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Purpose To date, the relationship between footstrike pattern and performance, as well as with injury incidence in endurance running remains unclear. For these reasons, it is currently not recommended to modify footstrike pattern in an uninjured long-distance runner. The purpose of this study was to analyse whether athletic coaches apply these current scientific recommendations with their endurance runners on the field. Methods A Delphi method study was used to develop an online survey that was administered to French-speaking athletic coaches in Belgium. The survey comprised three sections: 1) coaches’ profile, 2) coaches’ perception of footstrike patterns, 3) practices pertaining to footstrike patterns. Results One hundred and fourteen respondents completed the entire questionnaire. Ninety-six (84%) athletic coaches reported modifying the footstrike pattern of their endurance runners. They reported that they modify their runners’ rearfoot and forefoot strike more often than a midfoot strike (P < 0.0001) to prevent injury (83%) and to improve performance (66%). According to them, midfoot strike is considered as the best landing pattern for endurance performance (47%) and injury prevention (36%) whereas rearfoot strike is considered as the worst (respectively, 50% and 52%). Summary and conclusion This study highlights the disparities between scientific recommendations and athletic coaches’ field practices for modifying footstrike patterns in endurance runners. Contrary to current scientific literature recommendations, a large proportion of coaches modify the natural footstrike pattern of their endurance runners towards a midfoot strike pattern to improve performance and prevent injury.

Resume L’atteinte traumatique du ligament croise anterieur (LCA) represente la lesion ligamentaire la plus frequente du genou dont 10 a 27 % sont des ruptures partielles. Ces dernieres sont connues et etudiees depuis la moitie du 20e siecle mais, a ce jour, il n’y a pas de consensus sur la definition meme des lesions ou sur leur approche therapeutique.

Resume Le sport de haut niveau a un impact considerable sur l’appareil locomoteur mais egalement sur l’ensemble du corps des athletes. Les principales structures concernees sont les os, les muscles, les articulations mais egalement le systeme endocrinien. Les consequences sur celles-ci sont decrites et analysees afin de mieux comprendre les phenomenes biophysiologiques induits par la pratique sportive. Nous avons egalement mis l’accent sur les risques et les moyens de prevention de certaines lesions osteoarticulaires et musculaires. L’influence hormonale de l’activite sportive a aussi ete developpee, que ce soit en condition d’effort ou au repos. Enfin, un paragraphe a ete consacre a l’usage des produits dopants, les effets recherches mais egalement les risques engendres chez les athletes par l’utilisation de ceux-ci.

Muscle strength imbalances and poor flexibility are frequently described as risk factors for hamstring injury. Preventive strategies include eccentric exercises, but the influence of field eccentric exercises on these risk factors remains unclear. We investigated the influence of a field hamstring eccentric program on hamstring strength and flexibility. Twenty-seven amateur athletes were randomly assigned to an intervention (n=13) or control group (n=14). In the intervention group, participants were involved in 15 sessions of four eccentric exercises. Peak torque, hamstring-to-quadriceps ratios, passive and active flexibility were analyzed. No significant modifications of strength, passive or active flexibility were observed in the control group (p>0.05). Hamstring eccentric peak torque (+7.1%) and functional hamstring-to-quadriceps ratios (9.3%) were significantly increased (p0.05). In conclusion, a 6-week eccentric program, including four field exercises for hamstring muscles, is an effective method of improving eccentric strength, functional ratios and, especially, passive flexibility. As this program may be easily implemented in a real-world context, this association of multiple eccentric exercises might be useful in an injury prevention strategy.

IntroductionStandard care for anterior cruciate ligament (ACL) injuries includes surgical reconstruction of the ACL. However, two randomised controlled trials (RCTs) concluded that conservative treatment does not result in inferior clinical outcomes compared with immediate ACL reconstruction. More research is needed to in the first place verify these results, and second to assess whether patient-specific parameters determine whether a patient would benefit from one treatment option over the other. However, before running a full RCT, it seems necessary to perform a pilot study that assesses the feasibility of recruiting patients with ACL for such a RCT. This is because recruitment may be challenging as many patients have strong treatment beliefs. Therefore, this pilot study will assess whether a large RCT is feasible with regard to participant recruitment, adherence to the allocated treatment arm and protocol feasibility. These pilot findings will help deciding about progressing to a future full RCT.Methods and analysisThis is a pragmatic, multicentre, randomised controlled pilot trial with two parallel groups. Patients with an acute ACL injury will be recruited from two Belgian hospitals. Patients will be randomised to either conservative treatment or surgical treatment. Patients will be followed-up at 3, 6 and 12 months postrandomisation. Recruitment feasibility will be evaluated by calculating the recruitment rate 4 months after the two sites have been initiated. Clear criteria for progression to a full trial are defined. Adherence to the protocol will be assessed by calculating the proportion of patients who complete the assessments. Furthermore the proportion of patients who cross-over between treatment arms during the follow-up period will be assessed.Ethics and disseminationThe study was approved by the ethical committees: Ethische Commissie Onderzoek UZ/KU Leuven (S62004) and Comité d’Ethique Hospitalo-Facultaire Universitaire de Liège (2020212). Results will be made available to caregivers, researchers and funder.Trial registration numberThis trial is registered on ClinicalTrials.gov (NCT04408690) on 29 May 2020.

