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PubMed | Laurentian University, Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris, Bloorview Research Institute, Laval University and Holland Bloorview Kids Rehabilitation Hospital
Type: Comparative Study | Journal: Child: care, health and development | Year: 2016

Having a physical disability and using a wheelchair can create difficulties in navigating the physical and built environment, especially during winter when snow and ice become problematic. Little is known about the experiences of winter among youth who use an assistive mobility device. This study aimed to understand how youth with a physical disability experience winter, compared with typically developing peers.A purposive sample of 25 youths (13 with a physical disability; 12 typically developing) completed a 2-week weather journal and photographs in two Canadian cities during winter. These data were used to guide semi-structured interviews with participants.Youths with disabilities experienced many similar challenges in winter, such as health and safety concerns and accessibility issues, compared with typically developing youth - but to a greater extent. Youths with disabilities reported more challenges going outdoors during winter and negative psychosocial impacts, including loneliness and increased dependence, compared with peers without a disability. They also, however, described developing several adaptive strategies to cope with these challenges.There is a strong need to remove physical and environmental barriers to facilitate the participation and inclusion of youth with disabilities in winter.


Lecours A.,University of Quebec at Trois - Rivieres | Lecours A.,Jesus University | Sirois M.-J.,Laval University | Sirois M.-J.,Jesus University | And 4 more authors.
Journal of Head Trauma Rehabilitation | Year: 2012

PURPOSE: To identify factors associated with long-term independence in mobility and self-care activities of daily living of older adults after traumatic brain injury (TBI). PARTICIPANTS: One hundred thirty-six TBI survivors 55 years or older were assessed 2 to 4 years postinjury (mean of 3.2 years). SETTING: Level I or level II trauma centers in Quebec, Canada. MAIN MEASURES: Personal, injury-related, and environmental factors were gathered from hospital records or by telephone interview; a telephone version of the Functional Independence Measure motor scale was collapsed to 4 levels. ANALYSIS: Logistic regression analyses identified factors associated with independence in mobility and self-care. RESULTS: The strongest and most consistent factors associated with independence in mobility and self-care were fewer comorbid conditions, no difficulty of access to home modification services and home support services, male gender, younger age at time of injury, and shorter acute care length of stay. CONCLUSION: Factors associated with long-term functional outcome should be considered in the development of practice guidelines for rehabilitation of older adults who sustained a TBI. Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.


Jette F.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | Jette F.,Laval University | Jette F.,Institute Of Readaptation En Deficience Physique Of Quebec | Cote I.,Laval University | And 4 more authors.
Neurorehabilitation and Neural Repair | Year: 2013

Background. Neuropathic pain often follows spinal cord injury (SCI). Objective. To compare the effect of repetitive transcranial magnetic stimulation (rTMS) applied over different motor cortex targets (hand vs leg area) versus sham stimulation on neuropathic pain and local neurophysiological changes in patients with SCI. Methods. A total of 16 patients with complete or incomplete motor SCI and chronic neuropathic pain participated in a double-blind, cross-over randomized study. Three single sessions of sham or active rTMS (10 Hz, total of 2000 stimuli) were applied in random order over the hand or leg area with a minimal 2-week interval. The main outcome measures were the numeric rating scale for pain sensation and parameters derived from motor mapping of the first dorsal interosseous muscle, including maximal amplitude of evoked response as well as map area, volume, and location. Results. rTMS applied to either the hand or the leg area, but not sham stimulation, induced a significant but equivalent reduction in pain for the first 48 hours postintervention (P <.05). Participants with an incomplete lesion showed greater analgesia than those with a complete lesion (21% vs 3%, respectively; P <.05). The main change observed for motor map measurements was an increase in corticospinal excitability after stimulation of the hand area (P =.04) but not for the other conditions. Conclusion. rTMS applied over the hand or leg motor cortex decreased neuropathic pain regardless of any change in cortical excitability, suggesting that the analgesic effect is not associated with local changes at the motor cortex level itself. © The Author(s) 2013.


Ouellet M.-C.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | Ouellet M.-C.,Laval University | Beaulieu-Bonneau S.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | Beaulieu-Bonneau S.,Laval University | And 3 more authors.
The Lancet Neurology | Year: 2015

Sleep-wake disturbances are extremely common after a traumatic brain injury (TBI). The most common disturbances are insomnia (difficulties falling or staying asleep), increased sleep need, and excessive daytime sleepiness that can be due to the TBI or other sleep disorders associated with TBI, such as sleep-related breathing disorder or post-traumatic hypersomnia. Sleep-wake disturbances can have a major effect on functional outcomes and on the recovery process after TBI. These negative effects can exacerbate other common sequelae of TBI-such as fatigue, pain, cognitive impairments, and psychological disorders (eg, depression and anxiety). Sleep-wake disturbances associated with TBI warrant treatment. Although evidence specific to patients with TBI is still scarce, cognitive-behavioural therapy and medication could prove helpful to alleviate sleep-wake disturbances in patients with a TBI. © 2015 Elsevier Ltd.


