Marie Enfant Rehabilitation Center

Montréal, Canada

Marie Enfant Rehabilitation Center

Montréal, Canada
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Vertriest S.,Ghent University | Coorevits P.,Ghent University | Hagberg K.,Sahlgrenska University Hospital | Hagberg K.,Gothenburg University | And 7 more authors.
IEEE Transactions on Neural Systems and Rehabilitation Engineering | Year: 2015

This study aimed at presenting the intra-tester reliability of the static load bearing exercises (LBEs) performed by individuals with transfemoral amputation (TFA) fitted with an osseointegrated implant to stimulate the bone remodeling process. There is a need for a better understanding of the implementation of these exercises particularly the reliability. The intra-tester reliability is discussed with a particular emphasis on inter-load prescribed, inter-axis and inter-component reliabilities as well as the effect of body weight normalization. Eleven unilateral TFAs fitted with an OPRA implant performed five trials in four loading conditions. The forces and moments on the three axes of the implant were measured directly with an instrumented pylon including a six-channel transducer. Reliability of loading variables was assessed using intraclass correlation coefficients (ICCs) and percentage standard error of measurement values (SEMs). The ICCs of all variables were above 0.9 and the SEM values ranged between 0 and 87. This study showed a high between-participants' variance highlighting the lack of loading consistency typical of symptomatic population as well as a high reliability between the loading sessions indicating a plausible correct repetition of the LBE by the participants. However, these outcomes must be understood within the framework of the proposed experimental protocol. © 2014 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission.


Therrien M.,University of Montréal | Therrien M.,Marie Enfant Rehabilitation Center | Colloud F.,CNRS Pprime Institute | Begon M.,University of Montréal | Begon M.,Marie Enfant Rehabilitation Center
Movement and Sports Sciences - Science et Motricite | Year: 2012

In kayaking, performance depends on stroke rate and propulsive force. On water, only partial blade kinematics and kinetics can be measured. Our objective is to assess, using an instrumented ergometer, the stroke rate effect (from 50 to 110 strokes per min) in 14 elite paddlers. The local blade path is measured and then expressed in an absolute frame of reference by simulating the on-water kinematics. Inter-stroke reproducibility of the paddle tip path is assessed by a multiple correlation coefficient. Kinematic and kinetic parameters are putted in relation with stroke rate. Whatever the stroke rate, blade paths are reproducible. However, the duration and the anteroposterior displacement of the blade in the pull phase decrease while catch and exit phases remain unchanged. © ACAPS, EDP Sciences, 2011.


Sarcher A.,Ecole Polytechnique de Montréal | Raison M.,Ecole Polytechnique de Montréal | Ballaz L.,University of Quebec at Montréal | Lemay M.,University of Quebec at Montréal | And 3 more authors.
Clinical Biomechanics | Year: 2015

Background Children with spastic hemiplegic cerebral palsy are restricted in their daily activities due to limited active ranges of motion of their involved upper limb, specifically at the elbow. Their impaired muscles are frequently targeted by anti-spastic treatments that reduce muscle tone. But these treatments do not necessarily improve the limb function. There is a lack of comprehensive knowledge of the quantitative relations between muscle activation and joint active ranges of motion. Consequently, the objective of this study is to quantify the impact of muscle activation on the elbow active ranges of motion. Methods During voluntary elbow pronation/supination and extension/flexion movements, kinematic and electromyographic measurements were collected from the involved upper limb of 15 children with spastic hemiplegic cerebral palsy (mean age = 8.7 years, standard deviation = 2.2) and the dominant upper limb of 15 age-matched children who are typically developing. Representative indicators of the muscle activation, such as the muscle co-activation, were extracted from the electromyographic measurements. Findings Muscle co-activation in the involved upper limb accounted for 78% and 59% of the explained variance of the supination and extension limited active ranges of motion respectively. The agonist and antagonist muscle activations were both longer in the involved upper limb. Interpretations This study succeeded in quantifying the impact of longer antagonist muscle activation on decreased elbow active ranges of motion in children with spastic hemiplegic cerebral palsy. Longer agonist muscle activation suggests that strengthening agonist muscles could increase the extension and supination ranges of motion, which constitutes a perspective of future clinical studies. © 2014 Elsevier Ltd. All rights reserved.


