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Objectives: The restorative properties of platelets, through the local release of growth factors, are used in various medical areas. This article reviews fundamental and clinical research relating to platelet-rich plasma applied to tendinous lesions. Materials and method: Articles in French and English, published between 1 January 2012 and 31 December 2014. dealing with PRP and tendons were searched for using the Medline and Scopus data bases. Results: Forty-seven articles were identified which addressed pre-clinical and clinical studies: 27 relating to in vitro and in vivo animal studies and 20 relating to human studies. Of these, five addressed lateral epicondylitis, two addressed rotator cuff tendinopathies, ten dealt with patellar tendinopathies and three looked at Achilles tendinopathies. Conclusions: The majority of pre-clinical studies show that PRP stimulates the tendon's healing process. However, clinical series remain more controversial and level 1, controlled, randomised studies are still needed.

Objective: Beside matrix metalloproteinases, reactive oxygen species (ROS) are the main biochemical factors of cartilage degradation. To prevent ROS toxicity, chondrocytes possess a well-coordinated enzymatic antioxidant system formed principally by superoxide dismutases (SODs), catalase (CAT) and glutathione peroxidase (GPX). This work was designed to assess the effects of interleukin (IL)-1beta and IL-6 on the enzymatic activity and gene expression of SODs, CAT and GPX in bovine chondrocytes.Methods: Bovine chondrocytes were cultured in monolayer for 4-96 h in the absence or in the presence of IL-1beta (0.018-1.8ng/ml) or IL-6 (10-100 ng/ml). To study signal transduction pathway, inhibitors of mitogen-activated protein kinases (MAPK) (PD98059, SB203580 and SP600125) (5-20 microM) and nuclear factor (NF)-kappaB inhibitors [BAY11-7082 (1-10 microM) and MG132 (0.1-10 microM)] were used. SODs, CAT and GPX enzymatic activities were evaluated in cellular extract by using colorimetric enzymatic assays. Mn SODs, Cu/Zn SOD, extracellular SOD (EC SOD), CAT and GPX gene expressions were quantified by real-time and quantitative polymerase chain reaction (PCR).Results: Mn SOD and GPX activities were dose and time-dependently increased by IL-1beta. In parallel, IL-1beta markedly enhanced Mn SOD and GPX gene expressions, but decreased Cu/Zn SOD, EC SOD and CAT gene expressions. Induction of SOD enzymatic activity and Mn SOD mRNA expression were inhibited by NF-kappaB inhibitors but not by MAPK inhibitors. IL-6 effects were similar but weaker than those of IL-1beta.Conclusions: In conclusion, IL-1beta, and to a lesser extend IL-6, dysregulates enzymatic antioxidant defenses in chondrocyte. These changes could lead to a transient accumulation of H(2)O(2) in mitochondria, and consequently to mitochondria damage. These changes contribute to explain the mitochondrial dysfunction observed in osteoarthritis chondrocytes. [ABSTRACT FROM AUTHOR]

Published data related to javelin throwers remain poorly documented. The objectives of this study were therefore to compare isokinetic strength profile of the shoulder rotator muscles between javelin throwers and sedentary persons and to correlate isokinetic data with different field performance parameters. Eleven male javelin throwers and ten sedentary subjects participated in the study. Shoulder internal (IRs) and external rotators (ERs) were isokinetically assessed at 60, 240 and 400°/s in concentric and 60°/s in eccentric exertions. Subjects also performed throwing tests successively using a javelin and a ball (both of 800 g mass). Side to side comparison in the throwers group revealed a dominance effect in the concentric mode for the IRs at all speeds, and for the ERs at 240°/s. Sedentary subjects showed a dominance effect for the IRs at 60°/s and 240°/s. Simple isokinetic concentric-concentric ratios and mixed velocity DCRs (eccentric60/concentric240) of the dominant shoulder were significantly lower in comparison to the non-dominant side values, in the throwers population. Only the simple ratio at 400°/s and the mixed ratio were significantly lower in the sedentary subjects (dominant versus non dominant side). With respect to the dominant shoulder, no significant difference was noted between the groups the peak torque was bodyweight normalized. However, throwers showed a significant reduction of the DCR when compared to the control group. In addition, throwers exhibited moderate to strong correlations (0.61

