHU de Clermont-Ferrand, maladies infectieuses, Clermont-Ferrand, France ∗ Corresponding author. E-mail address: [email protected] (A. Chabaud) Objective To our knowledge, despite animal studies evidence; there is no rehabilitation consensus for rehabilitation after native septic arthritis ok the knee. The objective was to develop and validate an early rehabilitation protocol for knee Staphylococcus aureus arthritis. Material/patients and methods We followed, HAS guidelines to obtain formal consensus using several steps: systematic review of the literature, elaboration of a first version of the algorithm, critical review by a multidisciplinary expert panel involved in the management of septic arthritis (PMR physician, physiotherapist, rheumatologist, infectious disease physician, orthopaedic surgeon). Modification of the draft version, to obtain the final version of the algorithm.
Results Only six of the 17 professionals asked to evaluate the established rehabilitation protocol responded. Among the 24 items proposed in this rehabilitation strategy, 79.2% obtained a direct validation. Five items scored below 5/10 with associated comments were discussed. The modifications in relation to the different opinions were carried out in order to obtain a final version of the algorithm. The rehabilitation strategy is based on 3 main successive phases: early mobilization to recover range of motion, muscular strengthening first unloaded without any resistance, then gradual re-loading with walking stick to finish with functional work. Discussion – conclusion The use of a rigorous methodology resulted in a consensus strategy for early rehabilitation management. A clinical prospective validation is needed to definitely approve the effectiveness and tolerance of the algorithm. Daily practice implementation is also needed. Keywords Septic arthritis; Knee; Rehabilitation; Mobilization; Algorithm Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2017.07.195 P072
Rehabilitation’s importance in cervico brachial neuralgia management
Wafa Haj Hamad ∗ , Mouna Sghir , Aymen Haj Salah , Wafa Said , Wassia Kessomtini Hôpital Taher Sfar, médecine physique, Mahdia, Tunisia ∗ Corresponding author. E-mail address: [email protected] (W.H. Hamad) Objective Physical treatment is an integral part in the management of cervico brachial neuralgia (CBN). But it is rarely touched on in literature. The aim of this study is to evaluate the contribution of rehabilitation in the management of CBN and its effect on pain, function and psychology of patients. Material/patients and methods A prospective study including patients with CBN referred to the department of physical medicine and rehabilitation (PRM) of Mahdia from October 2016 to March 2017. All of the patients underwent physical rehabilitation and the evaluation was performed before and at the end of the protocol. Measures outcomes were: pain via the Visual Analog Scale (VAS), functional outcome using the neck disability index (NDI) and the psychological profile with HAD scale. Results Forty patients were enrolled in this study; 12 men (30%) and 28 women (70%). The average age was 51 years old and the mean duration of symptoms was 2.4 years. In most of the cases, CBN was unilateral (87%) and C6 root was concerned (52%). On physical examination, we found limited and painful spinal motion mobility in 95% of the cases associated with contracture of the neck muscles in 87.5% of the cases. The cervical spine X-rays showed osteoarthritis, pinching discs or osteophytosis in 90% of the cases. At the end of the protocol, all parameters improved. Patients had significantly improvement of VAS pain and NDI but the improvement of HAD scale was not significant. Discussion–conclusion This study concludes that rehabilitation reduces the perception of pain and improves function in patients with CBN. Keywords Cervico brachial neuralgia; Rehabilitation Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2017.07.196
Osteoarticular rehabilitation / Annals of Physical and Rehabilitation Medicine 60S (2017) e28–e32
Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2017.07.193 P056
Chronic disability in walking: Results of a school survey Salifou Gandema CHU Sourô Sanou, médecine physique, Bobo-Dioulasso, Burkina Faso E-mail address: [email protected] Introduction Walking disorder is a frequent reason for consultation in pediatric rehabilitation. It is most often a lameness that imposes a precise etiologic diagnosis for an appropriate treatment. Objectives Establish the epidemiological and diagnostic profile of chronic disability in school-based walking in Bobo-Dioulasso. Material/patients and methods This was a cross-sectional study conducted in Bobo-Dioulasso primary schools from January to May 2014. It involved 10 schools from a simple random draw. Sampling was exhaustive. The diagnosis of the cases was based on clinical and paraclinical examination. Only students with a walking disorder who have been living for more than six months have been selected. Results A total of 4336 students were examined. Of these, 62 had a chronic walking disability, giving a prevalence of 14.3‰. The main causes of chronic walking disability were axial deviations of the lower limbs (37.3%), followed by aseptic necrosis of the femoral head (30.65%) and iatrogenic paralysis of the sciatic nerve (11.3%). No cases of poliomyelitis were found. Discussion – conclusion Chronic walking disability occupies a modest place in childhood pathology in Burkina Faso. An epidemiological transition is under way with the disappearance of poliomyelitis sequelae in the infant population. Keywords Epidemiology; Disability; Walking; Poliomyelitis Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2017.07.194 P070