Frossard L.A.,University of Quebec at Montréal | Frossard L.A.,Marie Enfant Rehabilitation Center | O'Riordan A.,Alison oRiordan Sports Consultancy | Smeathers J.,Queensland University of Technology
Prosthetics and Orthotics International | Year: 2013

Background: Studies on the relationship between performance and design of the throwing frame have been limited and therefore require further investigation. Objectives: The specific objectives were to provide benchmark information about performance and whole body positioning of male athletes in F30s classes. Study Design: Descriptive analysis. Methods: A total of 48 attempts performed by 12 stationary discus throwers in F33 and F34 classes during seated discus throwing event of 2002 International Paralympic Committee Athletics World Championships were analysed in this study. The whole body positioning included overall throwing posture (i.e. number of points of contact between the thrower and the frame, body position, throwing orientation and throwing side) and lower limb placements (i.e. seating arrangements, points of contact on the both feet, type of attachment of both legs and feet). Results: Three (25%), five (42%), one (8%) and three (25%) athletes used from three to six points of contact, respectively. Seven (58%) and five (42%) athletes threw from a standing or a seated position, respectively. A straddle, a stool or a chair was used by six (50%), four (33%) or two (17%) throwers, respectively. Conclusions: This study provides key information for a better understanding of the interaction between throwing technique of elite seated throwers and their throwing frame. © The International Society for Prosthetics and Orthotics 2012.


Frossard L.A.,University of Quebec at Montréal | Frossard L.A.,Marie Enfant Rehabilitation Center | O'Riordan A.,Alison oRiordan Sports Consultancy | Smeathers J.,Queensland University of Technology
Prosthetics and Orthotics International | Year: 2013

Background: Studies on the relationship between performance and design of the throwing frame have been limited. Part I provided only a description of the whole body positioning. Objectives: The specific objectives were (a) to benchmark feet positioning characteristics (i.e. position, spacing and orientation) and (b) to investigate the relationship between performance and these characteristics for male seated discus throwers in F30s classes. Study Design: Descriptive analysis. Methods: A total of 48 attempts performed by 12 stationary discus throwers in F33 and F34 classes during seated discus throwing event of 2002 International Paralympic Committee Athletics World Championships were analysed in this study. Feet positioning was characterised by tridimensional data of the front and back feet position as well as spacing and orientation corresponding to the distance between and the angle made by both feet, respectively. Results: Only 4 of 30 feet positioning characteristics presented a coefficient correlation superior to 0.5, including the feet spacing on mediolateral and anteroposterior axes in F34 class as well as the back foot position and feet spacing on mediolateral axis in F33 class. Conclusions: This study provided key information for a better understanding of the interaction between throwing technique of elite seated throwers and their throwing frame. © The International Society for Prosthetics and Orthotics 2012.


Curran S.A.,Cardiff Metropolitan University | Frossard L.,University of Quebec at Montréal | Frossard L.,Marie Enfant Rehabilitation Center
Prosthetics and Orthotics International | Year: 2012

A biomechanical analysis of sports performance provides an objective method of determining performance of a particular sporting technique. In particular, it aims to add to the understanding of the mechanisms influencing performance, characterization of athletes and provide insights into injury predisposition. While the performance in sport of able-bodied athletes is well recognized in the literature, less information and understanding are known on the complexity, constraints and demands placed on the body of an individual with a disability. This article provides a dialogue that outlines scientific issues of the performance analysis of multi-level athletes with a disability, including Paralympians. Four integrated themes are explored, the first of which focuses on how biomechanics can contribute to the understanding of sports performance in athletes with a disability and how it may be used as an evidence-based tool. This latter point questions the potential for a possible cultural shift led by the emergence of user-friendly instruments. The second theme briefly discusses the role of reliability of sports performance and addresses the debate of two-dimensional and three-dimensional analyses. The third theme addresses key biomechanical parameters and provides guidance to clinicians and coaches on the approaches adopted using the biomechanical/sports performance analysis for an athlete with a disability starting out, to the emerging and elite Paralympian. For completeness of this discourse, the final theme is based on the controversial issues on the role of assisted devices, and the inclusion of Paralympians into able-bodied sport. All combined, this dialogue highlights the intricate relationship between biomechanics and training of individuals with a disability. Furthermore, it illustrates the complexity of modern training of athletes, which can only lead to a better appreciation of the performances to be delivered in the London 2012 Paralympic Games. © 2012 The International Society for Prosthetics and Orthotics.


Nantel J.,Stanford University | Mathieu M.-E.,Sainte Justine Research Center | Mathieu M.-E.,University of Montréal | Prince F.,University of Montréal | Prince F.,Marie Enfant Rehabilitation Center
Journal of Obesity | Year: 2011

Overweight (OW) and obesity (OB) are often associated with low levels of physical activity. Physical activity is recommended to reduce excess body weight, prevent body weight regain, and decrease the subsequent risks of developing metabolic and orthopedic conditions. However, the impact of OW and OB on motor function and daily living activities must be taken into account. OW and OB are associated with musculoskeletal structure changes, decreased mobility, modification of the gait pattern, and changes in the absolute and relative energy expenditures for a given activity. While changes in the gait pattern have been reported at the ankle, knee, and hip, modifications at the knee level might be the most challenging for articular integrity. This review of the literature combines concepts and aims to provide insights into the prescription of physical activity for this population. Topics covered include the repercussions of OW and OB on biomechanical and physiological responses associated with the musculoskeletal system and daily physical activity. Special attention is given to the effect of OW and OB in youth during postural (standing) and various locomotor (walking, running, and cycling) activities. © 2011 Julie Nantel et al.