Resume Le triathlon est un sport associant trois disciplines (natation, cyclisme et course a pied) qui gagne en popularite et occasionne des blessures compte tenu de la charge consequente d’entrainement quel que soit le niveau de pratique. Les donnees epidemiologiques precises doivent encore etre etablies mais il apparait que : (1) l’incidence rapportee par 1000 heures d’entrainement est relativement faible au vu de la charge hebdomadaire des triathletes ; elle augmente lors des competitions ; (2) les pathologies de surcharges sont majoritaires et sont assimilables a celles rencontrees en course a pied, discipline la plus traumatisante ; (3) les sites lesionnels les plus frequents sont le genou et la jambe ; (4) les facteurs de risque de blessures sont des antecedents de lesion et des erreurs d’entrainement. Considerant un modele ideal de prise en charge, un diagnostic precis doit etre pose par le medecin des l’apparition d’une douleur ayant un impact negatif sur les activites. Une prise en charge est alors etablie par les differents intervenants (medecin – kinesitherapeute – preparateur physique et entraineur) et sera adaptee selon l’evolution. Cette approche multidisciplinaire est indispensable pour eviter les situations figees et les echecs therapeutiques.

Resume Bien que la litterature scientifique relative a la prevention de blessures dans le triathlon soit globalement pauvre, des lignes de conduite directement applicables sur le terrain peuvent etre proposees. Les principales blessures du triathlete etant des lesions de surcharge des membres inferieurs (tendinopathies, fractures de fatigue, periostites), leurs facteurs de risque principaux sont un premier episode lesionnel et une charge de travail inadaptee. Concretement, les mesures preventives peuvent etre regroupees selon differents axes : realiser un bilan medical de pre-saison pour recenser tout element susceptible de predisposer a la survenue d’une blessure ulterieure ; monitorer et gerer la charge de travail ; prevoir une preparation physique incluant notamment un travail de core stability et de renforcement musculaire afin de preparer les organismes aux contraintes ; insister sur une qualite de gestuelles techniques dans chacune des trois disciplines ; ne pas negliger d’eventuels autres facteurs de risque modifiables comme l’hygiene de vie ou la pratique d’echauffement de qualite. Cependant, il apparait necessaire de disposer de plus d’etudes sur le sujet pour pouvoir repondre encore plus efficacement aux besoins fondamentaux de la prevention lesionnelle dans le triathlon.

Resume Le plasma riche en plaquettes (PRP), concentre plaquettaire obtenu par centrifugation de sang autologue, presente de nombreuses proprietes, notamment celles de favoriser l’hemostase et la cicatrisation tissulaire. Certes, son effet clinique est a ce jour toujours discute mais le PRP est de plus en plus utilise dans le cadre des tendinopathies rebelles aux traitements classiques. En vue d’une reprise de la pratique sportive sous les conditions optimales, un modele de decision de retour au jeu (Decision-Based RTP Model) a recemment ete propose. Nous discuterons de ses differents criteres.

Resume Objectif Cette revue de la litterature a pour but de recenser des criteres pertinents d’evaluation en vue de la reprise des activites sportives et de la vie quotidienne apres chirurgie des tendons de la coiffe des rotateurs, du tendon des epicondyliens et des tendons rotulien et calcaneen. Actualites La chirurgie constitue une option therapeutique pour les tendinopathies chroniques rebelles au traitement conservateur et les ruptures tendineuses. Les criteres de reprise des activites quotidiennes et sportives apres chirurgie tendineuse sont souvent peu fonctionnels et non individualises. Des lors, il apparait essentiel de proposer, a l’instar d’autres lesions musculo-squelettiques, des recommandations validees afin d’estimer au mieux le delai de reprise des activites. Perspectives et projets Nous avons retenu des criteres cliniques comme la douleur, l’amplitude articulaire, la force isometrique et isocinetique, l’endurance des muscles de la jambe et les tests de sauts. Les resultats de questionnaires algofonctionnels adaptes a l’etude de la structure tendineuse, tels que les scores de Constant, Patient-Rated Tennis Elbow Evaluation (PRTEE), Victorian Institute of Sport Assessment adapte au tendon rotulien (VISA-P), Achille tendon Total Rupture Score (ATRS) et Victorian Institute of Sport Assessment adapte au tendon achilleen (VISA-A), font aussi partie des criteres repertories. A l’avenir, il est necessaire de definir des valeurs-seuils des differents scores et epreuves proposes afin de pouvoir mieux definir le delai de reprise et garantir celui-ci en toute securite. Conclusion De nombreux criteres de reprise des activites apres chirurgie tendineuse sont recenses dans la litterature. Parmi ceux-ci, certains semblent plus pertinents. Concernant la pratique sportive, nous preconisons d’integrer ces parametres au modele defini par Creighton et son equipe.