Neuromuscular electrical stimulation (ES) and passive recovery (PR) were compared in ten healthy men after a provocation exercise inducing delayed onset of muscle soreness (DOMS). The exercise consisted of 3 sets of 30 maximal eccentric contractions performed by the knee flexor muscles of the dominant leg on an isokinetic dynamometer at 60'/s angular velocity. There was an interval of 8 weeks between both bouts and the order of the recovery mode (ES or PR) was block-randomly assigned. ES recovery consisted of a 25-min continuous and non-tetanic (5 Hz) stimulation of the hamstring muscles. Concentric and eccentric hamstrings peak torques were evaluated before and immediately after the provocation exercise, after the recovery period, as well as 24 h (dl), 48 h (d2), 72 h (d3) and 168 h (d7) after the bout. Subjective perception of muscle soreness (VAS, 0-10 a.u.) was evaluated before exercise and at dl, d2, d3 and d7. To assess the CK activity, five blood samples were drawn before exercise and at dl, d2, d3 and d7. For both recovery modes, the greatest reductions in isokinetic muscle performances were measured on d2 (66.3 ± 24.1% of initial values (ES) vs. 57.4 ± 26.5% (PR) for the concentric mode and 55.6 + 16% (ES) vs. 53.1 + 19.3% (PR) for the eccentric mode). d2 also corresponded to the highest painful sensations (5.4 + 2.14 a.u. (ES) vs. 6.15 + 2.55 a.u. (PR)). Peak activities of CK were reached on d3 (47507 + 19973 IU/l (ES) vs. 75887 + 41962 IU/l (PR)). Serum CK was lower with ES than PR at d3 (p < 0.05) but all other parameters changed in a manner that was not statistically different between the two recovery protocols (p > 0.05). This strong trend could be explained by an electro-induced hyperperfusion that may efficiently wash out the muscle from the cellular debris resulting from the initial injury, and hence diminish the inflammatory response and the delayed amplification of tissue damages. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the reproducibility of findings derived from a new iso-inertial dynamometer during bench press (BP) and squat (SQ) and to provide descriptive data for recreational athletes. A position transducer and accelerometer were combined to assess velocity and power during free weight lifting exercises. Simulated movement with a pulley system revealed the excellent technical consistency of the dynamometer. Sixteen male subjects participated in the study. Iso-inertial tests consisted of lifting as fast as possible four different relative loads (35, 50, 70, 90% 1RM in BP and 45, 60, 75, 90% 1RM in SQ). The test was repeated one week later. Analysis of variance revealed no significant variation between sessions or trials. Reproducibility was better in velocity than in power, although it remained fairly good in both exercises (coefficients of variation [CV] never exceeding 10%) except for the time to peak power parameter. Descriptive data confirmed the classical force-velocity and force-power relationships for BP and SQ. In conclusion, this study demonstrated reliable measurements in BP and SQ iso-inertial exercises. Monitoring force-velocity and force-power relationships offers an original functional approach in strength training supervision. [ABSTRACT FROM AUTHOR]

Objective. To establish the inter-session reproducibility of isokinetic concentric strength and fatigue profile of the elbow flexors and extensors in sedentary women.Methods. Forty healthy women who were physically inactive or engaged in recreational sports were included in the study. Strength was evaluated at 60 and 180 degrees/s. The fatigue protocol consisted of 30 maximal-intensity elbow flexion and extension at 180 degrees/s.Results. The extensors were stronger than flexors while no dominance effect was apparent. In addition the work output of the extensors during the fatigue protocol was larger than the flexors', the previous being more fatigue resistant. A dominance effect was observed for the extensors in the fatiguing protocol. Reproducibility expressed by the coefficient of variation was less or equal to 11%.Conclusions. This study highlights satisfactory reproducibility of isokinetic strength and fatigue parameters. The values derived may be useful for interpretation of clinical tests or characterization of pathological states in women with similar characteristics. [ABSTRACT FROM AUTHOR]

Delayed onset muscle soreness (DOMS) follows unaccustomed muscular exercise, most notably in the eccentric mode. That concept refers to a dull ache combined with tenderness, stiffness and weakness of the previously active muscles. Isokinetic device constitutes a specific model in generating and investigating DOMS. Respective effects of concentric and eccentric actions have been compared, emphasizing on the variability in the response (serum activity of CK for instance). The particular sensitivity of the hamstrings was underlined although causes remained unexplained. Some treatment have been proposed in the management of DOMS. Several studies reported that anti-inflammatory agents fail to alleviate pain and discomfort even if other authors indicated a relative effectiveness. Based on the repeated-bout effect, submaximal eccentric exercise currently represent the most useful preventive strategy. [ABSTRACT FROM AUTHOR]