Hetu S.,Laval University | Hetu S.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | Taschereau-Dumouchel V.,Laval University | Taschereau-Dumouchel V.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | And 2 more authors.
Brain Stimulation | Year: 2012

Empathy is a multi-dimensional concept allowing humans to understand the emotions of others and respond adaptively from a social perspective. This mental process, essential to social interactions, has attracted the attention of many scholars from different fields of study but the blooming interest for empathy in cognitive neurosciences has rekindled this interest. This paper reviews the growing literature stemming from studies using brain stimulation techniques that have investigated directly or indirectly the different components of empathy, including resonance, self-other discrimination, and mentalizing. Some studies have also ventured toward the modulation of this complex process and toward the investigation of different components in populations that show reduced empathic skills. We argue that brain stimulation techniques have the potential to make a unique contribution to the field of empathy research with their exclusive capacity, compared to other brain imaging techniques, to modulate the neural systems involved in the distinct components of this process. Provided the development of innovative ecological paradigms that will put people in actual social interactions as well as comprehensive and adaptive models that can integrate research from different domains, the ultimate goal of this research domain is to devise protocols that can modulate empathy in people with developmental, neurological and psychiatric disorders. © 2012 Elsevier Inc. All rights reserved.


Truchon M.,Laval University | Cote D.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | Schmouth M.-E.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | Leblond J.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | And 3 more authors.
Spine | Year: 2010

STUDY DESIGN. Twelve-month cohort study. OBJECTIVE. The aim of the study was to examine the ability of an adaptation of the stress process model to predict different outcomes among low back pain (LBP) sufferers. SUMMARY OF BACKGROUND DATA. Recently, the stress process model was adapted and was shown to be useful to partially explain long-term disability related to low back pain, an important occupational health problem. METHODS. French-speaking compensated workers on sick leave because of subacute common LBP (N ≤ 439) completed a questionnaire including the adapted stress process model's factors: life events and appraisal, cognitive appraisal of LBP, emotional distress, avoidance coping strategies, and functional disability. Six and 12 months later, participants gave information about their work status, number of days of absence, and functional disability. Regression analyses were performed to identify significant predictive factors of these outcomes. Pain intensity, fear of work, gender, and presence of pain radiating below the knee were used as control variables. RESULTS. Number of days of absence, functional disability, and absence from work were predicted at 6 and 12 months by cognitive appraisal of LBP and emotional distress. Functional disability was predicted in addition by functional disability at study entry (T1). When the control variables were considered, number of days of absence was predicted at 6 months by cognitive appraisal, fear of work, and being a male, and, in addition, by emotional distress at 12 months. Functional disability was predicted by functional disability t1, emotional distress, cognitive appraisal of LBP, and fear of work at 6 months, and by the same factors and variables at 12 months, except for functional disability t1. Regarding absence from work, it was predicted at 6 months by fear of work and being a male, and at 12 months by cognitive appraisal of LBP and fear of work. CONCLUSION. In association with fear of work, 2 factors from the adapted stress process model are significantly useful for predicting LBP related long-term disability outcomes and could be targeted by preventive interventions. © 2010, Lippincott Williams & Wilkins.


Flamand V.H.,University of Québec | Flamand V.H.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | Flamand V.H.,Laval University | Nadeau L.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | And 3 more authors.
Clinical Neurophysiology | Year: 2012

Objective: Our study aimed to test in 8. years old children born very prematurely whether a faulty primary motor cortex (M1) functioning could parallel visuomotor coordination difficulties. Methods: Ten very preterm children (PT; gestational age ≤32. weeks; 6 boys; 8. years 6. months, SD 4. months) were compared to seven healthy term peers (4 boys; 8. years 4. months, SD 4. months). Clinical assessment comprised two standardized tests for motor skills and visuomotor coordination. Transcranial magnetic stimulation (TMS) was applied over M1 area of the preactivated first dorsal interosseous muscle to measure the corticomotor excitability and the short intracortical inhibition (SICI). Results: PT scores were significantly lower on the Developmental Test of Visual-Motor Integration (p= 0.0018) and on the Movement Assessment Battery for Children (p= 0.038). In parallel, the dominant hemisphere worked differently with no SICI in PT (p= 0.009) and more variability of corticomotor excitability (p= 0.001). Conclusions: These intertwined neurophysiological findings suggest that a faulty motor programming in the dominant M1 of PT could explain visuomotor coordination deficits. Significance: Our study contributes to the understanding of possible mechanisms that underlie motor difficulties commonly observed in children who were born premature. In addition, the effectiveness of rehabilitation interventions may be better understood by applying TMS as an outcome measure in the future. © 2011 International Federation of Clinical Neurophysiology.


