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Covid long affects each patient differently. This disorder can occur in people with both severe and mild forms of the disease. It is often a series of symptoms that disrupt different areas of life in a very variable way. These symptoms can change rapidly. Moreover, several symptoms are associated and fluctuate (between aggravation and recovery) during very variable periods, which leads to a mosaic diagnosis and engages the need for multidisciplinary management., (Copyright © 2022. Publié par Elsevier Masson SAS.)

The amputation of multiple limbs is a rare but serious consequence of septic shock. It concerns young and active populations. The aim of rehabilitation is to enable patients to regain their independence and former everyday life. An overview of this specific care is presented here through a clinical case., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

At the patient's bedside 24 hours a day, the nurse is at the heart of the rehabilitation management of the severely burnt patient: installation, technical dressings, supervision of postures and placement of compressors, to limit the functional consequences to the type of retractable and hypertrophic scars. The nurse takes care of the patient in this long journey leading to social reintegration; from accompaniment to autonomy and acceptance of self-image., (Copyright © 2019. Publié par Elsevier Masson SAS.)

A real transition between intensive care and traditional rehabilitation, the post-intensive care rehabilitation service for patients with brain injuries aims to provide patients with early and intensive rehabilitation. Multi-disciplinary teams support the patients and their families on their journey towards new life projects., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Maxillofacial prosthesis (MFP) can be defined as the art and science of esthetic and functional reconstruction of the facial bones, art because it uses hand-crafted and empirical rules, science because of its technical rigorism and its integration in medicine. MFP aims to multidisciplinary rehabilitate patients presenting with cutaneous and underlying structures defects, It also allows for functional speech and swallowing rehabilitation related to temporo-mandibular joint disorders. Whatever the origin, (traumatic, infectious ortumoral), surgical treatment of these TMJ disorders is usually not indicated in first-line. Functional treatment is often sufficient if started early in an observant patient. The aim of our article was to present the different types devices available for the rehabilitation of the masticatory system according to pathology. The first part will treat about the preservation of the TMJ range of motion in a preventive way. A second part will treat about the possibilities to recover the range of motion in a curative way. A third part will treat about mandibular reposition. At last, we will focus on the devices allowing for mandibular kinetic rehabilitation in adults and in a special pediatric case., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Ankylosis of the temporomandibular joint is defined as a permanent constriction of the jaws with less than 30mm mouth opening measured between the incisors, occurring because of bony, fibrous or fibro-osseous fusion. Resulting complications such as speech, chewing, swallowing impediment and deficient oral hygiene may occur. The overall incidence is decreasing but remains significant in some developing countries. The most frequent etiology in developed countries is the post-traumatic ankylosis occurring after condylar fracture. Other causes may be found: infection (decreasing since the advent of antibiotics), inflammation (rheumatoid arthritis and ankylosing spondylitis mainly) and congenital diseases (very rare). Management relies on surgery: resection of the ankylosis block in combination with bilateral coronoidectomy… The block resection may be offset by the interposition temporal fascia flap, a costochondral graft or a TMJ prosthesis according to the loss of height and to the impact on dental occlusion. Postoperative rehabilitation is essential and has to be started early, to be intense and prolonged. Poor rehabilitation is the main cause of ankylosis recurrence., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

The rehabilitation of people having suffered a head injury requires an inter-disciplinary perspective. Understanding the family dynamics as well as assessing the patient's resources and limits help professionals organise the necessary support to guide the patient and their family towards social reintegration., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

The pathway of a patient after a stroke involves a continuation of care, from their admission to the emergency department to their discharge from the rehabilitation unit. Here, a Genevan hospital team shares its experience in the creation of a video of information for the patients and their family about the process of rehabilitation., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Swallowing disorders in neurological rehabilitation are common and important as they can have harmful consequences. A multi-disciplinary hospital team was created to study ways of preventing their occurrence. This article presents the areas to focus on and the main orientations of patient management., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

When a patient is admitted to a post-intensive care rehabilitation unit, the functional outcome is the main objective of the care. The motivation of the team relies on strong cohesion between professionals. Personalised support provides a heightened observation of the patient's progress. Listening and sharing favour a relationship of trust between the patient, the team and the families., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

In rehabilitation centres, patients having just undergone an amputation are cared for at every stage necessary for their return to daily living. The teams involved coordinate their efforts to provide the local and general care relating to the causal or intercurrent pathology. They also have skills in prostheses., (Copyright © 2015. Publié par Elsevier Masson SAS.)