The objectives of the study were to measure the isokinetic strength of the hip flexor-extensor and adductor-abductor muscle groups in unilateral lower limb amputees and to evaluate abnormalities in order to improve the usual rehabilitation programs.Thirty-three patients with unilateral lower limb amputation were included in this study; they served as their own controls, the amputated side being compared to the intact side. Using an isokinetic device, the relative peak torques (N.m by body weight), bilateral asymmetries and agonist/antagonist torque ratios were calculated for the hip flexor, extensor, adductor and abductor muscle groups.A significant reduction of mean concentric relative peak torque measured on the amputated limbs was generally observed when compared to the intact contralateral limb (p < 0.05). The mean percentage of relative peak torque decrease was greater for the extensors than for the flexors (33 +/- 20% and 22 +/- 23%, respectively, at 30 degrees/s angular velocity), and for the abductors than for the adductors (23 +/- 22% and 11 +/- 19%, respectively, at 30 degrees/s angular velocity). Furthermore, the flexor/extensor torque ratio was significantly increased for the amputated limb (for instance, 1.25 +/- 0.33 versus 1.09 +/- 0.25 for the intact limb at 30 degrees/s). The reduction of the abductor/adductor ratio of the operated limb reached the level of statistical significance at 60 degrees/s only (1.25 +/- 0.46 versus 1.07 +/- 0.36 for the intact limb).In conclusion, isokinetic testing revealed a significant reduction of the hip stabilizing muscle strength as a consequence of lower limb amputation. The more marked decrease of the strength of the abductor and extensor muscle groups, resulting in imbalances of the agonist/antagonist strength ratios should be taken into account to adapt the conventional rehabilitation programs. [ABSTRACT FROM AUTHOR]

Background: Various clinical trials have demonstrated the benefits of physical training offered during and/or after breast cancer treatments. However, given the variety of adverse events that may be encountered, physical training could be combined with psychologic, relational, and social guidance. This kind of multidisciplinary program, as well as its long-term effects, have been little studied so far. Therefore, the objective of our study was to determine the benefits at 3, 6, 12, and 24 months of a 3-month exercise and education program among women after breast cancer treatment., Patients and Methods: Two hundred nine outpatients treated for primary breast carcinoma were divided into a control group (n = 106) and an experimental group (n = 103) which underwent a 3-month rehabilitation program including physical training and psychoeducational sessions. The assessments, performed before the program and at 3, 6, 12, and 24 months after inclusion, included validated questionnaires on quality of life and symptoms., Results: The analyses revealed an improvement in quality of life and symptoms after the exercise and education program within the experimental group and a maintenance of these improvements during the 2 years of follow-up. These improvements were significantly better than those in the control group, clearly demonstrating that the program has benefits., Conclusion: This trial identified the benefits of a well-detailed 3-month exercise and education program over 24 months' follow-up among women after breast cancer treatment., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Context:   Few researchers have identified intrinsic risk factors for shoulder injury in team handball players by analyzing measurements of maximal isokinetic rotator muscle strength., Objective:   To identify possible intrinsic risk factors for shoulder injury by analyzing measurements of maximal isokinetic rotator muscle strength., Design:   Cross-sectional study., Setting:   Male team handball senior divisions (the highest level) in France and Belgium., Patients or Other Participants:   A total of 108 male high-level handball players (age = 24 ± 4 years, height = 189 ± 6 cm, mass = 87 ± 11 kg) were enrolled., Main Outcome Measure(s):   All players completed a preseason questionnaire and performed a bilateral isokinetic assessment of the shoulder rotator muscles. On a monthly questionnaire, players reported any shoulder injury that they sustained during the season., Results:   On the preseason questionnaire, 51 of 108 (47%) participants reported a history of dominant-shoulder injury. A total of 106 participants completed the in-season questionnaire, with 22% (n = 23) reporting a shoulder injury on their dominant side during the subsequent season. Fourteen percent (n = 15) sustained microtraumatic injuries, and 8% (n = 8) described a traumatic injury. Backcourt players had a 3.5-times increased risk of injury during the new season compared with players in other positions. Among the isokinetic results, no risk factor for further injury was identified in handball players with microtraumatic injuries. For traumatic injuries, the concentric maximal strength developed by the internal rotators at high speed (240°/s) in the dominant shoulder was a protective factor against the risk of further injury., Conclusions:   These results can potentially identify intrinsic risk factors for shoulder injury and may be used to determine potential interventions for reducing this risk in handball players.