Vanasse M.,University of Montréal | Pare H.,Marie Enfant Rehabilitation Center | Zeller R.,University of Toronto
Handbook of Clinical Neurology | Year: 2013

Most neuromuscular diseases (NMD) are rare inherited conditions presenting a relentlessly progressive course. Some NMD are associated with intellectual impairment and many are complicated by musculoskeletal, cardiac, or respiratory problems. Rehabilitation care of NMD is thus best provided by a team of medical specialists and health professionals working closely together in an interdisciplinary fashion. Rehabilitation for patients with NMD should include physical evaluation but also assessment of their ability to manage their daily activities or work and their need for assistive devices. With appropriate physical, psychological, and social support, those patients can maintain a good quality of life and an adequate level of well-being.Surgical management of musculoskeletal problems in children related to neuromuscular disorders remains a highly controversial subject. This review is based mainly on the author's personal experience with conservative and periopeporative rehabilitation care for neuromuscular diseases. A multidisciplinary approach is advocated. The importance of proactive respiratory care is emphasized. Rehabilitation after surgical treatment of spinal deformities is analyzed outlining the particular aspects in spinal muscular atrophy, Duchenne's muscular dystrophy, congenital muscular dystrophy, and congenital myopathies. A disease- specific approach is recommended as the wide variety of different neuromuscular pathologies requires careful planning of treatment strategies best managed in a team approach. © 2013 Elsevier B.V.


Frossard L.,University of Quebec at Montréal | Frossard L.,Marie Enfant Rehabilitation Center
Prosthetics and Orthotics International | Year: 2012

Background: There is a need for better understanding of the dispersion of classification-related variable to develop an evidence-based classification of athletes with a disability participating in stationary throwing events. Objectives: The purposes of this study were as follows: (1) to describe tools designed to comprehend and represent the dispersion of the performance between successive classes and (2) to present this dispersion for the elite male and female stationary shot-putters who participated in Beijing 2008 Paralympic Games. Study Design: Retrospective study. Methods: This study analysed a total of 479 attempts performed by 114 male and female stationary shot-putters in three F30s (F32-F34) and seven F50s (F52-F58) classes during the course of eight events during Beijing 2008 Paralympic Games. Results: The average differences of best performance were 1.46 ± 0.46 m for males between F54 and F58 classes as well as 1.06 ± 1.18 m for females between F55 and F58 classes. The results demonstrated a linear relationship between best performance and classification while revealing two male gold medallists in F33 and F52 classes as outliers. Conclusions: This study confirms the benefits of the comparative matrices, performance continuum and dispersion plots to comprehend classification-related variables. The study presented here represents a stepping stone into biomechanical analyses of stationary throwers, particularly on the eve of the London 2012 Paralympic Games where new evidences could be gathered. © 2012 The International Society for Prosthetics and Orthotics.


PubMed | Marie Enfant Rehabilitation Center
Type: | Journal: Rehabilitation research and practice | Year: 2011

Objective. To compare center of mass (COM) compensation in the frontal and sagittal plane during gait in patients with large diameter head total hip arthroplasty (LDH-THA) and hip resurfacing (HR). Design. Observational study. Setting. Outpatient biomechanical laboratory. Participants. Two groups of 12 patients with LDH-THA and HR recruited from a larger randomized study and 11 healthy controls. Interventions. Not applicable. Main Outcome Measures. To compare the distance between the hip prosthetic joint center (HPJC) and the COM. The ratio (R(HPJC-COM)) and the variability (CV(HPJC-COM)) were compared between groups. Hip flexor, abductor, and adductor muscle strength was also correlated between groups while radiographic measurements were correlated with the outcome measures. Results. In the frontal plane, HR shows less variability than healthy controls at push-off and toe-off and R(HPJC-COM) is correlated with the muscle strength ratios (FR(ABD)) at heel contact, maximal weight acceptance, and mid stance. In the sagittal plane, LDH-THA has a higher R(HPJC-COM) than healthy controls at push-off, and CV(HPJC-COM) is significantly correlated with FR(FLEX). Conclusions. One year after surgery, both groups of patients, LDH-THA and HR, demonstrate minor compensations at some specific instant of the gait cycle, in both frontal and sagittal planes. However, their locomotion pattern is similar to the healthy controls.

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