Pain and treatment of burn patient. The pain of patients with burns must be taken into account early on in their treatment to facilitate their experience in hospital. The treatment of acute pain resulting from dressings, movements and rehabilitation is essential. If they are given the right relief for their day-to-day activities, patients will regain their autonomy more quickly., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

With more than 8000 new amputees each year in France, mostly as a result of a trauma or vascular problem, the challenges are both surgical and technological. The success of the rehabilitation and readjustment of the patient is the fruit of multidisciplinary care., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Objective: To compare the benefits of a thermal cure and non-thermal rehabilitation in treatment of knee osteoarthritis (KOA)., Methods: Randomized therapeutic trial including patients with knee osteoarthritis (American College of Rheumatology criteria). Patients were randomly divided into two groups. Spa treatment consisted of underwater shower, massage-jet showers, hydromassage, pool rehabilitation and peloid therapy. Non-thermal rehabilitation consisted of analgesic physiotherapy, muscle strengthening and group physical rehabilitation. A blinded evaluation was carried out at day 21 and 12months following treatment. It was based on the visual analogic scale of pain (VAS), which represented the primary endpoint., Results: Two hundred and forty patients were included (February-June 2005). The spa treatment and non-thermal rehabilitation groups included 119 and 121 patients respectively. Two hundred and thirty-three patients completed their treatments. Significant improvement of the visual analogic scale of pain was noted in the thermal cure group (61.6±15 at day 0 versus 46.5±22.4 at 12months, P<0.001), but not in the non-thermal group (64.1±15 at day 0 versus 62±29 at 12months, P=0.68). At day 21, comparison of the two groups revealed no significant difference on the VAS (P=0.08). However, at 12months, the thermal cure group was significantly more improved (P=0.000)., Conclusion: In our study, crenobalneotherapy had resulted, at 12months, in more pronounced long-term improvement of the painful symptoms of KOA than had non-thermal rehabilitation., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Stroke rehabilitation has undergone a revolution over the last three decades. Cohort studies have consistently reinforced the importance of post-stroke rehabilitation to stimulate recovery, but the concepts of empirical methods originally proposed by therapists to rehabilitate these patients have not withstood clinical analysis. Functional neuroimaging and animal models have unveiled the mechanisms underlying functional recovery and helped teams understand its limitations and improvement modalities. These neuroscience discoveries constitute the grounds needed to understand the emergence of new technologies: robotics and virtual reality. The objective of this review of the literature was to select key works in this field to better understand current therapeutic possibilities., (Copyright © 2014. Published by Elsevier Masson SAS.)