Pain physiology education is an important component in the management of patients with chronic musculoskeletal pain. The Neurophysiology of Pain Questionnaire (NPQ) was developed in English to assess pain physiology knowledge in patients. This study aimed to translate the NPQ into French (NPQ-Fr) and to investigate the main psychometric properties of the NPQ-Fr. The translation was performed using the best practice translation guidelines. One hundred and one French-speaking patients with chronic non-specific spinal pain completed the NPQ-Fr to assess its acceptability and presence of floor/ceiling effects and test its dimensionality. The construct validity was tested by comparing the patients' NPQ-Fr scores to those of 17 physiotherapists and investigating its correlation with subscales of the Short Form-36 questionnaire. The reliability (i.e., internal consistency and test-retest reliability) was also investigated. To test the test-retest reliability, 70 patients were asked to complete the NPQ-Fr twice with one week in between. Regarding the NPQ-Fr psychometric properties: 1) acceptability was good; 2) internal consistency reached a Cronbach α-coefficient of 0.44; 3) no floor and ceiling effects were observed in patients; 4) a principal factor analysis generated three major factors; 5) construct validity was good; and 6) reliability was acceptable (intraclass correlation coefficient = 0.644; standard error of measurement = 1.5). The NPQ-Fr has satisfactory basic psychometric properties in patients with chronic spinal pain.

Background: Different clinical trials show beneficial effects of physical training offered during and/or after breast cancer treatment. However, given the variety of side effects that may be encountered, physical training could be combined with psychological, relational and social guidance. This kind of multidisciplinary program has been little studied so far., Aim: The aim of this study was to determine the benefits of a three-month multidisciplinary rehabilitation program among women after breast cancer treatment., Design: Controlled no-randomized trial., Setting: University for outcomes, University Hospital Center for interventions., Population: Two hundred and nine outpatients who have been treated for a primary breast carcinoma., Methods: Patients were divided into a control group (N.=106) and an experimental group (N.=103) which has benefited from a rehabilitation program of three months including physical training and psycho-educational sessions. The assessments, performed before and after the program, included functional assessments ("Sit and Reach Test", maximal incremental exercise test and "Six-Minute Walk Test"), body composition measurements (Body Mass Index [BMI] and body fat percentage) and a questionnaire (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30)., Results: After three months, flexibility, walking distance and all parameters measured during the maximal incremental exercise, except maximal heart rate, were significantly improved in the experimental group. The body fat percentage was significantly decreased and a significant improvement was observed for perceived health status (quality of life), functional role, emotional state, physical, cognitive and social functions and for most symptoms. In the control group, most of these improvements didn't appear and a significant increase in BMI and body fat percentage was observed., Conclusions: This trial identifies the benefits of a well detailed multidisciplinary rehabilitation program, including physical re-conditioning and psycho-educational sessions, with important improvements in functional capacity, body composition and the majority of functions and symptoms among women after breast cancer treatment., Clinical Rehabilitation Impact: Through its results, this study could contribute to the development of hospital quality standards for oncologic rehabilitation. Physiotherapists can efficiently propose this kind of multidisciplinary rehabilitation program.

Fibromyalgia (FM), whose diagnostic criteria were originally established in 1990 and updated in 2010, consists of a syndrome characterized by the presence of deep and diffuse musculoskeletal pain associated with other subjective manifestations (sleep, mood, cognitive problems). The prevalence is assessed in the general population at 2.2 %. Various risk factors were identified: age, gender, level of education and socio-economic status. Various etiological hypotheses have been explored, whether in neuroimaging or from the point of view of possible neuroendocrine and cytokine perturbations. In addition, various potential pathogenic mechanisms have been identified: genetic predisposition, central amplification, diffuse inhibitory control failure, muscle as peripheral nociceptive afferents. Finally, with regard to treatment and clinical course, the first will be multidisciplinary and the second will not be marked by real remission. In addition, patients tend to reduce their activities (professional, physical or leisure), which degrades and perpetuates the situation, while they must remain as active as possible.