Resume Le role joue par la scapula dans la gestuelle sportive d’arme-lancer ou de frappe d’un projectile apparait fondamental ; il concerne le placement et la mobilisation scapulaire adequate pour faciliter la fonctionnalite de l’epaule. A l’inverse, une position ou une mobilisation inappropriee de la scapula lors de la gestuelle pourrait limiter la performance ou exacerber une lesion. La dysfonction scapulothoracique, appelee dyskinesie, s’avere frequente dans l’epaule sportive incluant le membre superieur ; elle s’observe chez des athletes pathologiques, mais aussi dans l’epaule sportive asymptomatique. En presence d’une pathologie d’epaule, un bilan oriente doit permettre d’identifier une eventuelle dyskinesie. Le suivi reeducatif comprend alors une prise en charge specifique dediee aux causes fonctionnelles de cette dysfonction scapulothoracique. L’approche preventive s’avere egalement indispensable etant donne les liens mis en evidence par des etudes prospectives entre la presence d’une dyskinesie et la survenue lesionnelle. De plus, le benefice de l’intervention preventive apparait demontre lors d’un suivi longitudinal de sportif integrant un programme preventif par rapport a un groupe controle.

Resume La recherche sur la thematique de la prevention lesionnelle a connu ces dernieres annees, et toujours actuellement, un developpement important. Plusieurs modeles theoriques ont ete decrits afin d’optimiser l’efficacite des strategies preventives qui, si elles sont creees et pratiquees de maniere rigoureuse, peuvent s’averer particulierement efficaces. Parmi ces modeles, nous pouvons notamment pointer les tres recents « sports injury risk management approaches » qui pourraient s’averer pertinents dans le futur mais qui doivent etre confirmes par des etudes. Pour etre efficace, une strategie preventive devrait notamment inclure divers elements tels que : un bilan medico-sportif de pre-saison, une action coordonnee sur plusieurs facteurs de risque, une compliance maximale des participants ainsi que du staff, et une quantification/gestion de la charge de travail.

Resume Une approche raisonnable des strategies de prevention lesionnelle laisse penser qu’une seule technique, quelle qu’elle soit, ne permettra pas l’identification de l’ensemble des facteurs de risque. La complementarite de plusieurs outils et techniques parait regulierement indispensable. Sur le plan clinique, de nombreux centres realisent des evaluations isocinetiques, en debut de saison, a visee preventive dans le sport de haut niveau. Differentes publications relatent l’interet de l’isocinetisme en prevention primaire et secondaire pour des pathologies parfois specifiques a une activite sportive. D’autres travaux remettent en cause l’utilisation de l’isocinetisme dans le but de predire la survenue d’une lesion, en particulier au niveau des muscles IJ. Dans ce travail, nous evoquons les possibles raisons de resultats discordants dans la litterature.

Resume L’osteochondrite dissequante est une necrose de l’os sous-chondral et du cartilage sus-jacent. Dans les stades avances, un fragment peut se detacher et se retrouver libre dans l’articulation, responsable alors de blocages. Cette pathologie touche davantage les adolescents, surtout de sexe masculin ; une notion d’activite physique intense est souvent retrouvee. L’articulation la plus concernee est le genou, notamment le condyle femoral interne. Les symptomes (douleurs, blocages) et signes cliniques (œdeme, crepitations) s’aggravent lors des sollicitations. La prise en charge debute par un examen clinique exhaustif ; s’en suit le bilan iconographique (radiographies standard, IRM). Le traitement sera adapte a chaque patient. Les modalites conservatrices priment generalement sur les techniques chirurgicales. Ces dernieres sont parfois inevitables. La reeducation est essentielle et doit etre parfaitement menee afin d’eviter toute impotence fonctionnelle residuelle. Dans ce cadre, nous suggerons la realisation d’un test isocinetique permettant de personnaliser la prise en charge et d’adapter la reeducation aux besoins de chacun. Le suivi a long terme est indispensable pour surveiller et prevenir les lesions arthrosiques.

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.

Resume Introduction La reconstruction du LCA est une chirurgie lourde qui est suivie d’une longue periode de reeducation. Le retour au sport apres cette operation reste toutefois un defi. Plus d’un tiers des athletes sont incapables de reprendre leur activite au meme niveau. La peur de subir un nouvel accident reste un obstacle majeur a cette reprise sportive. Par ailleurs, la persistance de deficits fonctionnels est responsable de re-ruptures ligamentaires. Materiel et methodes Notre echantillon comprenait dix sujets, cinq dans le groupe experimental et cinq dans le groupe temoin. Le premier groupe realisait une seance de reathletisation precoce (apres un mois) hebdomadaire associee a la reeducation classique pendant six mois. Le deuxieme groupe beneficiait uniquement de seances de kinesitherapie. En preoperatoire, dans les deux groupes, un test isocinetique etait realise. A six mois postoperatoire, les sujets des deux groupes realisaient dans l’ordre suivant : un test isocinetique, un questionnaire KOOS et enfin des Hop-tests. Resultats L’analyse des tests isocinetiques et du questionnaire de KOOS nous a permis de constater des differences non significatives entre les deux groupes. En revanche, lors des tests fonctionnels le groupe ayant beneficie d’une reathletisation avait des resultats significativement superieurs. Conclusion Dans cette etude preliminaire, nous constatons une amelioration globale des performances, sans cependant etre significative, en faveur du groupe reathletisation. Ces resultats meritent d’etre confirmes par une etude a plus grande echelle.