Being able to predict an individual's potential for recovery of motor function after stroke may facilitate the use of more effective targeted rehabilitation strategies, and management of patient expectations and goals. This review summarises developments since 2010 of approaches based on clinical, neurophysiological and neuroimaging measures for predicting individual patients' potential for upper limb recovery. Clinical assessments alone have low prognostic accuracy. Transcranial magnetic stimulation can be used to assess the functional integrity of the corticomotor pathway, and has some predictive value but is not superior when used in isolation due to its low negative predictive value. Neuroimaging measures can be used to assess the structural integrity of descending white matter tracts. Recent studies indicate that the integrity of corticospinal and alternate motor tracts in both hemispheres may be useful predictors of motor recovery after stroke. The PREP algorithm is currently the only sequential algorithm that combines clinical, neurophysiological and neuroimaging measures at the sub-acute stage to predict the potential for subsequent recovery of upper limb function. Future research could determine if a similar algorithmic approach may be useful for predicting the recovery of gait after stroke., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Innovative technologies for sensorimotor rehabilitation after stroke have dramatically increased these past 20 years. Based on a review of the literature on "Medline" and "Web of Science" between 1990 and 2013, we offer an overview of available tools and their current level of validation. Neuromuscular electric stimulation and/or functional electric stimulation are widely used and highly suspected of being effective in upper or lower limb stroke rehabilitation. Robotic rehabilitation has yielded various results in the literature. It seems to have some effect on functional capacities when used for the upper limb. Its effectiveness in gait training is more controversial. Virtual reality is widely used in the rehabilitation of cognitive and motor impairments, as well as posture, with admitted benefits. Non-invasive brain stimulation (rTMS and TDCS) are promising in this indication but clinical evidence of their effectiveness is still lacking. In the same manner, these past five years, neurofeedback techniques based on brain signal recordings have emerged with a special focus on their therapeutic relevance in rehabilitation. Technological devices applied to rehabilitation are revolutionizing our clinical practices. Most of them are based on advances in neurosciences allowing us to better understand the phenomenon of brain plasticity, which underlies the effectiveness of rehabilitation. The acceptation and "real use" of those devices is still an issue since most of them are not easily available in current practice., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Objective: This study aimed at testing the ability of the superimposed electrical stimulation technique to restore the mobility of pre-stiff thumbs after operative repair for rupture of the ulnar collateral ligament., Material and Methods: Eight patients demonstrating a pre-stiff metacarpophalangeal joint were involved in two rehabilitation sessions of a counterbalanced design. In the voluntary contraction session, they performed 20min of repeated active flexions of the impaired metacarpophalangeal joint. In the superimposed electrical stimulation session, they performed 20min of percutaneous neuromuscular electrical stimulations which were superimposed to voluntary flexion., Results: Mean active range of motion improvement from pre- to post-session was significantly greater in the superimposed electrical stimulation condition compared to the voluntary contraction condition (11±5 deg versus 3±4 deg; P<0.01)., Conclusion: Superimposing electrical stimulation to voluntary contractions is an efficient technique to improve active range of motion of the pre-stiff metacarpophalangeal joint of the thumb., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

