La paralysie cérébrale est une pathologie qui dure toute la vie et qui entraîne des troubles moteurs hétérogènes. Les interventions de rééducation et de réadaptation visant la fonction motrice de ...l’appareil locomoteur doivent être adaptées à la topographie des symptômes, à la capacité de déambulation et à l’âge de l’individu. Les recommandations de bonnes pratiques actuellement disponibles ne font pas de distinction entre les différents profils des personnes diagnostiquées de paralysie cérébrale, ce qui peut limiter leur mise en œuvre en pratique clinique.
Développer des recommandations de bonnes pratiques fondées sur les données probantes et applicables pour la rééducation et la réadaptation visant la fonction motrice de l’appareil locomoteur des personnes diagnostiquées de paralysie cérébrale en fonction de leur âge, de la topographie de leur paralysie cérébrale et de capacité de déambulation de la personne, et déterminer un niveau de priorité pour chaque intervention.
La Haute Autorité de Santé a utilisé une méthode mixte combinant une revue systématique de la littérature sur les interventions de rééducation et de réadaptation de la fonction motrice de l’appareil locomoteur (incluant la littérature de janvier 2016 à octobre 2021) et des accords d’experts (à partir de 16 experts et 67 relecteurs). Sur la base de la méthode de la Haute Autorité de Santé, les recommandations ont été formulées et classées comme fortes (grade A), modérées (grade B) ou faibles (gradeC). Les experts ont ensuite classé les interventions par ordre de priorité en fonction des données probantes et de leur propre avis sur la pertinence et l’applicabilité, afin de fournir des recommandations aux cliniciens. Toutes les recommandations finales ont été approuvées par des experts indépendants du groupe de travail.
L’entraînement à la marche, les activités physiques et l’entraînement intensif bimanuel main-bras (HABIT) sont recommandés comme traitements de première intention pour tous les enfants et adolescents diagnostiqués de paralysie cérébrale (grade A). Des recommandations ont été formulées contre le recours aux mobilisations articulaires passives, aux étirements musculaires et aux postures passives diurnes (grade B). Les thérapies neurodéveloppementales ne sont également pas recommandés comme monothérapie ou traitement principal pour tous les enfants et adolescents diagnostiqués de paralysie cérébrale (grade B). Des recommandations en tant que traitements de première intention ont été établies pour l’entraînement à la marche pour tous les adultes diagnostiqués de paralysie cérébrale (grade A) et des recommandations en tant qu’interventions d’importance modérée pour les exercices de renforcement musculaire et les orthèses cheville-pied pour les déficiences motrices des pieds et des chevilles (grade B).
Ces recommandations, qui combinent les résultats de la recherche scientifique et l’accord des experts, pourraient aider les personnes diagnostiquées de paralysie cérébrale et leurs familles à co-déterminer les objectifs de rééducation et de réadaptation avec les professionnels de la santé, en fonction de leurs préférences.
Cerebral palsy is a lifelong condition with heterogeneous motor disorders. Rehabilitation interventions aimed at motor function of the locomotor system must be adapted to the topography of the symptoms, the ability to gait and the age of the individual. Clinical practice guidelines currently available do not distinguish between the different profiles of individuals diagnosed with cerebral palsy, which may limit their implementation in clinical practice.
To develop evidence-based, implementable clinical guidelines for motor rehabilitation in individuals diagnosed with cerebral palsy based on the individual's age, topography of cerebral palsy, and gait ability, and to determine a priority level for each intervention.
The French National Authority of Health used a mixed-method approach combining a systematic review of the literature on motor rehabilitation interventions (including evidence from January 2016 to October 2021) and expert opinion (from 16 experts and 67 peer-reviewers). Based on the French National Authority of Health methodology, recommendations were classified as strong (grade A), moderate (grade B), or weak (grade C). The experts then prioritized the interventions based on the evidence and their own opinion of relevance and applicability to provide recommendations to clinicians. All final recommendations were approved by independent experts on the task force.
Gait training, physical activities, and hand-arm bimanual intensive training (HABIT) are strongly recommended as first-line treatments for all children and adolescents diagnosed with cerebral palsy (grade A). Moderate recommendations were made against the use of passive joint mobilizations, muscle stretching, and passive daytime postures (grade B). Neurodevelopmental therapies were not recommended as monotherapy or primary treatment for all children and adolescents diagnosed with cerebral palsy (grade B). Strong recommendations as first-line treatment were made for gait training for all adults diagnosed with cerebral palsy and moderate recommendations as interventions of moderate importance for muscle strengthening exercises and ankle-foot orthoses for foot and ankle motor impairments.
