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Biomedical subjects

A Thévenon

Publications and source records attributed to A Thévenon.

At least 19 recordsLinked to original sources
PubMed2005

[Parkinson's disease, progressive lumbar kyphosis and focal paraspinal myositis].

INTRODUCTION: The camptocormia (bent spine) is characterized by a severe forward flexion of the thoracolumbar spine which disappears in the supine position. Clinical case. We describe a typical case observed in a parkinsonian patient. The MRI, electromyogram and biopsy of the paraspinal muscles revealed a typical myositis pattern. DISCUSSION: This case, the sixth published to our knowledge, confirms that focal myositis is associated with the camptocormia in Parkinson's disease. Typically it is observed in male subjects, appearing 4 to 6 years after the onset of Parkinson's disease, in fluctuating patients treated by an association of L-Dopa and agonist. It appears quickly and becomes the most important symptom. Antiparkinsonian drugs are useless. CONCLUSION: This exceptional picture raises original pathophysiological and therapeutic questions. Systematic studies should be performed in order to detail the pathophysiological link between these 3 entities: Parkinson's disease, focal myositis and camptocormia.

Disease Progression↗
PubMed2004

[The effect of similar speed's walking and functional classification of foot contact on variability of the vertical ground reaction force].

INTRODUCTION: The variability of the normal ground reaction force (F(z)) is a restrictive factor for the clinical analyse of kinetics parameters recorded during walking. OBJECTIVE: The aim of this study is the decrease of the inter-individual variability of the normal ground reaction force: F(z). MATERIAL AND METHOD: The method tested consists in imposing a similar speed to the subjects during walking tests, then to class foot according to their function: loading or propulsive foot. A group of seven young adults walk at spontaneous speed (VSpon) for the first walking test then at similar speed (Vsim = N(Fr) x square root of (g x li); where N(Fr) is the Froud's number, g is the gravitational acceleration and li is the length of the lower limb) for the second walking test. Two forces platforms register the F(z) of two consecutive steps. The normal ground reaction force and the mean coefficient of variability are retained to test for speed (VSim and VSpon) and functional classification effects. RESULTS: The CoV of F(z) decreases from 13% to 8% when the subjects walk at similar speed rather than at spontaneously chosen speed. The variability decreases by 1-1.5% when the data are classified according to functional criterion. The inter-individual variability of the F(z) significantly reduces when the tests are performed at similar speed and when the loading or propulsive factors are used for functional classification. CONCLUSION: The coupling of the methods described must permit to the clinician to constitute a data base which, tainted of less variability, should make easier the detection of pathology affecting the ground reaction force.

Adult↗
PubMed2004

[Effects of training on static and dynamic balance in elderly subjects who have had a fall or not].

OBJECTIVE: To evaluate the effects of a physical training program on static and dynamic balance during single and dual task conditions in elderly subjects who have had a fall or not. PATIENTS: Two groups, comprising a total of 33 elderly subjects, were trained: 16 who had a fall were 69.2 +/- 5.0 years old and 17 who had not had a fall were 67.3 +/- 3.8 years. METHODS: All subjects underwent an unipedal test with eyes open and eyes closed, followed by gait assessment during single and dual motor task conditions, before and after a physical training program. RESULTS: All subjects showed a significant decrease, by six times for subjects who had fallen and four times by those who had not, in the number of touch-downs in the unipedal test with eyes open (P < 0.05), and by 2.5 and 2 times, respectively, with eyes closed (P < 0.05) after the training program. All subjects showed a significant increase in speed (P < 0.05), cadence (P < 0.05) and stride length (P < 0.05) and a significant decrease in the single support time (P < 0.05) and stride time (P < 0.05) in gait assessment during single and dual task conditions after the training program. During the training program, no subjects fell. CONCLUSION: The physical training program improved static balance and quality of gait in elderly subjects who had had a fall and those who had not, which could contribute to minimizing and/or retarding the effects of aging and maintaining physical independence.

