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Testa R.,University Claude Bernard Lyon 1 | Testa R.,INRETS | Testa R.,Center Hospitalier Lyon Sud | Chouteau J.,University Claude Bernard Lyon 1 | And 11 more authors.
IRBM | Year: 2010

Introduction: Numerous measurement devices can help clinicians during the knee examination. However, manual evaluation still remains routinely used to assess the knee laxities. The present study evaluated how accurate was a clinician for a varus-valgus stress test. We compared the clinician evaluation to the objective measurement of the knee movements during the same test session. Methods: We studied six fresh-frozen anatomical lower limbs. The clinician performed a varus-valgus stress test in extension and at 25° flexion. The limbs were equipped with intracortical pins in femur and tibia, and spherical retro-reflecting markers were glued on the pins. Objective knees movements were measured by means of a Motion Analysis® system (Motion Analysis Corporation, Santa Rosa, CA, USA). Two statistical analyses were performed. A single sample t-test was first used to verify the required 25 flexion. Then, a multivariate anova was performed to analyse the varus-valgus laxity under the fixed factors of measurement method and flexion of the knee. Results: The results for varus-valgus and total laxity of the clinician always exhibited a greater variability than objective measurements of the device. Test condition is a factor of grouping differences for Valgus and for global mediolateral laxity. Statistical analysis revealed that the objective measurement was able to show a difference between extension and 25° flexion for global mediolateral laxity, whereas the clinician was not. Discussion: The clinician was relatively accurate in his manual evaluation. However, we demonstrated that a measurement device could clearly help clinician to exhibit differences in laxity. This can be very useful to compare a knee to itself in two successive conditions, e.g., before and after a surgery. © 2010 Elsevier Masson SAS.

Neri T.,Service dorthopedie et traumatologie hOpital Nord | Philippot R.,Service dorthopedie et traumatologie hOpital Nord | Philippot R.,Laboratoire Of Physiologie Of Lexercice | Carnesecchi O.,Service dorthopedie et traumatologie hOpital Nord | And 2 more authors.
Orthopaedics and Traumatology: Surgery and Research | Year: 2015

Introduction: Among the numerous techniques available, medial patellofemoral ligament (MPFL) reconstruction is increasingly used for the surgical treatment of objective patellar instability. The main objective of the present study was to assess efficacy in preventing recurrence of patellar dislocation and in correcting radiographic patellar tilt. The study hypothesis was that MPFL reconstruction, isolated or with associated bone surgery, by restoring "favorable" graft anisometry, provides a good trade-off between patellar stability and absence of postoperative stiffness. Materials and methods: Eighty-seven patients (90 reconstructions) presenting with objective patellar instability were prospectively included. The standardized procedure comprised MPFL reconstruction using the gracilis tendon. Femoral fixation used an interference screw in a blind tunnel between the adductor magnus tubercle and the medial epicondyle; patellar fixation used 2 anchors. Complementary distal bone graft was associated in 21 patients due to a preoperative tibial tubercle-trochlear groove (TT-TG) distance exceeding 20. mm or to patella alta. Functional IKDC and Kujala scores and radiographic measurement of patellar tilt and femoral tunnel position were assessed preoperatively and at end of follow-up. Results: Mean follow-up was 24.3. months (range, 6-49. months). Three patients showed recurrence of patellar dislocation. Mean Kujala score rose from 53.88 preoperatively to 86.24 postoperatively, and mean real IKDC score from 45.15 to 73.92 (P<. 0.001). Patellar tilt decreased significantly between pre- and postoperative X-ray (P<. 0.001). Discussion: MPFL gracilis reconstruction provides good clinical results and good radiologic correction of patellar tilt, making it a technique of choice in the treatment of objective patellar instability. Level of evidence: Level IV. Retrospective case series study. © 2014 Elsevier Masson SAS.

