J.-C. Daviet

Rating of perceived exertion with Borg scale in stroke over two common activities of the daily living

Abstract Background The Borg Scale for the rating of perceived exertion (RPE) is recommended to measure the intensity of physical exercise during stroke rehabilitation, but its reliability in activities of daily living is not explored. Objective To evaluate the correlation between the RPE using the Borg Scale (6–20) and the intensity of effort as measured by the Total Energy Expenditure per minute (TEE.min−1) in a post-stroke population for two tasks: walking at spontaneous comfortable speed and walking up and down stairs. Methods A cross-sectional study has been conducted. Any post-stroke subjects able to walk without being helped were recruited. Subjects were asked to walk at their spontaneous comfortable walking speed for 6 min and then to walk up and down stairs with a portable gas analyzer to measure the TEE.min−1. The RPE was evaluated by the Borg scale (6–20). The correlation between the RPE and the TEE.min−1 for each subject’s walking task and stairs task was calculated with the Pearson coefficient. Results Twenty subjects were included. TEE.min−1 averaged at 5.6 (±1.2 kcal.min−1) for the walking task and 9.58 (±4.3 kcal.min−1) for the stairs task. The median RPE was 11 (min 6; max 15) for the walking task and 11 (min 6; max 16) for the stairs task. The correlation coefficient between the RPE and TEE.min−1 was r = 0.12 (p = 0.25). Conclusion Our work has not determined a correlation between the RPE and TEE.min−1 for two common activities of daily living in post-stroke subjects.

Prediction of the oxygen cost of walking in hemiparetic stroke patients

OBJECTIVEnTo verify the relation between spontaneous walking speed (Sfree) and oxygen cost of walking at Sfree (Cwfree) in post-stroke hemiparetic patients and to test the validity of a prediction model to estimate Cwfree based on Sfree.nnnDESIGNnWe included 26 participants (mean age 65.1 years [SD 15.7]) with mild to moderate disability after stroke who walked at Sfree using mobility aids if necessary for 6min. The Cwfree was measured at a stabilized metabolic rate by indirect calorimetry with the Metamax 3B spiroergometry device. The relation between Sfree and Cwfree was analyzed by the correlation coefficient (r) and coefficient of determination (R2). The Cwfree prediction model was developed from a regression equation, then tested on a second population of 29 patients (mean age 62.1 years [SD 13.4]) with the same inclusion and exclusion criteria.nnnRESULTSnFor the 26 participants, the Sfree and Cwfree were highly correlated (r=-0.94 and R2=0.97), which allowed for formulating a regression equation and developing the Cwfree prediction model based on Sfree. The prediction model tests yielded accurate results (mean bias -0.02mL.kg-1.m-1; 95% limits of agreement -0.31 to 0.26mL.kg-1.m-1). The relation between Cwfree estimated by the model and measured by Metamax was high (R2=0.98).nnnCONCLUSIONnCwfree was strongly correlated with Sfree, which allowed for the development of a valid Cwfree prediction model. A practitioner could estimate the energy expenditure of walking for a patient without using an indirect calorimeter.

Poor level of information for young athletes regarding stress urinary incontinence: Reference to a survey conducted on the Internet

Introduction/Background Physical exercise performed intensively is a serious risk factor of stress urinary incontinence. Despite a better knowledge of the risks factors and the existence of available therapeutics measures, urinary incontinence remains taboo. The major purpose of this study was to assess the knowledge and expectations of athletes regarding stress urinary incontinence. Material and method We have released an anonymous questionnaire using “Google Form”. This questionnaire was developed by experts. The release took place on social networks and on sports women forums from 5 to 20 May 2016. We have obtained 178 answers and 163 were selected for the study. Then, we have accomplished a global statistical study as well as a statistical study in groups of the achieved outcomes. Results The average age of the athletes was 29 years old of which 77% were nulliparous. They practiced an average of 3.9xa0hours of sport per week. Eighty-three percent practiced sports as a hobby and 17% took part in competitions. The prevalence of stress incontinence was up to 45% of which 66% had an inconvenience in their everyday life. Sixty percent had never been informed of urinary incontinence. Eighty percent had no idea that this phenomenon may occur at a young age. Eighty-six percent had no knowledge of the physiopathology of the urinary incontinence. Sixty-seven percent knew that reeducation could help athletes to prevent stress urinary incontinence and only 34% thought they could improve it once it is established. Among the athletes affected by stress urinary incontinence, 67% had never dared speaking of it and only 19% benefited from rehabilitation. Conclusion The results of our study confirmed a high prevalence of stress urinary incontinence among athletes with a real impact on their well-being. However, knowledge of the subject remains very poor due to a clear lack of information. This subject is taboo, partially explained by the lack of education of athletes.

Experience with a process for acquiring assistive technology devices with testing in a semi-ecological situation

Assistive technology (AT) refers to ‘‘any product (including any item, piece of equipment, instruments, technology and software) specially manufactured or existing on the market intended to prevent, to compensate, to control, to alleviate or neutralize deficiencies, activity limitations and participation restrictions’’ (International Organization for Standardization [ISO]: https:// www.iso.org/fr/standard/60547.html). The French National Authority for Health recommends a process for AT acquisition based on a multidisciplinary assessment of the disability and requirements of the disabled person [1]. Nevertheless, we lack a consensus method or any universal method for such acquisition. The acquisition of AT by a person in a disability situation involves complex mechanisms respecting the requirements and the acceptance of the AT [2,3]. Moreover, numerous obstacles include lack of finances and no way to test the AT in an ecological situation. Not many studies have assessed the effectiveness of the process of AT acquisition [4]. The AT tools have been well described [5,6]. Knowledge of the reasons for the non-acquisition and abandonment of AT is essential to improve the acquisition process. The description of what some teams have done could improve the practices [4]. In the department of physical medicine and rehabilitation (PM&R) of Centre Hospitalier et Universitaire Limoges (CHU Limoges), our AT acquisition process includes a multidisciplinary recommendation and testing in an semi-ecological situation. However, the efficiency of this process is unclear. In this context, we sought to share our experience and reflections on this subject. Our recommendation procedure involves 3 phases:

Impact de différentes situations de double tâche sur la qualité de marche de personnes atteintes de démence

Résultats.– L’analyse révèle une absence systématique de différence significative entre les trois séries de mesure pour les paramètres cinématiques. L’analyse des paramètres non-linéaires montre des différences significatives pour les paramètres de CTM dans le plan antéro-postérieur (p < 0,002), de déterminisme de la RQA dans le plan médiolatéral (ML) (p < 0,0001) et d’entropie de la RQA en ML (p < 0,004). Discussion.– Il est satisfaisant d’observer qu’un exercice de marche n’induit pas une fatigue significativement perturbatrice de la réponse posturale chez ce public. De plus, il apparaît que les méthodes non-linaires constitueraient des méthodes pertinentes à la caractérisation des capacités d’adaptation posturales.

Efficiency of cough: Maximum phonation time: Bedside assessment

patient, a student performed the test of swallowing one another and the same test associated with cervical auscultation. The alternation between students for the test is performed with or without auscultation eliminates the ‘‘test effect’’. No information was communicated between students among themselves and with the doctor. The results are presented in the form of ROC curves established according to the use or not of auscultation during the test food. Cervical auscultation does not change the area under the curve. The trend is even reversed with a decrease in performance with the severity of silent aspiration. Thus, auscultation did not improve the performance of the test food in terms of predicting aspiration in the learning phase of swallowing tests by two students in speech therapy. The same study is now complete with experienced pathologists.