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Background The integration of artificial intelligence (AI) into health sciences students’ education holds significant importance. The rapid advancement of AI has opened new horizons in scientific writing and has the potential to reshape... more
Background The integration of artificial intelligence (AI) into health sciences students’ education holds significant importance. The rapid advancement of AI has opened new horizons in scientific writing and has the potential to reshape human-technology interactions. AI in education may impact critical thinking, leading to unintended consequences that need to be addressed. Understanding the implications of AI adoption in education is essential for ensuring its responsible and effective use, empowering health sciences students to navigate AI-driven technologies’ evolving field with essential knowledge and skills. Objective This study aims to provide details on the study protocol and the methods used to investigate the usability and efficacy of ChatGPT, a large language model. The primary focus is on assessing its role as a supplementary learning tool for improving learning processes and outcomes among undergraduate health sciences students, with a specific emphasis on chronic disease...
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Somatosensory Rehabilitation Centre, Clinique Générale, Hans-Geiler St. 6, CH-1700 Fribourg, Switzerland Pain Unit, Clinique Générale, Hans-Geiler St. 6, CH-1700 Fribourg, Switzerland Department of Neurology; General Fürth Hospital,... more
Somatosensory Rehabilitation Centre, Clinique Générale, Hans-Geiler St. 6, CH-1700 Fribourg, Switzerland Pain Unit, Clinique Générale, Hans-Geiler St. 6, CH-1700 Fribourg, Switzerland Department of Neurology; General Fürth Hospital, University of Erlangen-Nuremberg, Jakob-Henle-Str. 1, D-90766 Fürth, Germany Unit of Anatomy, Department of Medicine, Faculty of Sciences, University of Fribourg, Route Albert-Gockel 1, CH-1700 Fribourg, Switzerland Physiotherapy Program, Rehabilitation School, Faculty of Medicine, University of Montreal, H3C 3J7 Montreal (Qc), Canada Occupational Therapy Program, Rehabilitation School, Faculty of Medicine, University of Montreal, H3C 3J7 Montreal (Qc), Canada Department of Psychology and Neuroscience, University of Colorado, Muenzinger D158, Boulder, CO, 80309-0345, United States of America Rehabilitation Centre; 11, Rue Angely Cavaillé, F-81000 Albi, France Unit of Neurology, Department of Medicine, University of Fribourg, Chemin du Musée 5, CH-1700 Fr...
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Trans-cutaneous electrical nerve stimulation (TENS) is a treatment against pain that uses the application of an electric current. Some studies suggest that TENS would reduce the pain associated with certain types of cancer and this... more
Trans-cutaneous electrical nerve stimulation (TENS) is a treatment against pain that uses the application of an electric current. Some studies suggest that TENS would reduce the pain associated with certain types of cancer and this treatment is regularly used in therapy in contexts of interdisciplinary practice specializing in palliative oncology. However, the use of TENS in cancer cases is a matter of controversy, and its application is contraindicated by Canadian standards governing the practice of physiotherapy. This article aims to present, through a case study, some principles to guide decision making regarding the choice of this therapy in cases of cancer. Scientific evidence, standards of practice and ethical principles that should guide the choice of therapy are discussed. The use of TENS therapy in palliative care is a paradigmatic example of a common situation: the weighing by health care professionals of the benefits and potential costs, such as potential adverse effects ...
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Background: Previous studies have assessed the effects of perturbation training on balance after stroke. However, the perturbations were either applied while standing or were small in amplitude during gait, which is not representative of... more
Background: Previous studies have assessed the effects of perturbation training on balance after stroke. However, the perturbations were either applied while standing or were small in amplitude during gait, which is not representative of the most common fall conditions. The perturbations were also combined with other challenges such as progressive increases in treadmill speed. Objective: To determine the benefit of treadmill training with intense and unpredictable perturbations compared to treadmill walking-only training for dynamic balance and gait post-stroke. Methods: Twenty-one stroke individuals with reduced dynamic balance abilities, with or without a history of fall and ability to walk on a treadmill without external support or a walking aid for at least 1 minute were allocated to either an unpredictable gait perturbation (Perturb) group or a walking-only (NonPerturb) group through covariate adaptive randomization. Nine training sessions were conducted over three weeks. NonPe...