Resume Le volley-ball (VB) est un sport de ballon sans contact (non fautifs) avec les adversaires ou les pathologies de surcharge sont tres frequentes, notamment au niveau des genoux (exemple : jumper's knee ), des epaules (exemple : pathologies de la coiffe des rotateurs) et du rachis (exemple : spondylolyse). L’entorse de cheville represente le traumatisme le plus courant, surtout lors des phases d’attaque et de defense au filet. Des trois sports olympiques de ballon en salle, le volley-ball est celui ou les blessures graves sont les moins frequentes en raison de l’absence de contact avec l’adversaire. On retrouve une prevalence des traumatismes principalement lors des matchs et lorsque la surface du terrain est peu appropriee.

Resume Objectifs L’incidence des lesions musculaires est elevee dans les sports ou la vitesse de mouvement, l’explosivite ou les changements brusques de direction sont determinants. Cet article a pour objectifs d’analyser : (1) les facteurs de risque des principales lesions musculaires des membres inferieurs (ischiojambiers, quadriceps, adducteurs et triceps sural) ; (2) l’efficacite des principales strategies preventives de ce type de blessures. Actualites Ces dernieres annees, un nombre significatif d’etudes prospectives a permis d’identifier plusieurs facteurs de risque de lesions musculaires. Parmi ceux-ci, un premier episode lesionnel represente le seul facteur de risque intrinseque retrouve pour l’ensemble des quatre grands groupes musculaires. L’âge et la presence d’un desequilibre musculaire interviennent plus specifiquement dans la lesion des ischiojambiers ; la dominance dans la lesion du quadriceps ; un desequilibre musculaire et un manque de souplesse dans la lesion des adducteurs, et enfin l’âge ainsi qu’un manque de souplesse dans la lesion du triceps sural. Les facteurs de risque extrinseques apparaissent plus difficiles a associer a une localisation precise et sont principalement le type de sport pratique (sports collectifs et athletisme notamment), un echauffement inadapte, une charge de travail mal repartie, ainsi que la pratique de l’activite en competition. D’un point de vue preventif, il apparait essentiel de favoriser la pratique reguliere d’exercices de renforcement a haute intensite en mode excentrique et de corriger les eventuels desequilibres musculaires. Perspectives et projets L’influence de certains facteurs de risque comme le manque de souplesse dans les lesions des ischiojambiers et du quadriceps, la fatigue ou encore le moment de la saison meriterait d’etre approfondie. La realisation d’etirements, largement repandue sur les terrains de sport, ne devrait pas etre remise en cause mais l’evidence scientifique de l’efficacite preventive de toute lesion musculaire reste a demontrer, et des precisions concernant les modalites pratiques des etirements (duree, type d’etirement…) sont souhaitables. Des etudes ulterieures sont egalement necessaires pour confirmer l’interet preventif, dans les lesions des ischiojambiers et du quadriceps, de la therapie manuelle ou d’exercices de gainage. Conclusion Un premier episode de blessure musculaire represente le principal facteur de risque de lesions musculaires aux membres inferieurs, et chaque groupe musculaire semble presenter des facteurs de risque specifiques a leur localisation. Pour les quadriceps et surtout pour les ischiojambiers, l’incidence lesionnelle peut etre reduite de maniere consequente grâce a l’implementation de certaines mesures comme la realisation reguliere d’exercices a haute intensite en mode excentrique.

Objective To compare blood gas results obtained from 4 point-of-care (POC) blood gas analyzers under routine working conditions in order to determine their interchangeability. Design Prospective study. Setting University teaching hospital. Animals Arterial blood samples from 34 dogs, 22 presented for cardiorespiratory disease and 12 healthy experimental Beagles. Measurements Each sample was analyzed by 4 POC blood gas analyzers in a random order: Cobas b-123 POC system, IRMA TruPoint, Idexx VetStat, and ABL80 FLEX. Values obtained for pH, partial pressure of oxygen (PO2), and partial pressure of carbon dioxide (PCO2) were compared between analyzers using a statistical mixed linear model and the Bland–Altman method; P < 0.05 was set as the level of significance. One sample was also repeatedly measured 5 times on each machine to calculate and compare intra-analyzer variance for each measured variable using Fisher-statistics. Results PO2 and PCO2 values were significantly higher when measured with the Idexx and IRMA machine than with Cobas and ABL80 (PO2: P < 0.001; PCO2: P < 0.05). pH values were significantly higher when measured with the Idexx instrument than with others' devices (P < 0.01). An interaction between health status and results delivered by devices was found only for PO2 values. There was no significant difference in intra-analyzer variance between the 4 machines, for any of the measured variables. Conclusions PO2, PCO2, and pH differed significantly between the 4 analyzers. Differences in PO2 results were substantial and clinically relevant. All 4 analyzers displayed good intra-analyzer variance. Consequently, serial blood gas analysis should be performed on a single device and interpreted in accordance of the device's specific reference intervals.