Accidental Falls↗
PubMed2003

[Determination of an expected plantar pressure threshold: dimensionless approach use to reduce the variability of the plantar pressures].

OBJECTIVE: The aim of this study was to verify that the determination of walking velocities proportional to the leg lengths of the subjects together with the dimensionless expression of the results enable us to decrease the variability and to determine a plantar pressure threshold. MATERIALS AND METHODS: Fifteen male subjects performed two walking tests on a treadmill at imposed velocities (V1 and V3) and similar velocities (V27 and V37). Similar velocities (Vsim =Nfr(g.Li)(0.5)) were determined from two fractions of the Froude number (Nfr), the gravitational acceleration (g) and the length of the lower limb (Li) of the subjects. An in-shoe plantar pressure measurement system allowed the pressure peaks to be recorded. The peak of pressure (p) was reported to the step length (a) and the weight of the subject (mg) for the dimensionless pressure peaks (Dim(P)=p.a2/mg) to be expressed. The coefficients of variability (CoV) and extends of the dimensionless pressure peaks (Epp) have been studied at the different imposed walking velocities. RESULTS: The CoV and Epp of the dimensionless pressure peaks recorded at V27 and V37 (similar velocities) are from 2 to 9% and 3 to 22% lower than those observed at V1 and V3, respectively. DISCUSSION-CONCLUSION: The analysis of the pressure peaks CoV and Epp shows that the method should allow a data bank usable to detect the effects of a disability on the plantar pressures to be elaborated. Indeed, our results enable us to define a plantar pressure pattern with a variability lower than those reported in most scientific articles.

Adult↗
PubMed2002

[Camptocormia: a sign of axial myopathy. Report of 7 cases].

PURPOSE: Camptocormia or progressive lumbar kyphosis is an anterior bend of the trunk. It appears in orthostatism or while walking and is reducible in the decubitus position. It concerns patients older than 60 years of age. It is due to a fatty degeneration of the paravertebral muscles, although the physiopathology remains unclear. METHODS: We report seven cases of camptocormia revealing authentic myopathies. RESULTS: Our observations concern five women and two men of 55 to 72 years of age. All patients present lumbar kyphosis and had a fatty involution of the paraspinal muscles on the muscular MRI. Four patients fulfilled the Bohan and Peter criteria of polymyositis and dermatomyositis. In the other cases paravertebral muscular biopsies led to the diagnosis of a congenital myopathy, a mitochondrial myopathy and an amyloid myopathy. Four patients received a corticosteroid-immunoglobulins or cyclosporin regimen. An improvement in the camptocormia was observed in three cases. In the other cases the treatment consisted of chemotherapy on account of severe nephrotic syndrome, a coenzyme-Q treatment for the patient with mitochondrial myopathy and only physiotherapy in the case of congenital myopathy, but without positive effect on camptocormia. CONCLUSION: Camptocormia appears as a muscular symptom that may reveal an axial myopathy due to multiple and varied pathologies. Thus, the discovery of camptocormia requires an aetiological investigation in order to propose an adequate treatment, which should be associated with physiotherapy.

Aged↗
PubMed2001

[Spasticity and dynamic plantar pressure distribution measurements in hemiplegic spastic children].

OBJECTIVE: The aim of this study was to analyse the plantar pressure distribution in nine hemiplegic spastic children to illustrate the dynamic alteration during stance phase linked spasticity grade. MATERIAL AND METHODS: The graduation of the lower limbs muscle tone related to the Aschworth spasticity scale enabled us to identify two groups of hemiplegics subjects. The groups Asch 1 and Asch 3 have respectively presented a low and a strong spasticity. The peak pressures during consecutive gait cycles were determined under the feet of 30 healthy subjects and two cerebral palsy groups using a wearable footprint analysis system. RESULTS: A statistical study showed a similarity between the two disabled groups. Peak pressures under the midfoot were significantly higher compared to the control group. While the plantar pressure distribution profile was specific for each group under all other anatomical structures. The significant alterations were observed under the forefoot and hallux. DISCUSSION-CONCLUSION: Spasticity modifies the foot contact to ground and leads to a specific plantar pressure distribution profile linked to the spasticity grade. The equinovarus with clawed toes deformity due to higher spasticity seems to be an important factor in terminal stance phase perturbations. However spastic hemiplegic subjects seem to adopt a gait pattern in agreement with stability optimization criteria.