Background: The tendon is a dynamic entity that remodels permanently. Platelet-rich plasma (PRP) injection has been shown to have a beneficial effect on tendon healing after lesion in rats. Furthermore, eccentric exercise seems to improve the mechanical quality of the tendon., Hypothesis: A combination of PRP injection and eccentric training might be more effective than either treatment alone., Study Design: Controlled laboratory study., Methods: Adult male rats were anesthetized, an incision was performed in the middle of their left patellar tendon and an injection of physiological fluid (PF) or homologous PRP was randomly made at the lesion level. The rats were then divided into 2 groups: the eccentric group, undergoing eccentric training 3 times a week, and the untrained group, without any training. Thus, 4 groups were compared. After 5 weeks, the tendons were removed and their ultimate tensile strength and energy were measured. Tendons were frozen for proteomic analyses when all biomechanical tests were completed. Statistical analysis was performed with linear mixed effect models., Results: No significant difference was found between the treatments using PF injection or PRP injection alone. However, the value of the ultimate tensile force at rupture was increased by 4.5 N (108% of control, P = .006) when eccentric training was performed. An intragroup analysis revealed that eccentric training significantly improved the ultimate force values for the PRP group. Proteomic analysis revealed that eccentric training led to an increase in abundance of several cytoskeletal proteins in the PF group, while a decrease in abundance of enzymes of the glycolytic pathway occurred in the PRP-treated groups, indicating that this treatment might redirect the exercise-driven metabolic plasticity of the tendon., Conclusion: Eccentric training altered the metabolic plasticity of tendon and led to an improvement of injured tendon resistance regardless of the treatment injected (PF or PRP)., Clinical Relevance: This study demonstrates the necessity of eccentric rehabilitation and training in cases of tendon lesion regardless of the treatment carried out.

Background: Physical exercise in addition to standard care (SC) in patients with Parkinson's disease (PD) is now a common practice in many care units. However, exercises can cover a wide range of interventions, and the specific effects of different interventions still deserve to be further investigated., Aim: The aim of this study was to compare the effects of 12 weeks of two different types of physical exercises with SC in patients suffering from PD., Design: Pseudo-randomized controlled trial., Setting: University laboratory for outcomes, University Hospital Centre for interventions., Population: Fifty-two outpatients suffering from mild to moderate PD at baseline., Methods: Participants were allocated to three groups: the strength training (ST) group performed individualized upper and lower limbs strength training, the aerobic training (AE) group performed tailored gradual aerobic cycling, and the third group received SC. The effects of the interventions on body function were assessed by measuring isokinetic concentric peak torque for knee extension and flexion, peak oxygen consumption (VO2peak) and peak work load (PWL) during an incremental maximal cycling test. Changes in mobility were evaluated from spatial-temporal gait features measured by mean of an accelerometer system and the Six-Minute Walk Distance (6MWD) Test. We used questionnaires to estimate health-related quality of life and habitual physical activity., Results: No significant changes in any outcome measures occurred in the SC group. More than 80% of the participants adequately completed the AE and the ST interventions. The ST group significantly improved all peak torque measures (P≤0.01), except knee extension in the least affected side (P=0.13). This group also improved the PWL (P=0.009) and 6mwd (P=0.03). The AE group improved the VO2peak (P=0.02) and PWL (P<0.001)., Conclusions: Physical fitness in patients with PD rapidly improved in compliance with training specificities, but better fitness hardly translated into better mobility and health-related quality of life., Clinical Rehabilitation Impact: Physiotherapists can efficiently propose physical conditioning to patients with mild to moderate PD, but these interventions are insufficient to improve gait and participation. Notwithstanding, ST is an efficient intervention for improving walking capacity.

The clinical variability and complexity of multiple sclerosis (MS) challenges the individual clinical course prognostication. This study aimed to find out whether multimodal evoked potentials (EP) correlate with the motor components of multiple sclerosis functional composite (MSFCm) and predict clinically relevant motor functional deterioration. One hundred MS patients were assessed at baseline (T 0 ) and about 7.5 years later (T 1 ), with visual, somatosensory and motor EP and rated on the Expanded Disability Status Scale (EDSS) and the MSFCm, including the 9 Hole Peg Test and the Timed 25 Foot Walk (T25FW). The Spearman correlation coefficient (r S ) was used to evaluate the cross-sectional and longitudinal relationship between EP Z scores and clinical findings. The predictive value of baseline electrophysiological data for clinical worsening (EDSS, 9-HPT, T25FW, MSFCm) during follow-up was assessed by logistic regression analysis. Unlike longitudinal correlations, cross-sectional correlations between EP Z scores and clinical outcomes were all significant and ranged between 0.22 and 0.67 (p < 0.05). The global EP Z score was systematically predictive of EDSS and MSFCm worsening over time (all p < 0.05). EP latency was a better predictor than amplitude, although weaker than latency and amplitude aggregation in the global EP Z score. The study demonstrates that EP numerical scores can be used for motor function monitoring and outcome prediction in patients with MS.

