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Biomedical subjects

B Parratte

Publications and source records attributed to B Parratte.

At least 19 recordsLinked to original sources
PubMed2006

Changes in oxygen uptake, shoulder muscles activity, and propulsion cycle timing during strenuous wheelchair exercise.

STUDY DESIGN: Cross-over study. OBJECTIVE: To determine the effect of strenuous wheelchair exercise on oxygen uptake (VO2 ), muscle activity and propulsion cycle timing (including the push time and recovery time during one full arm cycle). SETTING: Laboratory of Sport Sciences at the University of France-Comte in France. METHODS: Two exercise bouts of 6-min duration were performed at a constant workload: (1) non-fatigable exercise (moderate workload) and (2) fatigable exercise (heavy workload). Measurement of VO2, surface electromyographic activity (EMG) from shoulder muscles, and temporal parameters of wheelchair ergometer propulsion were collected from eight able-bodied men (26+/-4 years). RESULTS: A progressive increase in VO2 associated with EMG alterations (P<0.05), and a decrease of the cycle and recovery time (P<0.05) during the heavy exercise. Whereas the push time remained constant, an increased muscle activation time (P<0.05) was found during heavy exercise. CONCLUSION: Observations during wheelchair ergometry indicate the development of fatigue and inefficient muscle coordination, which may contribute to deleterious stress distributions at the shoulder joint, increasing susceptibility to injury.

Adult↗
PubMed2006

[Cross-cultural adaptation of health-related quality of life questionnaire: English version of Qualiveen abstract].

INTRODUCTION: The Qualiveen questionnaire is a urinary disorder-specific health-related quality of life (HRQL) instrument. Developed in French, the instrument's translation into English was the first step of a process leading to an HRQL questionnaire that can be used in a different culture. However, the cultural adaptation of an HRQL questionnaire is achieved only when the psychometric properties of the translated questionnaire are documented. AIM: To develop an equivalent English version of the Qualiveen questionnaire and to assess its discriminative measurement properties. METHODS: Fifty-five Canadian out-patients with multiple sclerosis (MS) completed a set of questionnaires, including the Qualiveen; the MS Quality Of Life-54 (MSQOL-54), an MS-specific HRQL questionnaire; urinary function assessment; and the expanded disability status scale (EDSS) twice at an interval of 2 to 4 weeks. RESULTS: The English Qualiveen proved to be test-retest reliable (intraclass correlation coefficient=0.94). Consistent with a priori predictions, we found a strong association between overall Qualiveen score and degree of incontinence (0.63), a moderate association with type of urinary symptoms (0.49), a weak association with manner of voiding (0.28) and weak or absent associations with MSQOL-54, EDSS bladder/bowel and global EDSS domains. Predictions proved to be generally accurate (weighted kappa=0.65). CONCLUSION: The test-retest reliability and cross-sectional construct validity of the English version of Qualiveen are excellent and similar to the original French version. Further studies should explore Qualiveen's longitudinal validity and responsiveness.

Cross-Sectional Studies↗
PubMed2005

Extra- and intramuscular nerve supply of the muscles of the anterior antebrachial compartment: applications for selective neurotomy and for botulinum toxin injection.

Hypertonia of the upper limb due to spasticity causes pronation of the forearm and flexion of wrist and fingers. Nowadays this spasticity is often treated with injections of botulinum toxin and sometimes with selective fascicular neurotomy. To correctly perform this microsurgical technique, it is necessary to get precise knowledge of the extramuscular nerve branching in order to be better able to select the motor branches which supply the muscles involved in spasticity. The same knowledge is required for botulinum toxin injections which must be made as near as possible to the zones where intramuscular nerve endings are the densest, which is also where neuromuscular junctions are the most numerous. Thus, it is necessary to better know these zones, but their knowledge remains today imprecise. The muscles of the anterior compartment of 30 forearms were dissected, first macroscopically, then microscopically, to study the extra- and intramuscular nerve supply and the distribution of terminal nerve ramifications. The results were then linked to surface topographical landmarks to indicate the precise location of motor branches for each muscle with the aim of proposing appropriate surgical approaches for selective neurotomies. Then for each muscle, the zones with the highest density of nerve endings were divided into segments, thus determining the optimal zones for botulinim toxin injections.

