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Ouellet J.,Institute Of Readaptation Gingras Lindsay Of Montreal | Scherzer P.B.,University of Quebec at Montreal | Rouleau I.,University of Quebec at Montreal | Metras P.,University of Quebec at Montreal | And 4 more authors.
Journal of the International Neuropsychological Society | Year: 2010

We examined the capacity of patients with multiple sclerosis (MS) to attribute mental states to others and to identify cognitive abilities that subserve theory of mind (ToM). In this article, we report findings on 41 out-patients with diagnosed MS who underwent detailed neuropsychological and social-cognitive assessment. They were subdivided into a cognitively intact (n=15) and cognitively impaired (n=26) group according to their neuropsychological test results. Their results were compared with those of 20 age- and education-matched controls. MS patients with cognitive impairments were found to have more difficulties attributing mental states to others than did cognitively intact MS patients and normal controls on two ToM measures; short stories (Happé, Winner, & Brownell, 1998) and video clips (Ouellet, Bédirian, Charbonneau, & Scherzer, 2009). When attention, memory, and working memory were controlled, performance on the WAIS-III Picture Arrangement task accounted for 17.3% of the variance in performance on the video clips task. Performance on a WAIS-III index composed of Similarities and Comprehension subtests, accounted for 7.0% of the variance in performance on the short stories task. These results provide some preliminary information on the effect of MS-related cognitive deficits on the ability to attribute mental states to others. Copyright © 2010 The International Neuropsychological Society. Source

The ultimate goal of biomedical research is to improve the population's health. Nevertheless, the use of scientific data in clinical practice, i.e. evidence-based medicine, is still limited. Evidence-based medicine requires an assessment of the quality of scientific data collected in clinical studies. The example of the very limited use of muscle vibrations in physical rehabilitation despite encouraging results from several studies is discussed here to illustrate the importance of a high level of proof of efficacy. In addition, transferring scientific knowledge can also be limited by other factors related to personal, organizational and educational barriers. Different methods developed to ensure that scientific research gets beyond primary publication in specialized journals still remain to be widely applied in clinical practice. These methods advocate a specific approach for each situation, depending on the barriers present in the environment under consideration. Finally, in several countries, guidelines for professional education, on the masters or doctoral level, have favored the application of evidence-based medicine. The results of this new policy should be measurable in upcoming years. © 2010. Elsevier Masson SAS. All rights reserved. Source

Courtois F.,University of Quebec at Montreal | Courtois F.,Institute Of Readaptation En Deficience Physique Of Quebec | Courtois F.,Institute Of Readaptation Gingras Lindsay Of Montreal | Charvier K.,Medecine Physique et Re education | And 5 more authors.
BJU International | Year: 2011

What's known on the subject? and What does the study add? This study provides the first questionnaire on the specific bodily sensations that can be perceived at orgasm thereby complementing the subjective phenomenological experience of orgasm. OBJECTIVES To provide a questionnaire for assessing the sensations characterizing orgasm. To test the hypothesis that orgasm is related to autonomic hyperreflexia (AHR) in individuals with a spinal cord injury (SCI). SUBJECTS AND METHODS A total of 97 men with SCI, of whom 50 showed AHR at ejaculation and 39 showed no AHR, were compared. Ejaculation was obtained through natural stimulation, vibrostimulation or vibrostimulation combined with midodrine (5-25 mg). Cardiovascular measures were recorded before, at, and after each test. Responses to the questionnaire were divided into four categories: cardiovascular, muscular, autonomic and dysreflexic sensations. RESULTS Significantly more sensations were described at ejaculation than with sexual stimulation alone. Men with SCI who experienced AHR at ejaculation reported significantly more cardiovascular, muscular, autonomic and dysreflexic responses than those who did not. There was no difference between men with complete and those with incomplete lesions. CONCLUSIONS The findings show that the questionnaire is a useful tool to assess orgasm and to guide patients in identifying the bodily sensations that accompany or build up to orgasm. The findings also support the hypothesis that orgasm may be related to the presence of AHR in individuals with SCI. Data from able-bodied men also suggest that AHR could be related to orgasm, as increases in blood pressure are observed at ejaculation along with cardiovascular, autonomic and muscular sensations. © 2011 BJU INTERNATIONAL. Source

Desrosiers E.,University of Montreal | Duclos C.,University of Montreal | Duclos C.,Institute Of Readaptation Gingras Lindsay Of Montreal | Nadeau S.,University of Montreal | Nadeau S.,Institute Of Readaptation Gingras Lindsay Of Montreal
Clinical Biomechanics | Year: 2014

Background Individuals with incomplete spinal cord injury need to be assessed in different environments. The objective of this study was to compare lower-limb power generation in subjects with spinal cord injury and healthy subjects while walking on an inclined pathway. Methods Eleven subjects with spinal cord injury and eleven healthy subjects walked on an inclined pathway at their natural gait speed and at slow gait speed (healthy subjects only). Ground reaction forces were recorded by force plates embedded in the inclined pathway and a 3-D motion analysis system recorded lower-limb otions. Data analysis included gait cycle parameters and joint peak powers. Differences were identified by student t-tests. Findings Gait cycle parameters were lower in spinal cord injury subjects compared to healthy subjects at natural speed but similar at slow gait speed. Subjects with spinal cord injury presented lower power at the ankle, knee and hip compared to healthy subjects at natural gait speed while only the power generation at push-off remained lower when the two groups performed at similar speed. Interpretation The most important differences are associated with the fact that individuals with spinal cord injury walk at a slower speed, except for the ankle power generation. This study demonstrated that, even with a good motor recovery, distal deficits remain and may limit the ability to adapt to uphill and downhill walking. Inclined pathways are indicated to train patients with spinal cord injury. Clinicians should focus on the speed of uphill and downhill walking and on the use of plantar flexors. © 2014 Elsevier Ltd. All rights reserved. Source

Nadeau S.,Multidisciplinary Team in Locomotor Rehabilitation after Spinal Cord Injury and Stroke | Nadeau S.,University of Montreal | Jacquemin G.,Institute Of Readaptation Gingras Lindsay Of Montreal | Fournier C.,Institute Of Readaptation Gingras Lindsay Of Montreal | And 3 more authors.
Neurorehabilitation and Neural Repair | Year: 2010

Background. Spontaneous activity originating from the spinal cord has been sporadically reported in humans. Objectives. Investigation of such rhythmic activity of the trunk and legs in a 49-year-old male patient who had a complete severance of the spinal cord at the fifth thoracic vertebra. Methods. A multichannel electromyography (EMG) study was performed together with kinematics measurements obtained from an Optotrak system.Results. Episodes of rhythmic trunk and lower limb movements started 6 to 7 years after the spinal lesion, recurred at 2 to 3 month intervals, and continued uninterrupted for 2 to 3 days despite continuous delivery of intrathecal baclofen. Several muscles discharged more or less synchronously on both sides but others clearly alternated, for instance, between hip flexors and knee or ankle extensors. Sensory stimuli (hip repositioning or skin pinch) altered significantly the baseline rhythm of about 1 Hz. The patient had both hips injected with corticosteroids and was free of these episodic rhythmic crises for more than 6 months. Conclusion. The rhythmic activity observed in the patient appeared related to the activation of a spinal pattern generator akin to what has been described in most animal species after complete spinal lesions. © The Author(s) 2010. Source

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