Introduction: The objective of this study was to assess the number and magnitude of preoperative expectations and to correlate them with the degree of satisfaction expressed one year after Total Hip Arthroplasty (THA) or Total Knee Arthroplasty (TKA), in patients with severe and painful osteoarthritis (OA)., Materials and Methods: Preoperative expectations (within 20 days prior to surgery) and postoperative satisfaction (one year after the intervention) were measured using the previously validated French version of the Hospital for Special Surgery Hip or Knee Replacement Expectations Survey. Postoperative satisfaction was measured using a specific scale, following the same methodology as that used for the assessment of expectations. Prediction of the satisfaction of the patients was performed using multivariate linear regression modelling., Results: A total of 138 patients (80 THA and 58 TKA) completed the two parts of the study. The expectations score (mean ± SD) (range 0-100) was 72.58 ± 12.63 before THA and 69.10 ± 13.72 before TKA (p = 0.13). The number of expectations expressed was 14.34 ± 1.32 (out of a potential maximum of 18) before THA and 14.70 ± 2.29 (out of a potential maximum of 19) before TKA. After 1 year, THA generated a significantly higher degree of satisfaction compared to TKA (69.70 ± 14.46 v 60.44 ± 17.54, p<0.001) (range 0-100). The pre-operative expectations score was the single best positive predictor of the post-surgery satisfaction assessment both for TKA and THA., Conclusion: Patients undergoing total joint arthroplasty for end-stage OA have a high level of expectations, before both THA and TKA. While both types of interventions significantly improve essential and non-essential activities, the rate of satisfaction is significantly greater post THA. Preoperative expectations are a major contributor to the final degree of satisfaction, one year after surgery. These results re-emphasize the need for an optimal preoperative interaction between health care providers and patients, to allow patients a chance to foresee a reasonable outcome after TJA., Competing Interests: The authors have declared that no competing interests exist.

Breast cancer, with an increasing incidence, is the most frequently diagnosed cancer in women worldwide. The treatments proposed, generally a combination of surgery, radiotherapy, chemotherapy, endocrine therapy and/or targeted therapy, are constantly improving, allowing a reduction in the mortality rate, but they are still causing many side effects, not only early but also late, which leads us to consider the post-cancer period as a chronic condition. Side effects, reviewed in this commentary, may affect physical functions, psychological status, social situation, body composition, well-being and quality of life of the patient. In view of the extent of these areas in which side effects of breast cancer and of its treatments can be found, the supportive care offered at the end of treatment need to be multidisciplinary. Different supportive care interventions may be proposed to the patients such as psychological and behavioral interventions, complementary therapies, diet interventions, physical activity/rehabilitation or also physiotherapy interventions for example, all having shown some beneficial effects in the literature. The benefits of these supportive care interventions are thereby already established and they are described in this article, but others studies will be needed to clearly define indications and most optimal modalities of application to reduce side effects and improve quality of life of patients.

Purpose: The Victorian Institute of Sport Assessment - Achilles tendinopathy questionnaire (VISA-A) evaluates the clinical severity of Achilles tendinopathy. The aim of this study was to translate the VISA-A into French and to study the reliability and validity of this French version, the VISA-AF., Method: The VISA-A was translated into French to produce the VISA-AF using a validated methodology in six steps. Thereafter, several psychometric properties of this French version such as test-retest reliability, internal consistency, construct validity and floor and ceiling effects were evaluated. Therefore, we recruited 116 subjects, distributed into 3 groups: pathological patients (n = 31), at-risk athletes (n = 63) and healthy people (n = 22)., Results: The final version of the VISA-AF was approved by an expert committee. On a scale ranging from 0 to 100, the average scores of the VISA-AF obtained were 59 (± 18) for the pathological group, 99 (± 1) for the healthy group and 94 (± 7) for the at-risk group. The VISA-AF shows excellent reliability, low correlations with the discriminant subscales of the SF-36 and moderate correlations with the convergent subscales of the SF-36., Conclusions: The French version of the VISA-A is equivalent to its original version and is a reliable and valid questionnaire for French-speaking patients with Achilles tendinopathy. Implication for Rehabilitation The VISA-AF questionnaire is a reliable translation of the original VISA-A, from English into French, which is one of the most widespread languages in the world. The VISA-AF questionnaire is now a valid instrument that can be used by clinicians and researchers to assess the severity of pain and disability of French-speaking subjects with Achilles tendinopathy. The VISA-AF is a questionnaire to assess the severity of Achilles tendinopathy symptoms but is not a diagnostic tool.