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BackgroundRotator cuff calcific tendinopathy is characterised by the deposition of hydroxyapatite crystals in one of the rotator cuff tendons and can be managed by ultrasound-guided lavage. However, evidence regarding the efficacy of... more
BackgroundRotator cuff calcific tendinopathy is characterised by the deposition of hydroxyapatite crystals in one of the rotator cuff tendons and can be managed by ultrasound-guided lavage. However, evidence regarding the efficacy of ultrasound-guided lavage for rotator cuff calcific tendinopathy remains inconclusive. The aim of this systematic review and meta-analysis is to update the available evidence on the efficacy of ultrasound-guided lavage in adults with rotator cuff calcific tendinopathy.MethodsA literature search was conducted up to April 2018 in four bibliographic databases to identify randomised control trials that compared ultrasound-guided lavage alone with other interventions to treat rotator cuff calcific tendinopathy. Randomised control trials were assessed with the Cochrane Risk of Bias Tool. Meta-analyses and/or qualitative synthesis of the evidence were performed.ResultsThree randomised control trials were included. Pooled results for pain (n=226) indicated that ...
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Case report. Conventional rehabilitation alone may not be effective in reducing symptoms in some patients with complex regional pain syndrome. This case report portrays the benefits of a new tailored rehabilitation program for a... more
Case report. Conventional rehabilitation alone may not be effective in reducing symptoms in some patients with complex regional pain syndrome. This case report portrays the benefits of a new tailored rehabilitation program for a 39-year-old patient suffering from upper limb complex regional pain syndrome with severe touch-evoked pain (static mechanical allodynia). This patient had previously received conventional rehabilitation for a year and a half including physical and nonsurgical medical interventions that did not improve symptoms or function. In the search for an alternative, this patient was referred to occupational therapy to try a tailored rehabilitation program, drawing on multiple strategies used sequentially according to the patient's tolerance and symptom evolution. During this 22-month program, the following methods were added (listed chronologically): somatosensory rehabilitation of pain method, graded motor imagery, pain management modalities, active mobilizations...
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Health profession learners can foster clinical reasoning by studying worked examples presenting fully worked out solutions to a clinical problem. It is possible to improve the learning effect of these worked examples by combining them... more
Health profession learners can foster clinical reasoning by studying worked examples presenting fully worked out solutions to a clinical problem. It is possible to improve the learning effect of these worked examples by combining them with other learning activities based on concept maps. This study investigated which combinaison of activities, worked examples study with concept map completion or worked examples study with concept map study, fosters more meaningful learning of intervention knowledge in physiotherapy students. Moreover, this study compared the learning effects of these learning activity combinations between novice and advanced learners. Sixty-one second-year physiotherapy students participated in the study which included a pre-test phase, a 130-min guided-learning phase and a four-week self-study phase. During the guided and self-study learning sessions, participants had to study three written worked examples presenting the clinical reasoning for selecting electrother...
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Stimulation of the femoral nerve in healthy people can facilitate soleus H-reflex and electromyography (EMG) activity. In stroke patients, such facilitation of transmission in spinal pathways linking the quadriceps and soleus muscles is... more
Stimulation of the femoral nerve in healthy people can facilitate soleus H-reflex and electromyography (EMG) activity. In stroke patients, such facilitation of transmission in spinal pathways linking the quadriceps and soleus muscles is enhanced and related to co-activation of knee and ankle extensors while sitting and walking. Soleus H-reflex facilitation can be depressed by vibration of the quadriceps in healthy people, but the effects of such vibration have never been studied on the abnormal soleus facilitation observed in people after stroke. To determine whether vibration of the quadriceps can modify the enhanced heteronymous facilitation of the soleus muscle observed in people with spastic stroke after femoral nerve stimulation and compare post-vibration effects on soleus facilitation in control and stroke individuals. Modulation of voluntary soleus EMG activity induced by femoral nerve stimulation (2×motor threshold) was assessed before, during and after vibration of the pate...