These recommendations, which combine scientific research findings with expert opinion, may help individuals diagnosed with cerebral palsy and their families to co-determine rehabilitation goals with health care professionals based on their preferences.
The highest-yield musculoskeletal radiology exam prep and learning tool available today!
Top 3 Differentials in Musculoskeletal Imaging: A Case Review by Jasjeet Bindra, Robert D. Boutin, and expert ...contributors is one in a series of radiology case books mirroring the format of the highly acclaimed O'Brien classic, Top 3 Differentials in Radiology: A Case Review. The book is organized in 10 parts: trauma, bone tumors, upper extremity, lower extremity, arthropathies, infection, soft tissue tumors, metabolic musculoskeletal conditions, spine, and pediatric/developmental musculoskeletal conditions.
Each case is formatted as a two-page unit. The left page features clinical images, succinctly captioned findings, and pertinent clinical history. The right page includes the key imaging gamut, differential diagnoses, additional diagnostic considerations, the diagnosis, clinical pearls, and suggested readings.
Key Features
*A total of 146 cases, each focused on a specific imaging finding, including aggressive periosteal reaction, focal cortical thickening, diffusely increased bone density, focal periphyseal edema, acro-osteolysis, and more
*A wealth of meticulously selected, high-quality radiographs, CTs, and MRIs enhance diagnostic skills
*A list of differential diagnoses provides an ideal curriculum guide for trainees and educators alike
Radiology residents, fellows, and staff radiologists preparing for certification will greatly benefit from reading this text to prep for the radiology core and certifying exams. This is also an outstanding, day-to-day practice resource for practicing radiologists, clinicians, and orthopaedic surgeons involved in reviewing and interpreting musculoskeletal radiology studies.
This book includes complimentary access to a digital copy on https://medone.thieme.com.
This open access book focuses on imaging of the musculoskeletal diseases. Over the last few years, there have been considerable advances in this area, driven by clinical as well as technological ...developments. The authors are all internationally renowned experts in their field. They are also excellent teachers, and provide didactically outstanding chapters. The book is disease-oriented and covers all relevant imaging modalities, with particular emphasis on magnetic resonance imaging. Important aspects of pediatric imaging are also included. IDKD books are completely re-written every four years. As a result, they offer a comprehensive review of the state of the art in imaging. The book is clearly structured with learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers easily navigate through the text. As an IDKD book, it is particularly valuable for general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic knowledge, and for clinicians interested in imaging as it relates to their specialty.
User-friendly resource presents state-of-the-art management of orthopaedic trauma
Orthopaedic trauma spans the full spectrum of injury, from simple fractures to life-threatening accidents with ...multiple broken bones. As such, these incidents are a common reason patients visit emergency departments and receive treatment from orthopaedic surgeons. Synopsis of Orthopaedic Trauma Management by nationally recognized experts Brian Mullis, Greg Gaski, and esteemed contributors fills a gap in the literature by providing a concise yet comprehensive reference for evaluating these conditions and initiating immediate treatment.
The text provides a well-rounded perspective on the surgical and nonsurgical management of trauma in adult and pediatric patients. The opening section lays a solid foundation, with chapters covering physiology, open and closed fracture management, imaging, biomechanics, complications, and other core topics. Subsequent chapters address a full compendium of orthopaedic procedures to treat traumatic conditions of the upper and lower extremities, pelvis, and spine.
Key Features
*Bulleted format provides quick and authoritative navigation of essential information needed for effective treatment
*A wealth of high-quality illustrations, radiographic images, and tables supplement concise text
*Uniformly organized chapters include up-to-date, clinically relevant statistics and suggestions for further reading
*Videos by renowned experts enhance understanding of specific fractures and orthopaedic surgery approaches
*This is a must-have resource for providers who treat orthopaedic trauma patients, including general and orthopaedic surgeons, residents, ER physicians, nurse practitioners, physician assistants, nurses, medical students, and others on call. It also provides a robust review for orthopaedic residents prepping for the boards.
This book includes complimentary access to a digital copy on https://medone.thieme.com.