Background: Functional biomarkers able to identify multiple sclerosis (MS) patients at high risk of fast disability progression are lacking. The aim of this study was to evaluate the ability of multimodal (upper and lower limbs motor, visual, lower limbs somatosensory) evoked potentials (EP) to monitor disease course and identify patients exposed to unfavourable evolution., Methods: One hundred MS patients were assessed with visual, somatosensory and motor EP and rated on the Expanded Disability Status Scale (EDSS) at baseline (T0) and about 6 years later (T1). The Spearman correlation (rS) was used to evaluate the relationship between conventional EP scores and clinical findings. Multiple (logistic) regression analysis estimated the predictive value of baseline electrophysiological data for three clinical outcomes: EDSS, annual EDSS progression, and the risk of EDSS worsening., Results: In contrast to longitudinal correlations, cross-sectional correlations between the different EP scores and EDSS were all significant (0.33 ≤ rS < 0.67, p < 0.001). Baseline global EP score and EDSS were highly significant predictors (p < 0.0001) of EDSS progression 6 years later. The baseline global EP score was found to be an independent predictor of the EDSS annual progression rate (p < 0.001), and of the risk of disability progression over time (p < 0.005). Based on a ROC curve determination, we defined a Global EP Score cut off point (17/30) to identify patients at high risk of disability progression illustrated by a positive predictive value of 70%., Conclusion: This study provides a proof of the concept that electrophysiology could be added to MRI and used as another complementary prognostic tool in MS patients.

Supra-scapular nerve (SSN) damage is a rare, but classical diagnosis that can often be overlooked since the nonspecific clinical history and examination commonly lead to the misdiagnosis of another shoulder disorder. This article details the etiopathology, the patients at risk, the reasons for consultation and the clinical aspects of suprascapular neuropathy; it also outlines its diagnostic and therapeutic approaches.

Study Design Clinical measurement study. Background The Victorian Institute of Sport Assessment-Patella (VISA-P), originally developed in English, assesses the severity of patellar tendinopathy symptoms. To date, no French version of the questionnaire exists. Objectives The aim of our study was to translate the VISA-P into French and verify its psychometric properties. Methods The translation and cultural adaptation were performed according to international recommendations in 6 steps: initial translation, translation merging, back translation to the original language, use of an expert committee to reach a prefinal version, test of the prefinal version, and expert committee appraisal of a final version. Afterward, the psychometric properties of the final French version (VISA-PF) were assessed in 92 subjects, divided into 3 groups: pathological subjects (n = 28), asymptomatic subjects (n = 22), and sports-risk subjects (n = 42). Results All members of the expert committee agreed with the final version. On a scale ranging from 0 to 100, with 100 representing an asymptomatic subject, the average ± SD scores on the VISA-PF were 53 ± 17 for the pathological group, 99 ± 2 for the healthy group, and 86 ± 14 for the sports-risk group. The test-retest reliability of the VISA-PF was excellent, with good internal consistency. Correlations between the VISA-PF and divergent validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were low, and the correlation coefficient values measured between the VISA-PF scores and converged items of the SF-36 were higher. Conclusion The VISA-PF is understandable, valid, and suitable for French-speaking patients with patellar tendinopathy. J Orthop Sports Phys Ther 2016;46(5):384-390. Epub 21 Mar 2016. doi:10.2519/jospt.2016.5937.

Objectives: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of two or three successive infiltrations. The aim of this study was to evaluate whether two infiltrations of PRP proves more effective than a single treatment., Design: Prospective, randomized and comparative study of level 2., Methods: Twenty patients suffering from chronic proximal patellar tendinopathy were enrolled into the study and split into two randomized groups (one or two infiltrations of PRP, respectively). The 3-month follow-up evaluation consisted of VAS, IKDC and VISA-P scores, along with algometer, isokinetic and ultrasounds evaluations. After 1 year, subjects were contacted to define their functional evolution., Results: The concentration of the PRP used for each infiltration was similar in both groups, and contained no red or white cells. Results revealed no difference in treatment efficacy between the groups., Conclusions: The comparison between one or two infiltrations of PRP did not reveal any difference between the two groups at short to mid term. A second closely-timed infiltration of PRP to treat proximal patellar tendinopathies is not necessary to improve the efficacy of this treatment in the short term., (Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Introduction: recently, the viscoelastic properties of hyaluronic acid (HA) on liquid connective tissue have been proposed for the treatment of tendinopathies. Some fundamental studies show encouraging results on hyaluronic acid's ability to promote tendon gliding and reduce adhesion as well as to improve tendon architectural organisation. Some observations also support its use in a clinical setting to improve pain and function. This literature review analyses studies relating to the use of hyaluronic acid in the treatment of tendinopathies., Methods: this review was constructed using the Medline database via Pubmed, Scopus and Google Scholar. The key words hyaluronic acid, tendon and tendinopathy were used for the research., Results: in total, 28 articles (in English and French) on the application of hyaluronic acid to tendons were selected for their relevance and scientific quality, including 13 for the in vitro part, 7 for the in vivo animal part and 8 for the human section., Conclusions: preclinical studies demonstrate encouraging results: HA permits tendon gliding, reduces adhesions, creates better tendon architectural organisation and limits inflammation. These laboratory observations appear to be supported by limited but encouraging short-term clinical results on pain and function. However, controlled randomised studies are still needed.