Adult↗
PubMed2005

[Symptom and quality of life assessment in urinary disorders].

OBJECTIVES: To identify all available symptom and quality of life questionnaires for men and women with urinary disorders and assess their psychometric properties. METHODS: We systematically reviewed the literature in Medline using the key words urinary disorders, urinary incontinence, bladder, score, quality of life, questionnaire, and psychometric validation. RESULTS: The first search using the terms urinary incontinence and quality of life resulted in 1018 Abstracts. Articles mentioning but not measuring quality of life were not investigated. Questionnaires were selected because their psychometric properties were tested and they assessed how much a person was bothered by urinary symptoms or quality of life specific to urinary disorders. The questionnaires were usually gender specific. Their psychometric value was far from uniform, and, for most, responsiveness was not reported. CONCLUSION: Few quality of life questionnaires are at an advanced stage of validation to be applied in clinical practice. They need to be shorter, responsive and validated in different populations to permit their easy use.

Disability Evaluation↗
PubMed2004

Surface electromyography of nine shoulder muscles in two iron cross conditions in gymnastics.

AIM: The rules of gymnastics impose an element of static strength such as an iron cross (IC) on the rings. For IC training, coaches use a custom made device -- the herdos -- to simulate the conditions of competition. The purpose was to compare muscle activity and coordination during IC performed both on the rings and using herdos. Secondly, we tried to determine whether herdos usage induced functional adaptations of the shoulder muscles. METHODS: Six male gymnasts performed 10 IC in each condition. Surface electromyogram of muscles pectoralis major, latissimus dorsi, teres major, infraspinatus, rhomboideus, trapezius, serratus anterior, biceps brachii, and triceps brachii in the right shoulder were analysed using root-mean-square (RMS), and muscle part's in each condition. Muscle part represents the contribution of each of the 9 shoulder muscles studied in each condition. Total muscle activity (SUM) was also used to compare the 2 conditions. RESULTS: Except for the muscle teres major, the RMS decreases (p<0.05) when using the herdos. The SUM also decreases (p<0.05) when using this device. The muscle parts indicate that the contribution of the muscle latissimus dorsi decreases (p<0.05) when using the herdos. These results suggest that the herdos modified shoulder coordination. But their usage does not seem to induce any functional adaptations of these muscles. CONCLUSIONS: The herdos do not seem to provide a valid method to reproduce the same shoulder coordination as on the rings. Therefore IC training with this special device could be called in question.

Adult↗
PubMed2003

Arterial vascularization of the human thalamus: extra-parenchymal arterial groups.

The problem of the arterial vascularization of the human thalamus has been debated at length. Anatomical references concerning the thalamic arterial groups are contradictory and complex, preventing any solid application in practice. It is, therefore, difficult to produce reliable anatomical radio-clinical correlation. In this work, 12 adult human cerebellums (24 hemispheres) were dissected after intra-vascular injection. With care for clarification and standardization, the extra-parenchymal thalamic arteries were classified in six groups: pre-mamillary artery, perforating thalamic arteries, thalamo-geniculate arteries, perforating branches of the postero-medial, postero-lateral and anterior choroidal arteries. Variations in the pre-mamillary artery were rare. The origin of the perforating thalamic artery was unilateral in two of three cases. The origin of the thalamo-geniculate arteries arose between the posterior cerebral artery (53%) and the posterior choroidal arteries (43%). The postero-median choroidal artery was most often single and usually gave the perforating branches for the medial aspect of the thalamus. The postero-lateral choroidal artery was frequently multiple and essentially gave the perforating branches for the superior aspect of the thalamus. The pulvinarian branches most often rose from the postero-lateral choroidal arteries (two thirds of cases) and more rarely from the postero-median choroidal arteries (one third of cases). The anterior choroidal artery is a source of thalamic vascularization by its cisternal branches running towards the lateral thalamus. It can also participate in the vascularization of the pulvinar by the plexiform branches crossing the temporal horn of the lateral ventricle. This study has allowed definition of the intra-parenchymatous arterial map of the thalamus. This mapping is essential for producing anatomical radio-clinical correlations which are pertinent for therapeutic decisions.