Busso T.,Jean Monnet University | Busso T.,Laboratoire Of Physiologie Of Lexercice | Fluck M.,Manchester Metropolitan University
European Journal of Applied Physiology | Year: 2013

Altered expression of a broad range of gene transcripts after exercise reflects the specific adjustment of skeletal muscle makeup to endurance training. Towards a quantitative understanding of this molecular regulation, we aimed to build a mixed-effects model of the dynamics of co-related transcript responses to exercise. It was built on the assumption that transcript levels after exercise varied because of changes in the balance between transcript synthesis and degradation. It was applied to microarray data of 231 gene transcripts in vastus lateralis muscle of six subjects 1, 8 and 24 h after endurance exercise and 6-week training on a stationary bicycle. Cluster analysis was used to select groups of transcripts having highest co-correlation of their expression (r > 0.70): Group 1 comprised 45 transcripts including factors defining the oxidative and contractile phenotype and Group 2 included 39 transcripts mainly defined by factors found at the cell periphery and the extracellular space. Data from six subjects were pooled to filter experimental noise. The model fitted satisfactorily the responses of Group 1 (r 2 = 0.62 before and 0.85 after training, P < 0.001) and Group 2 (r 2 = 0.75 and 0.79, P < 0.001). Predicted variation in transcription rate induced by exercise yielded a difference in amplitude and time-to-peak response of gene transcripts between the two groups before training and with training in Group 2. The findings illustrate that a mixed-effects model of transcript responses to exercise is suitable to explore the regulation of muscle plasticity by training at the transcriptional level and indicate critical experiments needed to consolidate model parameters empirically. © 2012 Springer-Verlag Berlin Heidelberg.

Frappe E.,Service de pneumologie et oncologie thoracique | Frappe E.,Laboratoire SNA EPIS | Gautier-Guillot M.,Service de Physiologie Clinique et de lExercice | Gautier-Guillot M.,Laboratoire SNA EPIS | And 8 more authors.
Revue des Maladies Respiratoires | Year: 2013

As chronic respiratory symptoms and the presence of expiratory flow limitation (EFL) are commonly reported in the elderly, we investigated whether they were associated in a population of 75 years old volunteers. We analyzed the results of a prevalence survey of chronic respiratory symptoms and respiratory infections, and performed spirometry and measured EFL after application of a negative expiratory pressure at the mouth (NEP). EFL was present in 170 (46%) subjects, a chronic cough in 49 (13%), chronic sputum in 58 (29%) and a history of respiratory infection in 62 (17%). Chronic cough and the composite outcome "chronic cough or sputum" were significantly associated with the presence of EFL (respectively 60% vs. 43%, OR = 2.04 [1.09 to 3.78], P = 0.023, and 56% vs. 43%, OR = 1.74 [1.05 to 2.87], P = 0.04), after controlling for smoking or airway obstruction. History of respiratory infections were not associated with an increased prevalence of EFL. We concluded that the presence of a LED could be an interesting indicator of respiratory aging. Its detection could be advocated in elderly subjects presenting with respiratory symptoms. © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Terrier R.,Laboratoire Of Physiologie Of Lexercice | Terrier R.,University of Savoy | Rose-Dulcina K.,University of Savoy | Toschi B.,University of Savoy | Forestier N.,University of Savoy
Clinical Biomechanics | Year: 2014

Background Previous studies have proposed that evertor muscle weakness represents an important factor affecting chronic ankle instability. For research purposes, ankle evertor strength is assessed by means of isokinetic evaluations. However, this methodology is constraining for daily clinical use. The present study proposes to assess ankle evertor muscle weakness using a new procedure, one that is easily accessible for rehabilitation specialists. To do so, we compared weight bearing ankle inversion control between patients suffering from chronic ankle instability and healthy subjects. Methods 12 healthy subjects and 11 patients suffering from chronic ankle instability conducted repetitions of one leg weight bearing ankle inversion on a specific ankle destabilization device equipped with a gyroscope. Ankle inversion control was performed by means of an eccentric recruitment of evertor muscles. Instructions were to perform, as slow as possible, the ankle inversion while resisting against full body weight applied on the tested ankle. Results Data clearly showed higher angular inversion velocity peaks in patients suffering from chronic ankle instability. This illustrates an impaired control of weight bearing ankle inversion and, by extension, an eccentric weakness of evertor muscles. Interpretation The present study supports the hypothesis of a link between the decrease of ankle joint stability and evertor muscle weakness. Moreover, it appears that the new parameter is of use in a clinical setting. © 2014 Elsevier Ltd.

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