This study aimed to investigate the relationship between the history of low back pain and quality of lumbopelvic motor control in soccer players. Forty-three male elite soccer players (mean age, 18.2 ± 1.4 years) filled in questionnaires related to low back pain and attended a session to assess lumbopelvic motor control by means of five tests (the bent knee fall out test, the knee lift abdominal test, the sitting knee extension test, the waiter's bow and the transversus abdominis test). A physiotherapist, blinded to the medical history of the participants, scored (0 = failed, 1 = correct) the performance of the players for each of the tests resulting in a lumbopelvic motor control score ranging from 0 to 5. Forty-seven per cent of the soccer players reported a disabling low back pain episode lasting at least two consecutive days in the previous year. These players scored worse lumbopelvic motor control than players without a history of low back pain (lumbopelvic motor control score of 1.8 vs. 3.3, P < 0.01). The between-groups difference was particularly marked for the bent knee fall out test, the knee lift abdominal test and the transversus abdominis test (P < 0.01). In conclusion, most soccer players with a history of low back pain had an altered lumbopelvic motor control. Further research should examine whether lumbopelvic motor control is etiologically involved in low back pain episodes in soccer players.

Background: Very few studies have quantified the degree of fatigue characterized by the decline in the maximal voluntary contraction (MVC) force of the trunk extensors induced by the widely used Sørensen test., Objective: Measure the degree of fatigue of the trunk extensor muscles induced by the Sørensen test., Methods: Eighty young healthy subjects were randomly divided into a control group (CG) and an experimental group (EG), each including 50% of the two genders. The EG performed an isometric MVC of the trunk extensors (pre-fatigue test) followed by the Sørensen test, the latter being immediately followed by another MVC (post-fatigue test). The CG performed only the pre- and post-fatigue tests without any exertion in between., Results: The comparison of the pre- and post-fatigue tests revealed a significant (P< 0.05) decrease in MVC force normalized by body mass (-13%) in the EG, whereas a small increase occurred in the CG (+2.7%, P= 0.001)., Conclusions: This study shows that the Sørensen test performed until failure in a young healthy population results in a reduced ability of the trunk extensor muscles to generate maximal force, and indicates that this test is valid for the assessment of fatigue in trunk extensor muscles.

Aim: The aim of this study was to compare tennis players with and without low back pain (LBP) and healthy sedentary participants regarding the trunk muscle strength and flexibility., Methods: Thirty-eight male elite tennis players and 22 healthy sedentary male students (24.8±4.0 years) participated in this investigation. Tennis players were divided into two groups: 11 players (27.8±5.5 years) with current LBP and 27 players (24.3±5.9 years) without LBP. Maximal isometric strength of trunk extensor, rotator, flexor and lateralflexor muscles was assessed by means of specific trunk dynamometers. Pelvic and lumbar flexion mobility were measured by means of inclinometer technique., Results: Comparison of tennis players with and without LBP revealed no significant difference regarding trunk muscle strength and ratio or lumbar spine flexibility (all P>0.05). In comparison with sedentary participants, the tennis players showed a sport-specific profile determined by a non-dominant trunk lateralflexors (P=0.02, F=4.05) and rotators (P=0.03, F=3.62) strength significantly higher than the dominant side., Conclusion: In the current study, comparison of tennis players with and without LBP showed no significant difference regarding trunk strength and spine flexibility. Trunk profile of tennis players showed selective unilateral strength increase of the non-dominant trunk lateralflexors and rotators. This finding could result from the forehand and the service action which involves simultaneously left trunk rotators and lateralflexors, in right-handed players, to generate power. In order to confirm that trunk muscle imbalance has no influence on LBP, further studies should study the effectiveness of a programme aiming to normalize strength ratios in tennis players with LBP.

The pathophysiological mechanisms of tendinopathies integrate various intrinsic and extrinsic factors. Classic "passive" therapeutics have a limited action. Because of a better pathophysiological understanding of tendinopathies, more recent treatments (injections of various compounds, infiltrations of platelet-rich plasma, stem cells) would lead to a long-term healing. In case of failure of conservative managements and depending on the anatomical site, a surgical approach may be considered.