Adolescent↗
PubMed2001

[Effect of spasticity on functional capacity in spinal cord injuries: value of visual analogue scale (preliminary study)].

OBJECTIVES: Assessment of the influence of spasticity on activities of daily living in spinal cord injuries. MATERIAL AND METHODS: Fifteen patients with spinal cord injuries have been submitted to a clinical examination and functional assessment by FIM. They answer to a questionnaire on the influence of spasticity on 11 activities of daily living (response by visual analogic scale). RESULTS: The impact of spasticity in daily life is weak (evaluation of difficulties less than 3 on 10 for 7 of the 11 activities of daily living), except for transfers and precision motions when it is on superior limbs. Spasticity has never been considered as useful by patients (VAS less than 3 for 13 persons). DISCUSSION: This study discusses about the real functional influence of spasticity in daily life. It shows the insufficiency of currently used scales and their lack of sensibility to detect the effects of spasticity in daily life's activities. CONCLUSION: Further outcome studies are required to assess the functional role of spasticity in neurologic patients and the real interest of treatments.

Humans↗
PubMed2001

Diagnosing thoracic outlet syndrome: contribution of provocative tests, ultrasonography, electrophysiology, and helical computed tomography in 48 patients.

OBJECTIVE: To evaluate the diagnostic usefulness of provocative tests, Doppler ultrasonography, electrophysiological investigations, and helical computed tomography (CT) angiography in thoracic outlet syndrome (TOS). PATIENTS AND METHODS: We prospectively evaluated 48 patients with a clinical suspicion of thoracic outlet syndrome. Standardized provocative tests, an electromyogram and somatosensory evoked responses, a Doppler ultrasonogram, and a helical CT arterial and/or venous angiogram with dynamic maneuvers were done on each patient. The final diagnosis was established by excluding all other causes based on all available data. The agreement between the results of each investigation and the final diagnosis was evaluated. RESULTS: Provocative tests had mean sensitivity and specificity values of 72% and 53%, respectively, with better values for the Adson test (positive predictive value [PPV], 85%), the hyperabduction test (PPV, 92%), and the Wright test. Using several tests in combination improved specificity. Doppler ultrasonography visualized vascular parietal abnormalities and confirmed the diagnosis in patients with at least five positive provocative tests. Electrophysiological studies were useful mainly for the differential diagnosis or for detecting concomitant abnormalities. Although helical CT angiography provided accurate information on the location and mechanism of vascular compression, the usefulness of this investigation for establishing the diagnosis of TOS and for obtaining pretherapeutic information remains unclear.

Adult↗
PubMed1987

[Evaluation by biphotonic absorptiometry of bone mineral content and determination of the fracture threshold in a population of patients 60 to 75 years old].

A measurement of the bony density of vertebrae and femur was carried out, in the course of a prospective study, in 99 patients between the ages of 60 and 75 years, living in northern France. 76 patients had no recognized problem of demineralization and 23 others were consulting for an evaluation of vertebral compression. The measurement of the bony density was done by biphotonic absorptiometry with a source of labelled Gadolinium. In women, a significant difference in the values obtained by absorptiometry in terms of the existence of vertebral compressions, symptomatic or not, is noted. A statistical study using the ROC curves method (Receiver Operating System) has enabled us to determine a threshold of high risk of vertebral fracture measured at 31 g or 0.85 g/cm2 in women, and 35 g or 0.85 g/cm2 in men. In addition, there is a significant correlation with the vertebral radiographical index as defined by Meunier. Among the various factors of influence which were studied, only the size and the morphotype seem to play an essential role in our study group. The comparative study of the densities measured in the femoral neck and the lumbar spine enabled us to find a very significant correlation in patients with as well as without compression (r = 0.714, p less than 0.001). Biphotonic absorptiometry proves therefore to be a method which may be used to define a group with a high fracture risk permitting to determine, as early as possible, therapeutic, curative and preventive measures.