The Wolf-Hirschhorn syndrome (WHS) encompasses deletions at the distal part of the short arm of one chromosome 4 (4p16 region). Clinical signs frequently include a typical facial appearance, mental retardation, intrauterine and postnatal growth retardation, hypotonia with decreased muscle bulk and seizures besides congenital heart malformations, midline defects, urinary tract malformations and brain, hearing and ophthalmologic malformations. Pathogenesis of WHS is multigenic and many factors are involved in prediction of prognosis such as extent of deletion, the occurrence of severe chromosome anomalies, the severe of seizures, the existence of serious internal, mainly cardiac, abnormalities and the degree of mental retardation. The phenotype of adult with WHS is in general similar to that of childhood being facial dysmorphism, growth retardation and mental retardation the rule in both adults and children. Avoid long-term complications and provide rehabilitation programs and genetic counseling may be essential in these patients., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Objective: To assess the relevance of the RAPT (Risk Assessment and Prediction Tool), among a cohort of patients undergoing total hip arthroplasty (THA)., Method: Prospective study of a cohort of patients evaluated before and after THA. The difference between the postoperative orientation predicted by the RAPT and the real one is assessed. Clinical, environmental and psychosocial criteria that could significantly change the orientation are discussed., Results: One hundred and thirty-four patients (94 women and 40 men) were included. The average age was 71.6 (±10) years. Primary hip osteoarthritis was the indication for surgery in 78% of cases. The average length of stay in the surgery ward was 10 (±3) days. It was significantly higher for patients referred to a rehabilitation ward (P<0.0001). Sixty-six percent of patients were referred to a rehabilitation ward and 34% returned directly home. The average length of stay in rehabilitation ward was 27 (±13) days. The validity of the RAPT as a help decision tool has been confirmed. Thus, a low RAPT score was significantly associated with more frequent referral to a rehabilitation ward, conversely, a high RAPT score is significantly related to more frequent direct return to home., Conclusion: This study confirmed the usefulness of the RAPT to help in patient orientation decision after total hip arthroplasty. The patient preference remains the main variable for orientation after THA. By the way, the patient preference must not be integrated into the RAPT, but need to be collected and be discussed with the patient., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Gait and balance disorders are often major causes of handicap in patients with cerebellar ataxia. Although it was thought that postural and balance disorders in cerebellar ataxia were not treatable, recent studies have demonstrated the beneficial effects of rehabilitation programs. This article is the first systematic review on the treatment of postural disorders in cerebellar ataxia. Nineteen articles were selected, of which three were randomized, controlled trials. Various aetiologies of cerebellar ataxia were studied: five studies assessed patients with multiple sclerosis, four assessed patients with degenerative ataxia, two assessed stroke patients and eight assessed patients with various aetiologies. Accurate assessment of postural disorders in cerebellar ataxia is very important in both clinical trials and clinical practice. The Scale for the Assessment and Rating of Ataxia (SARA) is a simple, validated measurement tool, for which 18 of the 40 points are related to postural disorders. This scale is useful for monitoring ataxic patients with postural disorders. There is now moderate level evidence that rehabilitation is efficient to improve postural capacities of patients with cerebellar ataxia - particularly in patients with degenerative ataxia or multiple sclerosis. Intensive rehabilitation programs with balance and coordination exercises are necessary. Although techniques such as virtual reality, biofeedback, treadmill exercises with supported bodyweight and torso weighting appear to be of value, their specific efficacy has to be further investigated. Drugs have only been studied in degenerative ataxia, and the level of evidence is low. There is now a need for large, randomized, controlled trials testing rehabilitation programs suited to postural and gait disorders of patients with cerebellar ataxia., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Objective: To analyse usefulness of the SPASE programme, a coordinated facility programme to assist traumatic brain injury (TBI) persons in returning to work and retaining their job in the ordinary work environment., Design: A retrospective study including 100 subjects aged over 18 who had suffered traumatic brain injury (GOS 1 or 2). The criterion for return to work (RTW) success was the ability to return to the job he/she had before the accident or to a new professional activity., Results: Factors associated with RTW success were at short-term (2-3 years): the presence of significant workplace support OR=15.1 [3.7-61.7], the presence of physical disabilities OR=0.32 [0.12-0.87] or serious traumatic brain injury OR=0.22 [0.07-0.66]. At medium-term (over 3 years) these factors were: significant workplace support OR=3.9 [1.3-11.3] and presence of mental illness OR=0.15 [0.03-0.7]., Conclusion: This study suggests that a case coordination vocational programme may facilitate the return and maintain to work of TBI persons. It reveals that the workplace support is a key factor for job retention in the medium-term., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: To evaluate the differences in gait characteristics and gait symmetry of post-polio syndrome (PPS) patients ambulating with or without shoes and between subgroups walking with different walking aids and orthoses, study the correlation of these data with personal data, illness condition, physical health, frequency of using aids and orthotics and frequency of falls, and derive recommendations for standardization of