Roosink M.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | Roosink M.,Laval University | Mercier C.,Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris | Mercier C.,Laval University
Spinal Cord | Year: 2014

Study design:Interventions using virtual feedback (VF) impact on motor functions and pain and may be relevant for neurorehabilitation after spinal cord injury (SCI) in which motor dysfunctions and (concomitant) pain are frequently observed. Potential mechanisms underlying VF include a modulation of cortical sensorimotor integration, increased therapy engagement and distraction from effort and pain. Still, the optimal parameters for VF and their technical implementation are currently unknown.Objectives:To provide an overview of interventions that have used VF to improve motor functions or to reduce pain after SCI.Methods:Literature review.Results:A total number of 17 studies were identified. VF interventions commonly focused on improving motor functions (n=12) or reducing pain (n=4). Only one study assessed both motor functions and pain. Studies generally report beneficial effects. However, the evidence is of low-level quality and many practical as well as theoretical issues remain unclear. Remaining knowledge gaps include: (1) optimal VF system characteristics, (2) the impact of different VF modalities and tasks, (3) dose-response relationships and (4) the identification of patients that are likely to benefit from VF. Future work should start by closing these knowledge gaps using systematic and controlled multi-session interventions and by assessing the underlying mechanisms involved.Conclusion:These results provide an important incentive to further assess the potential of VF interventions to simultaneously improve motor functions and reduce pain after SCI, which could contribute to better neurorehabilitation outcomes after SCI. © 2014 International Spinal Cord Society All rights reserved.


PubMed | Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris and Laval University
Type: | Journal: Neuroscience | Year: 2016

When subjects learn a novel motor task, several sources of feedback (proprioceptive, visual or auditory) contribute to the performance. Over the past few years, several studies have investigated the role of visual feedback in motor learning, yet evidence remains conflicting. The aim of this study was therefore to investigate the role of online visual feedback (VFb) on the acquisition and retention stages of motor learning associated with training in a reaching task. Thirty healthy subjects made ballistic reaching movements with their dominant arm toward two targets, on 2 consecutive days using a robotized exoskeleton (KINARM). They were randomly assigned to a group with (VFb) or without (NoVFb) VFb of index position during movement. On day 1, the task was performed before (baseline) and during the application of a velocity-dependent resistive force field (adaptation). To assess retention, participants repeated the task with the force field on day 2. Motor learning was characterized by: (1) the final endpoint error (movement accuracy) and (2) the initial angle (iANG) of deviation (motor planning). Even though both groups showed motor adaptation, the NoVFb-group exhibited slower learning and higher final endpoint error than the VFb-group. In some condition, subjects trained without visual feedback used more curved initial trajectories to anticipate for the perturbation. This observation suggests that learning to reach targets in a velocity-dependent resistive force field is possible even when feedback is limited. However, the absence of VFb leads to different strategies that were only apparent when reaching toward the most challenging target.


PubMed | Center Interdisciplinaire Of Recherche En Readaptation Et Integration Sociale Cirris
Type: Comparative Study | Journal: Experimental brain research | Year: 2016

Although pain is present in a large proportion of patients receiving rehabilitation, its impact on motor learning is still unclear, especially in the case of neuropathic pain that is not tightly linked to specific movements. The aim of this study was to determine the effect of local and remote tonic cutaneous heat pain applied during training on motor learning of a finger-tapping sequence task. Forty-five healthy participants, randomized to the control, local pain or remote pain groups, were trained to perform an explicit finger motor sequence of five items as fast as possible. During the 10 training blocks (30 s each), local pain and remote pain groups received a heat pain stimulus on the wrist or leg, respectively. Performance was tested in the absence of pain in all groups before (baseline), immediately after (post-immediate), 60 min after (post-60 min) and 24 h after training (post-24 h) to assess both acquisition and next-day retention. Speed increased over time from baseline to post-24 h (p < 0.001), without any significant effect of group (p = 0.804) or time group interaction (p = 0.385), indicating that the acquisition and retention were not affected by the presence of pain during training. No changes were observed on error rates, which were very low even at baseline. These results with experimental heat pain suggest that the ability to relearn finger sequence should not be affected by concomitant neuropathic pain in neurorehabilitation. However, these results need to be validated in the context of chronic pain, by including pain as a co-variable in motor rehabilitation trials.

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