Aged↗
PubMed1986

[Erosive disk diseases of chronic hemodialysis patients. 3 cases of cervical localization].

The authors report three new cases of erosive disk disease in chronically hemodialysed patients. The cases included one man and two women, who were diagnosed, on the basis of cervical or shoulder pain, as having spinal injuries involving pinched disks, punched-out lesions and incipient condensation. Discal puncture was carried out in only one patient, and proved futile. All three patients were followed-up for periods of at least one year. These three cases raise the problem of erosive disk disease in long-term dialysis patients; several other cases have been reported recently. The etiology remains obscure, but the part played by amylosis, by apatite microcrystals and by the duration of dialysis treatment are all discussed. It would appear that a novel disease entity is indeed involved, one for which, although several etiologic factors can be suggested, it has not been possible to definitely identify any single cause as the exclusive origin of the lesions detected.

Adult↗
PubMed1986

[Bone involvement in hypothyroidism in adults. Apropos of 20 patients].

Although bone changes in hyperthyroidism are well known, they have been much less studied in hypothyroidism and we set out to establish whether they did occur in the latter condition. We present the results of a prospective study of 20 adult patients, with acquired primary hypothyroidism. No changes in urinary or blood calcium or phosphorus metabolism were observed and serum parathormone, 25-hydro, 125-dihydro and 24-25-dihydroxycholecalciferol concentrations were normal. Histological examination of iliac crest bone biopsy after double labelling with tetracycline showed normal bone trabeculation volume, surface of resorption and rates of calcification. However, the relative osteoid volume was increased and there was a much higher osteoid thickness index. These observations may be explained by a global decrease in the activation and activity of the multicellular units of bone remodeling due to the general slowing of cellular metabolism encountered in that condition.

Adult↗
PubMed1983

[A new case of rheumatoid nodulitis].

A new case of rhumatoid nodulitis is reported in à 28 year old man presenting with rapidly regressive arthralgia, numerous rhumatoid nodules and metatarsal lesions without signs of associated arthritis. The biochemical profile was non-specific; serology was weakly positive for rhumatoid factor; there was no obvious immunological disorder (no circulating immune complexes, total complement and its various fractions within normal limits). The clinical findings, treatment and classification of this condition are discussed with reference to six other published cases with a similar clinical and paraclinical features.

Adult↗
PubMedDate not supplied

[Phosphocalcium metabolism in the elderly. Study of 101 subjects living in an institution].

Calcium and phosphorus metabolism was studied in 101 institutionalized subjects over 70 years of age (mean: 82.5 years). The study was performed in serum and urine; it included parathyroid hormone and calcidiol (250HD3) assays and radiological examination of bones with determination of Meunier's index and metacarpal cortical index. Calcidiol concentrations did not vary with age but were higher in people who left the institution and in men. In contrast, there was a significant age-group related increase of parathyroid hormone concentrations. This increase was accompanied by an increase of parathyroid hormone activity, as shown by a parallel fall in phosphorus reabsorption rate. These findings are in agreement with current pathogenetic theories on senile osteoporosis. Invalid subjects had higher urinary calcium and serum parathyroid hormone levels and a lower cortical index. Paradoxically, there was less vertebral collapse as evaluated by Meunier's index, which may suggest that very old patients develop progressive cortical bone hyperresorption entirely independent of sequelae from their former trabecular osteoporosis.

Aged↗