Annales de réadaptation et de médecine physique : revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique
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Ann Readapt Med Phys · Feb 2004
[A long-term follow up of the shoulder in obstetrical brachial palsy].
To study shoulder impairment and disability caused by obstetrical brachial plexus palsy, their evolution under physical and surgical treatments, and the place of complementary explorations in persistent sequels. ⋯ After-effects in shoulder are frequent especially the limitation of external rotation, which can lead to a deformation, and subluxation of the humeral head. The authors insist on the importance to push investigations in case of limitation of the passive external rotation to improve the therapeutic choice.
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Relaxant muscle properties and pain relieve effectiveness in neurological spasmodic disorders of botulinum toxin A (BTXA) suggested its relevance to relieve musculoskeletal pain. The aim of this article was to collect literature data and to assess the different analgesia indications of BTXA proposed in the treatment of musculoskeletal pains. ⋯ The first data concerning use of BTXA to treat musculoskeletal pains are few and are worth specifying by other studies.
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To realize a clarification about the interest of the use of botulinum toxin in spinal cord injured patients. ⋯ There are some indications of botulinum toxin in spinal cord injured patients ASIA C and D when spasticity induce focal functional discomfort. Indications are exceptional for ASIA A and B patients. No study showed improvement of functional abilities after botulinum toxin injection in spinal cord injured patients. Published studies only covered small number of patients.
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Ann Readapt Med Phys · Jun 2003
Review[Indications, effectiveness and tolerance of the rehabilitation techniques aimed at improving recovery of awareness following a traumatic brain injury].
In the context of a consensus conference, this review aims at identifying through a comprehensive review and critical analysis of the literature the different rehabilitation programs used to promote the level of consciousness of brain injured patients. ⋯ Because of these methodological flaws and despite the good results claimed by the authors, there is up to date no evidence that clearly demonstrate the effectiveness of sensory stimulation or sensory regulation programs. Further clinical research in this area is necessary.
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Ann Readapt Med Phys · Nov 2002
Review[Traumatic brain injuries in adults: from coma to wakefulness. Neurophysiological data].
To analyse relevant literature and to express an expert point of view concerning the interest of electroencephalography and evoked potentials recordings in the evaluation of severe head trauma in adults in the context of a consensus conference. ⋯ Electroencephalography (EEG) and evoked potentials (Eps) evaluate the functional status of the brain. They augment the clinical examination. They are non invasive and easy to perform at patient's bedside. The EEG evaluate globally the functional status of the brain but it is very sensitive to sedative and anaesthetic drugs. It can disclose subclinical or electroclinical epileptic seizures. When reactivity to sensory stimulations can be elicited, this can be considered a prognostic indicator for a good outcome. Evoked potentials are less influenced by sedative drugs. There are several types of evoked potentials, each one with a different localizing value. Brainstem auditory evoked potentials (or short-latency Eps) evaluate the auditory nerve and brainstem. When normal they have no specificity. When abnormal they are an indicator of a poor or bad outcome. Somatosensory and auditory middle-latency Eps evaluate the primary cortex. In coma due to traumatic brain injury the presence of primary cortex components is an indicator of a good outcome and its absence is an indicator of a poor outcome at least when there is no focal brain lesion as to have the primary cortex component to be absent. Event-related potentials evaluate associative brain areas. When they are present in a comatose patient they favor the idea that some cognitive processes are active and they have a high positive predictive value for a return to consciousness. The electrophysiological evaluation can help to identify atypical situations and pathologies close to coma, disclose nonconvulsive seizures and localize certain complications or dysfunctions in atypical cases.