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Vanasse M.,University of Montreal | 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. Source

Frossard L.,University of Quebec at Montreal | 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. Source

Curran S.A.,Cardiff Metropolitan University | Frossard L.,University of Quebec at Montreal | 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. Source

Nantel J.,Stanford University | Mathieu M.-E.,Sainte Justine Research Center | Mathieu M.-E.,University of Montreal | Prince F.,University of Montreal | 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. Source

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. Source

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