Aged↗
PubMed2003

"Mesorectum": the surgical value of an anatomical approach.

The quality of total extirpation of the "mesorectum" nowadays determines the prognosis of rectal cancer but the planes of surgical dissection which have been proposed and the anatomical restrictions of this "mesorectum" are sometimes contradictory. The aim of this study was to clarify the relationships of the "mesorectum" with the fascias and nerves of the pelvic cavity to harmonize the plane of dissection in its total extirpation. Four pelvises (2 male, 2 female) harvested from embalmed cadavers were studied by dissection and anatomico-imaging correlation. Two pelvises (1 male, 1 female) were injected with copolymer via the internal iliac and inferior mesenteric arteries. They were then frozen and sectioned sagittally into two hemi-pelvises for the dissection. The two other pelvises were initially studied in 5 mm cuts with CT scanning and magnetic resonance scanning in the sagittal and "transverse oblique" planes. They were then frozen and then cut sagittally into two hemi-pelvises. Each hemi-pelvis was then cut into anatomical sections with an electric saw similar to the radiological cuts: sagittal cuts on the right hemi-pelvis, and "transverse oblique" cuts on the left hemi-pelvis. It was noted that the "mesorectum" was carpeted behind and laterally by a postero-lateral fibrous envelope belonging to the pelvic visceral fascia and in front by a recto-genital membrane of variable nature corresponding to the "Denonvilliers fascia". The postero-lateral fibrous envelope splits into two leaves (anterior and posterior) in front of the sacral concavity and constitutes, lateral to the rectum, the armature of the pelvic plexus. These two leaves delineated the avascular retro-rectal space. The results of the correlations were deceptive. Their use was limited by dilatation of the rectum, which flattened the perirectal fat onto the pelvic walls on all the sections. Nonetheless, the description of the "mesorectum" and the demonstration of its enveloping fascias by dissection allowed the development of a dissection plane for its total extirpation.

Aged↗
PubMed2003

[EMG support in botulinum toxin treatment].

INTRODUCTION: The aim of this work is to sum up how the use of EMG improves BT therapy. METHOD: A systematic review of the literature in the Pub Med computer database, along with a manual biography, allowed us to choose the most synthetic and the most pertinent publications according to our own practical experience. RESULTS: There is no consensus of opinion, but the great majority of authors emphasize the importance of EMG in the different stages of botulinum toxin treatment: before injections, at the time of the injection, and finally during the follow-up after the first injection or after the repeated injections that transient efficiency make necessary. DISCUSSION: A symptomatic therapeutic means recently recognized in focal dystonias and spasticity, BT is injected locally into the muscles to be treated. EMG can be used: at pre-injection for physiopathological evaluation but above all to establish a diagnosis and precise pre-intervention evaluation; at the moment of injection to provide guidance in precise muscle selection and for maximum efficiency with reduced, therefore less costly, doses. It also limits the risk of product diffusion susceptible of causing iatrogenic side effects and/or auto-immunisation resulting in resistance to the toxin; during follow-up, to understand why treatment failed and to look for changes in the dystonia pattern leading to objective re-evaluations and adapted reinjections. Although neglected by some, electrological logistics seem to us, as to many other practitioners who inject, to be a considerably helpful aid, particularly at the moment of injection when targeting the muscle to be treated.

Anti-Dyskinesia Agents↗
PubMed2003

[Sialorrhea, hyperhidrosis and botulinum toxin].

