Search

BACKGROUND: Adductor-related groin pain (ARGP) is the most common groin injury in athletes. If conservative treatment fails, then adductor tenotomy to relieve tension can be considered. The use of botulinum toxin A (BoNT-A) has shown good results in other musculoskeletal pathologies. OBJECTIVE: Assess the effectiveness of BoNT-A injections in ARGP in cases where usual treatment has failed. DESIGN: Retrospective cohort study. SETTING: Orthopedic Medicine and Rehabilitation Unit, University of Bordeaux. PARTICIPANTS: Fifty patients treated by BoNT-A injection in ARGP after failure of medical and/or surgical treatment were included in this study. INTERVENTIONS: One or several adductor muscles were injected with BoNT-A, according to clinical evaluation using ultrasound and electrical stimulation guidance. Patients were followed up at 1, 3, 6, and 12 months. MAIN OUTCOME MEASURES: The primary assessment criterion was the improvement of Hip and Groin Outcome Score subscales at day 30. Secondary outcomes included pain intensity and impact on sport, work, and quality of life (QoL), the Blazina scale, and side effects. RESULTS: All the first 50 injected patients (45 male and 5 female patients) were included. A significant improvement was noted regarding the majority of Hip and Groin Outcome Score subscales at day 30 ( P < 0.05). Pain intensity and its impacts were both significantly reduced ( P < 0.001): less sport and professional disability and lower impact on QoL. Severity of symptoms assessed by the Blazina scale was significantly reduced ( P < 0.001). The improvements remained significant until 1-year postinjection. CONCLUSIONS: BoNT-A is promising as a new treatment for ARGP but should be fully assessed in a randomized controlled trial.

BACKGROUND: Several articular, muscular and neurological diseases generate mobility loss in the shoulder and pelvis girdles. Joint mobilization contributes to improving shoulder-pelvis girdles dissociation, but current mobilization techniques are not always successful and standardized. A robotic medical device, DPA Med®, by inducing trunk mobilization through lower limb oscillation has been developed for producing such a shoulder-pelvis girdles dissociation and is already used worldwide in rehabilitation hospitals. RESEARCH QUESTION: To determine the optimal lower limb oscillation frequency that generated the best shoulder-pelvis girdles dissociation using the DPA Med® device. METHODS: Thirty healthy adult volunteers (mean age: 38.6 [SD 15.2] years, mean height: 174 [SD 11.9] cm, mean body mass: 70.3 [SD 14.7] kg) participated in this prospective study. A kinematic analysis quantified pelvic and shoulder girdle mobility (rotation and lateral tilt) at different DPA Med® frequencies, from 0.5 Hz to 1 Hz. A visual analysis of the lower limb movement was also performed, using video sensors, to better understand the kinematics involved. RESULTS: All DPA Med® frequencies have shown significant shoulder-pelvis girdles dissociation (p

L’objectif de ce travail était d’analyser la reproductibilité inter-observateur d’une posture debout permettant de visualiser les gibbosités thoraciques par un enroulement antérieur des bras (position " enroulée") et de comparer l’effet de cette position sur les paramètres surfaciques habituellement mesurés dans deux positions radiologiques standards. Une analyse topographique de la surface du dos a été réalisée sur 46 patients (40 filles et 6 garçons) présentant un angle de Cobb d’au moins 158 sur des grands clichés du rachis de face. La reproductibilité des mesures inter- examinateurs a été évaluée à l’aide de l’erreur technique de mesure (ETM) et du coefficient de corrélation intraclasse (CCI). Les variations entre les positions étaient comparées par un test de Student. Nos résultats montrent que la reproductibilité inter-observateur des mesures semble de qualité suffisante dans les trois positions étudiées. La position "enroulée " entraînait des modifications significatives dans le plan sagittal ainsi que pour l’identification des gibbosités par rapport à celles observées dans les deux autres positions. Cette étude révèle la reproductibilité de la position "enroulée" et sa complémentarité vis-à-vis des positions habituelles, permettant de mieux explorer les gibbosités thoraciques avec les outils de topographie de surface du dos.