reporting these data., Method: Twenty-six PPS subjects ambulated with their own walking devices. We calculated spatio-temporal parameters and symmetry indices (SI) of gait using a data acquired by a motion capture system. We compared inter-subject differences in gait pattern for PPS groups that differed by questionnaire-obtained data of demographics, physical activity, polio history, falls and walking aids. Additional inter-subject comparisons were performed between normal subjects (n=16), PPS patients walking with shoes with/without an ankle-foot-orthosis (n=11), PPS patients walking with knee-ankle-foot-orthosis (n=5), and PPS patients walking with a walker/crutches (n=10). We also compared intra-subject variability in PPS subjects who were able to repeat the trials barefoot., Results: Our main results show that subjects who reported participating in physical activity twice a week or more had significantly better step time and double support symmetry. Subjects who use walking aids on a daily basis had significantly higher gait cadence and shorter stride time. Also, subjects that do not require knee-ankle-foot orthoses and/or walking aids walked with a smaller base width and better symmetry in stance and swing durations than PPS subjects who require these aids., Conclusions: The gait pattern of PPS patients is related to numerous intrinsic and extrinsic factors. Standardization of the reporting protocol of gait-related data of PPS patients is crucial for patient evaluation and treatment design., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Aims: To describe the rehabilitation of non-ambulatory children with cerebral palsy and to explore adjustability on their individual needs., Material and Method: Data described are extracted from an on-going national cohort study, following during 10years 385 children with cerebral palsy, aged from 4 to 10, Gross Motor Function Classification System IV and V. We analysed data from the first 190 patients (mean age 6years 10months (SD 2.0), 111 boys), focusing on physiotherapy, ergotherapy, psychomotility and speech therapy in medico-social and liberal sectors., Results: In medico-social sector, duration of paramedical care is significantly more important than in liberal sector (structure of care: median=4.25h/week, liberal sector: median=2.00h/week) (P<0.0001). More than 4 different types of care per week are given in medico-social sector, while in liberal sector children benefit from only 2 different types of care a week. In investigators opinion, rehabilitation in structures of care is 71.65% adapted as opposed to 18.75% in the liberal sector (P<0.001). Children level V have less time of rehabilitation than the others (P=0.0424)., Interpretation: Rehabilitation of children with cerebral palsy who are not able to walk, with an objective to improve quality of life, is truly multidisciplinary and suitable in medico-social sector., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Unlabelled: To assess the impact of rehabilitation on healing and recurrence rate of ankle sprain, 1year apart, 111 patients, who suffered an ankle sprain (67 men and 44 women; 17 mild sprains, 67 medium and 27 severe), were included by emergency physicians of four emergency rooms (ER) of Finistère. The physician was free to prescribe, or not, further investigations. He prescribed systematically to patients RICE (rest, ice, compression, elevation) protocol, put an ankle brace, and gave a prescription of standardized rehabilitation. The prescription was the same for the four ER. All patients were recalled to 1year. Of the 111 patients initially included, 21 patients were excluded for lack of response after three phone calls. In the end, 90 patients were assessable (56 men and 34 women), mean age 31.4±12.6years (range 15-55) at the time of initial trauma. Emergency physicians had diagnosed, initially, 16 mild sprains (17.8%), 56 medium sprains (62.2%) and 18 severe sprains (20%). Of the 90 patients, 73 patients have been rehabilitated (81.1%). Of the 44 accidents of everyday life, 31 were rehabilitated (70.5%). Of the 27 sports accidents, 25 were rehabilitated (92.6%). Of the 19 work-related injuries, 17 were rehabilitated (89.5%). There is no significant relationship between rehabilitation and no recurrence (P=0.45) nor between rehabilitation and full recovery of the ankle (P=0.59)., Conclusion: We find no association between rehabilitation and prevention of recurrence, nor between rehabilitation and healing of patients. However, our study is limited by the small size of the non-rehabilitated group., (Copyright © 2013. Published by Elsevier Masson SAS.)

Purpose: Testing the new hip joint Helix3D efficiency through clinical data and walking parameters., Method: Three young hip-disarticulated patients (P1, P2 and P3) were assessed both with their previous prosthesis at first day, then four days and six months after being trained with a new prosthesis equipped with the Helix3D hip joint. Assessments comprised a satisfaction questionnaire, a two-minute walk test and a recording of main spatiotemporal gait parameters, Results: After four days with the Helix3D, the satisfaction for the prosthesis was improved for P1, unchanged for P2 and reduced for P3. Distance walked during two minutes increased for P1, unchanged for P2 and slightly improved for P3. Gait pattern was improved in P1, only. P1 abandoned the Helix3D at six months due to an ischiatic wound. P2 and P3 chose not to use the Helix at the end of the four days training period because they could not adapt to the Helix3D characteristics (hydraulic control of hip extension and assistance to hip flexion) and because they did not gain enough benefits. Despite much effort to adjust the prosthesis, the three patients definitively abandoned the Helix3D because of comfort problems, and decided to walk with their previous prosthesis equipped with a monocentric hip joint or even with crutches only., Conclusion: The Helix3D hip joint may need further developments to get clinically relevant for hip-disarticulated amputees who may also need a long training period to adapt to its technical characteristics., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)