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Background Abnormal coactivation of leg extensors is often observed on the paretic side of stroke patients while they attempt to move. The mechanisms underlying this coactivation are not well understood. This study (1) compares the... more
Background Abnormal coactivation of leg extensors is often observed on the paretic side of stroke patients while they attempt to move. The mechanisms underlying this coactivation are not well understood. This study (1) compares the coactivation of leg extensors during static contractions in stroke and healthy individuals, and (2) assesses whether this coactivation is related to changes in intersegmental pathways between quadriceps and soleus (Sol) muscles after stroke. Methods Thirteen stroke patients and ten healthy individuals participated in the study. Levels of coactivation of knee extensors and ankle extensors were measured in sitting position, during two tasks: maximal isometric voluntary contractions in knee extension and in plantarflexion. The early facilitation and later inhibition of soleus voluntary EMG evoked by femoral nerve stimulation were assessed in the paretic leg of stroke participants and in one leg of healthy participants. Results Coactivation levels of ankle ex...
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La troisième édition de l’Atlas des territoires cutanés pour le diagnostic des douleurs neuropathiques vient de paraître chez Sauramps Médical. Les deux premières avaient été préfacées par Bernard Moxham (Cardiff, Royaume-Uni) et par... more
La troisième édition de l’Atlas des territoires cutanés pour le diagnostic des douleurs neuropathiques vient de paraître chez Sauramps Médical. Les deux premières avaient été préfacées par Bernard Moxham (Cardiff, Royaume-Uni) et par Stephen Carmichael (Rochester, États-Unis), celle-ci l’a été par John Fraher (Cork, Irlande). À partir de 2519 patients et des données de 97 ouvrages d’anatomie consultés, les auteurs définissent les territoires cutanés des nerfs spinaux et de leurs branches principales en précisant les bornes limitrophes de leur territoire maximal de distribution, et leur territoire autonome, qu’elles ne partagent avec aucun autre nerf.
Research Interests: Neuroscience, Sociology, Psychology, Physiotherapy, Neurology, and 14 moreSurgery, Anthropology, Occupational Therapy, Chronic Pain, Human Anatomy (Biological Anthropology), Hand Therapy, Somatosensory Neuroscience, Clinical Anatomy, Anatomy, Hand Surgery, Neuropathic pain, Neurological Physiotherapy, Clinical Neurology, and Somatosensory Rehabilitation of Pain
Background Thoracic neuropathic pain may be related to an area of altered skin sensation over the territory of cutaneous thoracic branches. The somatosensory rehabilitation method (SRM), a non-pharmacological treatment, focuses on the... more
Background Thoracic neuropathic pain may be related to an area of altered skin sensation over the territory of cutaneous thoracic branches. The somatosensory rehabilitation method (SRM), a non-pharmacological treatment, focuses on the detection, classification and treatment of this condition. The aim of this prospective observational case series of 66 thoracic neuropathic pain patients (tNPP) was to evaluate a management algorithm of two different types of neuropathic pain: spontaneous ongoing neuropathic pain (type A) and touch-evoked neuropathic pain (type B). Material and methods The authors precisely explain the assessment and treatment algorithm for findings of tactile hypoaesthesia versus static mechanical allodynia (SMA). 66 chronic tNPP referred in a single centre were assessed by two mapping techniques of the skin A) aesthesiography (in case of tactile hypoaesthesia) or B) allodynography (in case of SMA) and pre/post treatment evaluations with the McGill pain questionnaire (MPQ). In clinical practice, hypoaesthetic territories were treated by basic somatosensory rehabilitation. Allodynic territories were treated initially by distant vibratory counter-stimulation (DVCS), then by basic somatosensory rehabilitation once the allodynia disappeared. Results All tNPP presented somatosensory abnormality on at least one damaged cutaneous thoracic branch: 52 hypoaesthetic and 47 allodynic. At a mean of 76 days, 34 of these 47 were converted by DVCS into hypoaesthetic territory, which finally is amenable to treatment by basic somatosensory rehabilitation. 61 % of the tNPP treated with SRM had a pain reduction of at least 50% on the MPQ. Conclusion These observations illustrate a management algorithm for assessing and treating A) hypoaesthesia and B) SMA.
