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Pain has multiple consequences, forcing people to change the way they carry out their activities (domestic, work, leisure, social). Classically, three behavioural strategies have been described: avoidance, modulation, and persistence. Recent research suggests that the use of these strategies is more complex and subtle than previously imagined. Identifying behavioural activity strategies early in the management process with simple, precise, and concrete questions is particularly useful for adapting treatment plans. From a therapeutic point of view, the recommendations for promoting activity are both to choose activities that are valued by the patient in order to reinforce his or her commitment, and to encourage flexibility in the choice of behavioural strategies depending on the context., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Physical and rehabilitation medicine (PRM) is an independent medical specialty, little known in Switzerland. This specialty, strongly linked to the holistic approach of the International Classification of Functioning, will be increasingly solicited by the epidemiology of disability and the imperatives of "ageing better". Its skills in prescribing human and material resources for rehabilitation provide added value in terms of loss of autonomy. Based on a biopsychosocial model, PRM has a high role to play in prevention and primary healthcare, as well as in the management and prevention of the consequences of functionally limiting diseases. There are, however, financial (pricing) and demographic (lack of representation) obstacles to effective action on behalf of the population and the healthcare system., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

The shortening of hospital stays implies rethinking the pre- and post-operative management of lower limb arthroplasty. Optimal preparation of the patient and anticipation of the postoperative process are necessary to limit the length of stay and ensure quality, safety and patient satisfaction. This article summarises what is known about preoperative information, education and rehabilitation for primary care physicians. Physical rehabilitation is not recommended in isolation. However, patient-centred information and education is recommended for those at risk of complicated postoperative outcomes. Interdisciplinary collaboration is needed to coordinate the whole process effectively in a context of shortened lengths of stay., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

This article aims to present the principles of rehabilitation following anatomical and reverse total shoulder arthroplasties. The rehabilitation consist of three phases: wound healing and movement initiation (weeks 0-6), movement recovery (7-12), strengthening and return to activity (13-18). At 6 to 12 months follow-up, most patients report a substantial decrease in pain and a return to light to moderate activity level. The rehabilitation of the reverse arthroplasty specifically requires deltoid muscle strengthening and dislocation prevention. The functional outcome is slightly inferior for reverse arthroplasty, which is indicated when musculotendinous lesions are associated to bone lesions, but satisfaction rates are comparable between the two types of implants. The durability of total shoulder arthroplasties is globally satisfying, though shorter in young active patients., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

The Complex Regional Pain Syndrome (previously algodystrophy) is a rare affliction that usually affects a distal extremity (hand, foot). It occurs most frequently within weeks following a traumatic injury or stroke. It is a syndromic entity whose diagnosis is based on precise criteria, known as the Budapest criteria, excluding any disease that better explains the symptoms. The treatment must be given early. Functional restoration (physiotherapy, occupational therapy) is at the heart of the treatment, along with psychoeducation. Inappropriate disuse and avoidance, often encountered, must be combated. Bisphosphonates or steroids are first-line drugs at early stages. The evolution is often long, but the prognosis is favorable in about 75 % of cases (≤ 1 year)., Competing Interests: les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

A century and a half after its first description, adhesive capsulitis (frozen shoulder) has revealed only part of its secrets. Its definition remains clinical since the imaging technology we have at our dis-posal is insufficiently sensitive and specific. Next to its idiopathic form, the most frequent and the most characteristic, there are numerous situations inducing a functional limitation of the glenohumeral joint and of its environment. The clinical course inexorably takes place in one to two years, and develops in 3 phases where successively pain, retraction, and then recovery, as a rule complete recovery, dominate. No treatment is likely to shorten it. In the absence of clearly established proof, our therapeutic approach must be prudent and conservative., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Primary care physicians play a crucial role in rehabilitation following rotator cuff surgery. This synthesis paper aims to address essential issues of postsurgical rehabilitation, based on recent recommendations. The rehabilitation comprises 4 phases, which are determined by the tendon healing process.For each phase, this article presents the stage of tendon healing, the allowed mechanical constraints, the exercise and physiotherapy modalities, the possible activities and the potential complications. Information and counseling to support the patient implication in the rehabilitation are also detailed. This article contributes to an enhanced comprehension of the healing process, which is a prerequisite for appropriate follow-up and efficient complication detection., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

The rehabilitation process after total knee arthroplasty (TKA) relies more and more on the family doctor. Many factors contribute to this development: the constantly increasing number of TKA performed, the reduced length of stay at the hospital and the rehabilitation process after TKA requiring care for 3 to 4 months. After this time, it is also of major importance to encourage patients to take up physical activities in order to limit the negative effects of sedentarity. The goal of this paper is to give family doctors an overview of the current knowledge in the area of rehabilitation after TKA for physicians.