Resume Objectifs Les tendinopathies patellaires et calcaneennes demeurent des affections musculosquelettiques tres frequentes chez les sportifs. Le but de notre travail etait de valider une version francaise du Victorian Institute of Sports Assessment – Patellar et – Achilles (VISA-P et VISA-A), questionnaires en anglais developpes respectivement afin d’evaluer la severite des tendinopathies patellaires et calcaneennes. Materiels et methodes La traduction francaise et l’adaptation transculturelle du VISA-P et du VISA-A ont ete realisees selon les recommandations internationales. Pour ces adaptations, 92 (VISA-P) et 116 (VISA-A) sujets furent recrutes et repartis en 3 groupes (asymptomatiques, pathologiques et sportifs a risque), afin de tester ses proprietes psychometriques. Tous ces sujets durent egalement repondre au MOS SF-36 pour la validite de construit. Resultats La moyenne des scores du VISA-PF obtenu est de 99 pour le groupe sain, 53 pour le groupe pathologique et 86 pour le groupe a risque. La fidelite test-retest du VISA-PF est excellente avec un coefficient de correlation intraclasse de 0,99, la coherence interne mesuree par le coefficient α de Cronbach est tres bonne (α = 0,9). Les correlations entre le VISA-PF et les mesures divergentes du SF-36 sont faibles et les coefficients de correlation mesures entre les scores du VISA-PF et les items convergents du SF-36 ont des valeurs plus elevees. La moyenne des scores obtenus pour le VISA-AF est de 99 dans le groupe sain, 59 dans le groupe pathologique et 94 dans le groupe a risque. La fidelite test-retest du VISA-AF est excellente avec un coefficient de correlation intraclasse de 0,99, la coherence interne mesuree est tres bonne (α = 0,92). Les correlations entre le VISA-AF et certaines mesures divergentes du SF-36 sont faibles. Les coefficients de correlation mesures entre les scores du VISA-AF et les items convergents du SF-36 sont moderes. Aucun effet plancher ou plafond n’a ete observe lors de l’evaluation des proprietes psychometriques des deux questionnaires. Conclusion Les versions francaises des questionnaires VISA-P et VISA-A constituent donc des adaptations francaises comprehensibles, fiables et adaptees aux patients francophones souffrant de tendinopathie patellaire ou calcaneenne.

Resume Le tennis est un sport de raquette comptant environ 10 millions de licencies et 26 millions de joueurs non-affilies en Europe. Les blessures liees a cette activite representent 21 % de celles engendrees par les sports de raquettes. Les joueurs de tennis sont sujets a des charges repetitives, intenses et brusques durant toute la duree du match pouvant provoquer des pathologies traumatiques et microtraumatiques. Cette revue epidemiologique des blessures liees a la pratique du tennis aborde leur type et localisations, les causes et temps d’absence, les differences demographiques et de sexe, ainsi que l’influence de la technique de jeu et du type de terrain sur leur incidence.

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.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).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.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.

Resume Objectifs Evaluer le risque traumatique du rugby a VII. Actualites Le rugby a VII est en plein essor surtout depuis la creation de l’IRB Sevens World Series en 2000 et son introduction comme sport olympique en 2016. Malgre ses fortes similitudes avec le rugby a XV, il n’en demeure pas moins un sport different avec une intensite de jeu plus elevee, entrainant un nombre plus important de blessures. L’incidence moyenne de blessures au rugby a VII est de 249,27 pour 1000 heures de jeu contre 102,25 pour 1000 heures de match pour le rugby a XV. Conclusion Cette revue epidemiologique des blessures chez le rugbyman a VII evoque leur localisation et leur nature, les causes, la position des joueurs, le type de terrain, ainsi que le temps d’interruption de la pratique a la suite d’un traumatisme.

Resume Objectif Cette etude controlee, randomisee, et en double insu, a pour but de determiner si l’application d’un Kinesiotape® sur les ischio-jambiers du sujet sain influence les performances isocinetiques de ce groupe musculaire et de son antagoniste, le quadriceps. Materiel et methode Douze sujets masculins sains, âges de 18 a 30 ans, ont ete soumis a une evaluation isocinetique dans 3 conditions differentes (sans Kinesiotape®, avec un Kinesiotape® placebo des ischio-jambiers, avec un Kinesiotape® stimulant des ischio-jambiers) dans un ordre randomise. Les 3 tests ont mesure le moment de force maximum (N.m), le travail (J) et l’angle d’efficacite maximale (°) en concentrique a 60 et 240°/s pour les ischio-jambiers et le quadriceps, et en excentrique a 30°/s pour les ischio-jambiers. Resultats Les performances isocinetiques mesurees lors des 3 conditions ne presentent pas de difference significative (p > 0,05), en particulier pour les moments de force maximum concentrique et excentrique des ischio-jambiers. Seul l’angle d’efficacite maximale des ischio-jambiers en excentrique 30°/s apparait modifie lors de la comparaison entre Kinesiotape® placebo et sans Kinesiotape® (p Conclusion L’application d’un Kinesiotape® sur les ischio-jambiers du sujet sain n’influence pas la force analytique de ce groupe musculaire. Il ne semble pas non plus perturber les performances de son antagoniste, le quadriceps.