Therapeutic algorithm for native septic arthritis rehabilitation of the knee Aurore Chabaud 1,∗ , Morgane Tetard 1 , Stephane Descamps 1 , Christelle Nguyen 2 , Sylvie Aubreton 1 , Anne Plan-Paquet 1 , Franc¸ois Rannou 2 , Anne Tournadre 3 , Olivier Lesens 4 , Emmanuel Coudeyre 1 1 CHU de Clermont-Ferrand, MPR, Clermont-Ferrand, France 2 Hôpital Cochin, université Paris Descartes, MPR, Paris, France 3 CHU de Clermont-Ferrand, rhumatologie, Clermont-Ferrand, France 4 CHU de Clermont-Ferrand, maladies infectieuses, Clermont-Ferrand, France ∗ Corresponding author. E-mail address: [email protected] (A. Chabaud) Objective To our knowledge, despite animal studies evidence; there is no rehabilitation consensus for rehabilitation after native septic arthritis ok the knee. The objective was to develop and validate an early rehabilitation protocol for knee Staphylococcus aureus arthritis. Material/patients and methods We followed, HAS guidelines to obtain formal consensus using several steps: systematic review of the literature, elaboration of a first version of the algorithm, critical review by a multidisciplinary expert panel involved in the management of septic arthritis (PMR physician, physiotherapist, rheumatologist, infectious disease physician, orthopaedic surgeon). Modification of the draft version, to obtain the final version of the algorithm.
Results Only six of the 17 professionals asked to evaluate the established rehabilitation protocol responded. Among the 24 items proposed in this rehabilitation strategy, 79.2% obtained a direct validation. Five items scored below 5/10 with associated comments were discussed. The modifications in relation to the different opinions were carried out in order to obtain a final version of the algorithm. The rehabilitation strategy is based on 3 main successive phases: early mobilization to recover range of motion, muscular strengthening first unloaded without any resistance, then gradual re-loading with walking stick to finish with functional work. Discussion – conclusion The use of a rigorous methodology resulted in a consensus strategy for early rehabilitation management. A clinical prospective validation is needed to definitely approve the effectiveness and tolerance of the algorithm. Daily practice implementation is also needed. Keywords Septic arthritis; Knee; Rehabilitation; Mobilization; Algorithm Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2017.07.195 P072
Rehabilitation’s importance in cervico brachial neuralgia management
Wafa Haj Hamad ∗ , Mouna Sghir , Aymen Haj Salah , Wafa Said , Wassia Kessomtini Hôpital Taher Sfar, médecine physique, Mahdia, Tunisia ∗ Corresponding author. E-mail address: [email protected] (W.H. Hamad) Objective Physical treatment is an integral part in the management of cervico brachial neuralgia (CBN). But it is rarely touched on in literature. The aim of this study is to evaluate the contribution of rehabilitation in the management of CBN and its effect on pain, function and psychology of patients. Material/patients and methods A prospective study including patients with CBN referred to the department of physical medicine and rehabilitation (PRM) of Mahdia from October 2016 to March 2017. All of the patients underwent physical rehabilitation and the evaluation was performed before and at the end of the protocol. Measures outcomes were: pain via the Visual Analog Scale (VAS), functional outcome using the neck disability index (NDI) and the psychological profile with HAD scale. Results Forty patients were enrolled in this study; 12 men (30%) and 28 women (70%). The average age was 51 years old and the mean duration of symptoms was 2.4 years. In most of the cases, CBN was unilateral (87%) and C6 root was concerned (52%). On physical examination, we found limited and painful spinal motion mobility in 95% of the cases associated with contracture of the neck muscles in 87.5% of the cases. The cervical spine X-rays showed osteoarthritis, pinching discs or osteophytosis in 90% of the cases. At the end of the protocol, all parameters improved. Patients had significantly improvement of VAS pain and NDI but the improvement of HAD scale was not significant. Discussion–conclusion This study concludes that rehabilitation reduces the perception of pain and improves function in patients with CBN. Keywords Cervico brachial neuralgia; Rehabilitation Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2017.07.196