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Chalfoun C.,University of Montreal | Abdel-Baki A.,Center Hospitalier Of Luniversite Of Montreal Chum Hopital Notre Dame | Letendre E.,Center Hospitalier Of Luniversite Of Montreal Chum Hopital Notre Dame | Karelis A.D.,University of Quebec at Montreal
Obesite | Year: 2015

Background: Several factors could increase the risk of cardiovascular disease (CVD) in individuals with schizophrenia including genetics, antipsychotic medication, smoking, an unhealthy diet and physical inactivity. Several assessment protocols have been developed but few have defined the optimal strategy of care in reducing the risk of CVD in this population. Among the interventions studied, exercise training is the strategy of choice since it could improve cardiorespiratory fitness levels (VO2 max), which is an independent risk factors for CVD, as well as metabolic risk factors such as elevated waist circumference, high triglycerides, high blood glucose and blood pressure.Objective: To determine the impact of exercise training on cardiovascular risk factors in individuals with psychotic disorders and identify the most effective type of exercise for the improvement of these metabolic risk factors. In line with the previous results, to develop a specific exercise program for this population.Methods: A systematic review of the literature on supervised exercise training programs in individuals with psychotic disorders was performed using the following databases: Medline, PubMed, Embase and PsycINFO.Conclusion: Aerobic training, in particular high intensity interval training (HIT), seems to be the optimal form of training for the improvements of cardiovascular risk factors. Therefore, a protocol of implementation of this type of exercise is recommended in individuals with SCZ; in addition to a protocol for assessing cardiometabolic risk in these patients. Many factors suggest that HIT may be an optimal strategy in this population. Several obstacles in implementation of these programs or limits inherent to this population are also presented, accompanied by suggested solutions. Further studies are needed to evaluate the feasibility of such programs. © 2014, Springer-Verlag France.

Denis I.,Center Hospitalier Of Luniversite Of Montreal Chum Hopital Notre Dame | Fortin L.,Center Hospitalier Of Luniversite Of Montreal Chum Hopital Notre Dame
Spine | Year: 2012

STUDY DESIGN.: Cross-cultural translation and psychometric testing. OBJECTIVE.: To translate, culturally adapt, and validate the Oswestry Disability Index (ODI) version 2.0 for the French-Canadian population. SUMMARY OF BACKGROUND DATA.: Many authors have recommended the administration of standardized instruments, rather than the creation of new scales, and advocate the adaptation of validated questionnaires in other languages. The application of these scales in different countries and by cultural groups necessitates cross-cultural adaptation. Many scales evaluate the functional incapacity resulting from low back pain. The ODI is among the most commonly used for this purpose. METHODS.: The French-Canadian ODI (ODI-FC) was developed by cross-cultural adaptation following internationally recommended methodology: forward translation, back translation, expert committee revision, and clinical evaluation of the prefinal version. Psychometric testing was performed on 72 patients with chronic low back pain. The subjects were recruited from a physiatry department in a university hospital and from a private practice physiatry clinic. They came from the Montreal area. The psychometric testing included internal consistency (Cronbach α), test-retest reliability (intraclass correlation coefficient) with a time interval set at 48 hours, and construct validity, comparing the ODI-FC with the Roland-Morris Disability Questionnaire and the Quebec Back Pain Disability Scale (Pearson correlation coefficient). RESULTS.: In 44.4% of the subjects, the average duration of low-back pain varied between 1 and 5 years. Average score for the ODI-FC was 29.2. Good internal consistency was found (Cronbach α = 0.88). Reliability was excellent, with intraclass correlation coefficient = 0.92 (95% confidence interval, 0.87-0.95). Construct validity results revealed excellent correlations between the ODI and the Quebec Back Pain Disability Scale (r = 0.90) and between the ODI and the Roland-Morris Disability Questionnaire (r = 0.84). CONCLUSION.: Cross-cultural translation and adaptation of the ODI-FC were successful. Psychometric testing determined that the instrument was homogeneous, reliable, and valid. It could be employed in future clinical trials in Canada and possibly in other French-speaking countries. © 2012, Lippincott Williams & Wilkins.

Zimmermann M.,Center Hospitalier Of Luniversite Of Montreal Chum Hopital Notre Dame | Taussky D.,Center Hospitalier Of Luniversite Of Montreal Chum Hopital Notre Dame | Menkarios C.,Hopital Maisonneuve Rosemont HMR | Vigneault E.,University of Quebec | And 5 more authors.
Clinical Oncology | Year: 2016

Aims: To report the long-term toxicities and sexual quality of life of a once-weekly hypofractionated radiation therapy schedule for low-risk prostate cancer. Materials and methods: A multi-institutional phase II trial was conducted, using a three-dimensional conformal radiation therapy (3D-CRT) approach for low-risk prostate cancer (T1a-T2a, Gleason ≤ 6 and prostate-specific antigen ≤ 10 ng/ml). Forty-five Gray (Gy) were delivered in nine fractions of 5 Gy given on a weekly basis. Acute and late genitourinary and gastrointestinal toxicities were graded according to the Radiation Therapy Oncology Group toxicity scale. Sexual function and sexual bother were assessed with the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Results: Between March 2006 and August 2008, 80 patients were treated, with a median age of 69 years (interquartile range 64-72). The median follow-up was 83 months (interquartile range 73-85 months). At 7 years, overall survival was 88%. No patients died of prostate cancer. Cumulative grade ≥2 genitourinary and gastrointestinal late toxicity was reported for 31.3% and 30% of our patients, respectively. Cumulative grade ≥3 genitourinary and gastrointestinal late toxicity was seen in 3.8% and 12.5% of cases, respectively. Late genitourinary grade 2 toxicity was correlated with the occurrence of acute genitourinary grade 2 toxicity (P = 0.006). The occurrence of late gastrointestinal toxicity was not correlated with acute gastrointestinal toxicity. Pre-treatment EPIC sexual function was low (37.5%) and the mean EPIC sexual function score at 7 years after treatment was 14%. On the other hand, pre-treatment EPIC sexual bother reached 80.5%, meaning little bother, and remained stable during follow-up. Conclusions: Once-weekly 3D-CRT leads to excellent biochemical disease-free survival and acceptable toxicities. Pre-treatment EPIC sexual function dropped by 42% at 5 years of follow-up. This functional deficit did not bother patients, possibly due to the already low sexual function at baseline. © 2015 The Royal College of Radiologists.

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