Resume Objectifs Analyser la demarche suivie par les medecins de clubs professionnels de football lorsqu’ils decident, en pratique quotidienne, d’autoriser le retour competitif apres plastie du ligament croise anterieur chez un footballeur. Materiels et methodes Trente-sept medecins responsables de clubs professionnels de football francais et belges (Ligue 1, n = 15 ; Ligue 2, n = 14 ; Division 1 belge, n = 8) ont rempli un questionnaire a choix multiple concernant : (1) les criteres utilises afin de determiner si un joueur est apte a reprendre la competition apres plastie du ligament croise anterieur ; (2) l’importance relative de chacun de ces criteres ; (3) le role eventuel d’intervenants specifiques (kinesitherapeute…) dans cette decision. Resultats Plus de 80 % des medecins interroges ont declare utiliser au moins huit criteres (sur 17 proposes) afin d’evaluer la capacite d’un footballeur a reprendre la competition apres plastie du ligament croise anterieur. Les trois criteres consideres comme les plus determinants etaient, par ordre d’importance : la stabilite dynamique du genou lors d’un exercice specifique au football, la force musculaire et la recuperation complete ou quasi complete d’amplitudes articulaires de flexion et d’extension de genou. Pour certains de ces criteres (notamment la force musculaire), nous constatons cependant un manque de consensus sur les modalites pratiques d’evaluation, sur les parametres ainsi que sur les valeurs-limites tolerees afin de garantir un retour sur terrain securise. La prise en compte de l’avis du kinesitherapeute et du preparateur physique par une tres nette majorite de medecins souligne l’importance d’un travail pluridisciplinaire. Conclusion L’utilisation de differents criteres objectifs afin d’autoriser le retour competitif apres plastie du ligament croise anterieur semble etre une realite dans le football professionnel. Des etudes supplementaires devraient cependant contribuer a preciser les modalites des epreuves ainsi que des valeurs-seuils.

Rugby is a sport that is growing in popularity. A contact sport par excellence, it causes a significant number of injuries. In Rugby Union, there are 30 to 91 injuries per 1000 match hours. This epidemiological review of injuries incurred by rugby players mentions the position and type of injuries, the causes, time during the match and season in which they occur and the players’ positions as well as the length of players’ absences following the injury.

Resume Le rugby est un sport en plein developpement. Sport de contact par excellence, il est a l’origine d’un nombre important de blessures. Au rugby a XV, l’incidence des blessures s’eleve de 30 a 91/1000 heures de match. Cette revue epidemiologique des blessures chez le rugbyman evoque leur localisation et leur nature, les causes, les moments des matches et de la saison auxquels elles se produisent, la position des joueurs et le type de terrain, ainsi que le temps d’interruption de la pratique a la suite d’une lesion.

En complement aux epreuves classiques evaluant la force musculaire maximale, l’isocinetisme permet l’exploration de la fatigue musculaire. L’utilisation clinique des epreuves de resistance a la fatigue reste actuellement plus confidentielle. Une mise au point methodologique prealable s’impose. L’elaboration de protocoles devra prendre en consideration la qualite de reproductibilite et la specificite physiologique. Le choix des parametres caracterisant la fatigue et l’obtention de valeurs de reference constituent egalement une etape indispensable. Les consequences en particulier cardiovasculaires de telles epreuves ne pourront etre negligees.

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.

Objective—To assess the influence of age on pulmonary hemodynamics and hemorheological properties in healthy dogs. Animals—14 healthy Beagles. Procedures—Dogs were placed in 2 age groups as follows: young dogs (≤ 5 years old; n = 8) and old dogs (≥ 8 years old; 6). Hematologic characteristics, plasma total protein and fibrinogen concentrations, and blood viscosity were measured. Systolic time intervals of pulmonary blood flow were recorded by pulsed-wave Doppler echocardiography. Early (E′) and late (A′) diastolic myocardial velocities, isovolumic contraction velocity, and systolic myocardial velocity of the free tricuspid annulus were recorded by pulsed-wave tissue Doppler imaging (TDI). Dogs were anesthetized and pulmonary arterial pressures (PAP) and cardiac output were recorded with a pediatric thermodilution Swan-Ganz catheter. Results—Hemorheological measurements were not different between the 2 groups. Systolic, mean, and diastolic PAP were higher in old dogs, compared with values in young dogs; this difference was attributed to a high pulmonary vascular resistance and low arterial compliance in old dogs. Systolic time intervals of pulmonary blood flow stayed unchanged. The A′ wave of the free tricuspid annulus was increased in old, compared with that young dogs, and the E′:A′ ratio was decreased. Pulmonary vascular resistance was inversely correlated with compliance. Conclusions and Clinical Relevance—The age of dogs should be taken into account when interpreting pulmonary hemodynamic results and TDI variables of right ventricular diastolic function.