Research Interests: Neuroscience, Physiotherapy, Occupational Therapy, Chronic Pain, Clinical Neuroscience, and 12 moreMedicine, Somatosensory Neuroscience, Physical Therapy, Pain Management, Clinical Anatomy, Hand Surgery, Assessment of Neuropathic Pain, Neuropathic pain, Neurological Physiotherapy, Clinical Neurology, Occupational Therapy/hand Therapy, and Somatosensory Rehabilitation
Purpose/Objectives and Rationale: To investigate whether the alterations in the modulation of soleus activity by intersegmental projections from quadriceps are related to motor deficits in hemiparesis. Relevance to the Physiotherapy... more
Purpose/Objectives and Rationale: To investigate whether the alterations in the modulation of soleus activity by intersegmental projections from quadriceps are related to motor deficits in hemiparesis. Relevance to the Physiotherapy Profession: Changes in these pathways may contribute to the motor deficits of the paretic leg. Materials and Methods: The modulation of soleus activity evoked by the stimulation of femoral nerve (2 x MT of quadriceps) was assessed in 14 healthy participants and in 14 stroke participants. Analysis: The levels of the early facilitation and of the later inhibition were assessed on soleus H reflex and volontary EMG activities Results: There was an increase (Mann-Whitney U; p < 0.05) of the heteronymous facilitation of both soleus reflex (mean ± SEM: 78 ± 23% of control H reflex) and voluntary (212 ± 45% of control EMG) activities on the paretic side of the stroke participants compared to the control participants (30 ± 3% of control H reflex and 67 ± 15 % ...
Groupe de travail sur le raisonnement clinique – 14 avril 2011
Example-based learning using worked examples can foster clinical reasoning. Worked examples are instructional tools that learners can use to study the steps needed to solve a problem. Studying worked examples paired with completion... more
Example-based learning using worked examples can foster clinical reasoning. Worked examples are instructional tools that learners can use to study the steps needed to solve a problem. Studying worked examples paired with completion examples promotes acquisition of problem-solving skills more than studying worked examples alone. Completion examples are worked examples in which some of the solution steps remain unsolved for learners to complete. Providing learners engaged in example-based learning with self-explanation prompts has been shown to foster increased meaningful learning compared to providing no self-explanation prompts. Concept mapping and concept map study are other instructional activities known to promote meaningful learning. This study compares the effects of self-explaining, completing a concept map and studying a concept map on conceptual knowledge and problem-solving skills among novice learners engaged in example-based learning. Ninety-one physiotherapy students wer...
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Extensor synergy is often observed in the paretic leg of stroke patients. Extensor synergy consists of an abnormal stereotyped co-activation of the leg extensors as patients attempt to move. As a component of this synergy, the... more
Extensor synergy is often observed in the paretic leg of stroke patients. Extensor synergy consists of an abnormal stereotyped co-activation of the leg extensors as patients attempt to move. As a component of this synergy, the simultaneous activation of knee and ankle extensors in the paretic leg during stance often affects gait pattern after stroke. The mechanisms involved in extensor synergy are still unclear. The first objective of this study is to compare the co-activation of knee and ankle extensors during the stance phase of gait between stroke and healthy individuals. The second objective is to explore whether this co-activation is related to changes in heteronymous spinal modulations between quadriceps and soleus muscles on the paretic side in post-stroke individuals. Thirteen stroke patients and ten healthy individuals participated in gait and heteronymous spinal modulation evaluations. Co-activation was measured using peak EMG activation intervals (PAI) and co-activation a...