Thoracic radiography is an important diagnostic tool for feline respiratory medicine. The aim of this study was (1) to assess age-related changes of thoracic radiographic views in healthy young cats and (2) to test if experimentally-induced bronchial inflammation by inhaling Ascaris suum (AS) allergens leads to radiographic changes after single or repeated exposures. Healthy cats (n = 15–30) aged between 6 and 30 months were evaluated. Eight healthy cats and eight AS-sensitised cats, respectively, inhaled sterile saline or allergen. Radiographs were taken 24 h before, and 6, 24 and 48 h after the challenge. Bronchoalveolar lavage (BAL) was performed after the last radiographic examination. AS-sensitised cats underwent three further allergen challenges at 3-month intervals. The radiographic evaluation was based on a scoring system considering bronchial, interstitial and alveolar patterns. A significant age-related increase in interstitial and total radiographic score was detected in healthy cats older than 18 months and in healthy cats older than 24 months. Whilst saline inhalation did not affect radiographic scores, a single AS challenge induced significant changes of all scores within 6–24 h. A significant positive correlation between radiographic scores and BAL neutrophils and eosinophils was found. Repeated AS challenges did not induce irreversible changes in radiographic scores.

Study Design Translation and validation of algo-functional questionnaire. Introduction The lateral elbow tendinopathy is a common injury in tennis players and physical workers. The Patient-Rated Tennis Elbow Evaluation (PRTEE) Questionnaire was specifically designed to measure pain and functional limitations in patients with lateral epicondylitis (tennis elbow). First developed in English, this questionnaire has since been translated into several languages. Purpose of the study The aims of the study were to translate and cross-culturally adapt the PRTEE questionnaire into French and to evaluate the reliability and validity of this translated version of the questionnaire (PRTEE-F). Methods The PRTEE was translated and cross-culturally adapted into French according to international guidelines. To assess the reliability and validity of the PRTEE-F, 115 participants were asked twice to fill in the PRTEE-F, and once the Disabilities of Arm, Shoulder and Hand Questionnaire (DASH) and the Short Form Health Survey (SF-36). Internal consistency (using Cronbach's alpha), test-retest reliability (using intraclass correlation coefficient (ICC), standard error of measurement and minimal detectable change), and convergent and divergent validity (using the Spearman's correlation coefficients respectively with the DASH and with some subscales of the SF-36) were assessed. Results The PRTEE was translated into French without any problems. PRTEE-F showed a good test-retest reliability for the overall score (ICC 0.86) and for each item (ICC 0.8-0.96) and a high internal consistency (Cronbach's alpha = 0.98). The correlation analyses revealed high correlation coefficients between PRTEE-F and DASH (convergent validity) and, as expected, a low or moderate correlation with the divergent subscales of the SF-36 (discriminant validity). There was no floor or ceiling effect. Discussion and Conclusions The PRTEE questionnaire was successfully cross-culturally adapted into French. The PRTEE-F is reliable and valid for evaluating French-speaking patients with lateral elbow tendinopathy.

Copyright: © 2015 Delvaux F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The anterior cruciate ligament (ACL) injury is the sport-related injury that generates the largest amount of scientific studies. By simply searching for the keywords « anterior cruciate ligament » on Pubmed, about 15000 results appear, with more than 1200 in 2015 alone. The important sports, medical and economic consequences of such an injury could justify this scientific enthusiasm. In these studies, there is a large variety of topics: epidemiologic data in specific populations, comparisons of different types of surgery or rehabilitation...

The objective of this study was to establish a reference base for respiratory variables (respiratory rate [ R R ], inspiratory and expiratory time [ T i and T e ], peak inspiratory and expiratory pseudoflow [PIF and PEF], tidal volume [ V T ], minute ventilation [ V E ] and enhanced pause [Penh]) of healthy cats by use of barometric whole body plethysmography (BWBP). Eighteen healthy European cats (10 male, 8 female) were studied from the age of 3 to 13 months in order to assess growth- and gender-related changes of BWBP variables. Chest radiographs and bronchoalveolar lavage cytology were performed to confirm pulmonary health status. Diurnal changes were investigated every 2 h over a period of 24 h when the cats were adult. V T , V E , PIF and PEF significantly increased during somatic growth and were higher in males than in females, whereas R R , T i , T e , T e / T i ratio, PEF/PIF ratio and Penh remained unchanged and were not affected by gender. When measured over 24 h, Penh, T e and T i were significantly increased in the early morning hours (04:00 h), whereas R R , PIF and PEF were decreased at that time. This study provides reference values of BWBP variables for healthy male and female cats and indicates when circadian changes might be observed.

This study investigated the effect of inhaled fluticasone on lower airway inflammation and bronchial responsiveness (BR) to inhaled carbachol in cats with very mild, chronic bronchitis ( n=5) that were compared with healthy cats serving as controls ( n=6). Chest radiographs, BR tests performed non-invasively by barometric whole body plethysmography (BWBP) and bronchoalveolar lavage (BAL) were performed before and after treatment. BR was quantified by calculating the concentration of carbachol inducing bronchoconstriction (C-Penh300%), defined as a 300% increase of baseline Penh, an index of bronchoconstriction obtained by BWBP. BAL fluid was analyzed cytologically and the oxidant marker 8-iso-PGF2α was determined. At test 1, healthy cats and cats with bronchitis were untreated, whereas for test 2 inhalant fluticasone (250 μg once daily) was administrated for 2 consecutive weeks to cats with bronchitis. Control cats remained untreated. Inhaled fluticasone induced a significant increase in C-Penh300% and a significant decrease of BAL fluid total cells, macrophages, neutrophils and 8-iso-PGF2α in cats with bronchitis, whilst untreated control cats did not show significant changes over time. This study shows that a 2-week fluticasone treatment significantly reduced lower airway inflammation in very mild bronchitis. BR could be successfully monitored in cats using BWPB and decreased significantly in response to inhaled fluticasone. 8-Iso-PGF2α in BAL fluid was responsive to treatment and appeared as a sensitive biomarker of lower airway inflammation in cats.

The objective of this study was to describe a standardised and non-invasive method for exhaled breath condensate (EBC) collection in cats and to test whether determination of hydrogen peroxide (H(2)O(2)) in EBC might be used as marker of lower airway inflammation. The technique of barometric whole body plethysmography for cats was combined with a system to condense the effluent air from the plethysmograph, allowing simultaneous EBC collection and respiratory pattern measurement. H(2)O(2) was determined spectrophotometrically. Eighteen experimental cats were used to investigate the impact on EBC volume and EBC H(2)O(2) of plethysmograph ventilation rate, collection duration, sample stability, within-day and day-to-day variability. After determination of a standardised EBC collection procedure, correlation analyses between EBC H(2)O(2) and bronchoalveolar lavage (BAL) cytology of healthy and allergen-challenged Ascaris suum (AS)-sensitised cats were performed. A significant and positive correlation between EBC H(2)O(2) and bronchoalveolar lavage (BAL) neutrophil% was found in healthy cats (P0.001, r = 0.55), whereas in AS-sensitised cats, correlation with BAL eosinophil% was significant (P0.005, r = 0.61). H(2)O(2) was increased after an allergen challenge in AS-sensitised cats (n = 6, 0.56+/-0.12 versus 1.08+/-0.35 micromol/L, P0.05). This study proposes a non-invasive, well tolerated and repeatable method of EBC collection for cats and suggests that EBC H(2)O(2) might be used as non-invasive biomarker for monitoring lower airway inflammation.

Introduction. Different series emphasized the necessity of rehabilitation program after infiltration of platelet-rich plasma (PRP) in case of tendino - pathy. However, most of them describe only briefly the reeducation protocol and these programs vary. Our aim was to extensively describe a specific standardized rehabilitation program. Methods. After a review of literature of post-PRP infiltration protocols, we had developed a standardized rehabilitation protocol. This protocol was evaluated by 30 subjects with chronic jumper’s knee who. A standardised progressive sub-maximal eccentric program supervised by a physical therapist for 6 weeks was started 1 week post-infiltration. The patient benefited also from electromyostimulation, isometric strengthening and stretching of the quadriceps, cycloergometer and cryotherapy. After the supervised program, the patient had to make an auto-reeducation added to the reathletisation protocol for 6 more weeks which was followed by maintenance exercises up to 1 year. The assessments were made using a VAS, IKDC and VISA-P scores. Results. The VAS, IKDC and VISA-P scores decreased very significantly with time. The compliance to auto-reeducation was good. Conclusions. We proposed a simple and efficient protocol based on sub-maximal eccentric reeducation to add to PRP infiltrations in case of patellar tendinopathy

Introduction: Joint hypermobility involves an increased range of motion compared to normal amplitudes for the same age, sex and ethnic group. Patients with hypermobility suffer from joints problems and chronic pain is the most frequently reported symptom. Eccentric muscle strengthening could be very important to protect hypermobile joints. Case report: An Ehler-Danlos syndrome patient presented pain in the right elbow and the right wrist after a season of tennis. Her physiotherapy (18 sessions, 3 times a week) consisted of wrist prono-supination and flexion-extension muscle group reinforcement and proprioceptive training. To protect the wrist against excessive load, the eccentric strengthening exercises of prono-supinator and flexor-extensor muscles of elbow and wrist were undertaken gradually, at increasing speeds [30°/s, 60°/s, and 90°/s] within a limited range of motion in flexion and extension, on an isokinetic device after an evaluation. She was also given an ortheosis restricting the joint range of motion of the wrist. The patient rapidly noted a decrease in pain and an increase in the stability of her right arm even when playing tennis. Isokinetic evaluation objectified an improvement in maximal torque of 20 to 25% in flexion-extension muscles of the right elbow. She was also given individualized home exercises. Conclusion: The goal of rehabilitation is to avoid hypermobility by using the muscles as a protective brake in the control of joint positioning. Muscles can be reinforced in eccentric mode with starting position at the maximum length of these muscles when unstreched. The exercises can be carried out safely on an isokinetic device, at slow speed and limited range of joint motion to avoid risk of luxation. Thus, in this case report, the eccentric exercises using an isokinetic device were effective to safely reinforce the muscles as a protective brake for joint hypermobility.