OBJECTIVE: The first clinical studies indicate that Botox provides effective treatment for hyperhidrosis and sialorrhea. The aim of this work is to sum up current evaluation of this use. METHOD: A systematic literature search was conducted on the Pub Med database, along with on chapters in other publications. The most interesting articles in relation to our own personal experience were chosen. RESULTS: Despite recent use of BT to treat focal hyperhidrosis, there have been numerous publications since 1997. However, the injected areas have not been listed so frequently. Axillary hyperhidrosis has been studied most; it is also in this case and in the case of gustatory sweating that the best results have been obtained. Publications about palmar and especially plantar hyperhidrosis are much rarer, almost anecdotic. It has been demonstrated to a lesser extent that BT injections are effective in these cases. Literature about sialorrhea is just beginning. However, the reduction of the production of saliva following intra parenchymatic injection of toxin into the parotid and submandibular glands, thus rarifying drooling, has been demonstrated. For each of the pathological indications, both the injection techniques and the optimal doses remain to be determined. DISCUSSION: Because BT blocks all cholinergic transmission, including the autonomous nervous system, it was plausible to expect a reduction in sweating and salivation on local injection of the product. In fact, the first publications indicated such efficiency without serious side effects. For hyperhidrosis, there has developed a consensus for making intracutaneous injections only. Of the injections in axillary areas, the palms of the hands, the plantar regions, the face or other cutaneous areas, palmoplantar hyperhidrosis is the least accessible, in any case causes the most technical problems, because of difficulty in pain management. For sialorrhea and the drooling that accompanies certain chronical neurological diseases, BT seems to have very promising effects. However, it has not been precisely determined whether to inject the parotid gland, the submandibular gland, or both. Necessary and sufficient means of targeting are still imprecise. It also remains to be determined the number of sites per gland and the doses to be injected.

Anti-Dyskinesia Agents↗
PubMed2003

[Detrusor-sphincter dyssynergia and botulinum toxin].

OBJECTIVE: Botulinum toxin (BT) injection into the external urethral sphincter is a promising therapy for neurogenic voiding disorders due to detrusor-sphincter dyssynergia (DSD). However the optimal treatment protocol remains unclear. METHOD: A PubMed reference search and manual bibliography review were performed, along with a search in the Annales de réadaptation et de médecine physique and in the reports of the International French-language Society of Urodynamics and the International Continence Society, which allowed us to select twelve pertinent articles with PubMed, two articles from the Annales and two conference reports. Our analysis gave special emphasis to assessment criteria, application, dosage and BT injection technique. RESULTS: Used for the first time in 1988 in spinal cord injury patients to reduce outflow obstruction due to DSD, BT injections have been shown to be a valuable alternative management of bladder dysfunction with DSD. They have been proposed in neurological patients unable to perform self-catheterisation, after drug failure and before surgery. Parameters for results assessment are mostly clinical (increased free interval between voiding, decreased post-void residual urine volumes), urodynamic (improvement in bladder emptying, increase in functional bladder capacity and decrease in urethral pressure) and electromyographic (denervation of striated urethral sphincter). The literature data regarding type of BT, dosage and protocol vary widely. Duration of action is from 2 to 12 months. Both transurethral and transperineal injections monitored by EMG are equally effective in improving detrusor-sphincter dyssynergia. CONCLUSION: With few side effects and satisfactory medium-term results, BT should be recommended as a component of DSD therapies. We propose a practical method for BT use.

Anti-Dyskinesia Agents↗
PubMed2003

Effects of a wheelchair ergometer training programme on spinal cord-injured persons.

STUDY DESIGN: Before and after investigation of the effects of a wheelchair ergometer Training programme. OBJECTIVE: To investigate the effects of an original interval-training programme on work capacity and cardiorespiratory variables with spinal cord-injured persons (SCIP's) on a wheelchair-specific ergometer. SETTING: BESANCON, FRANCE. METHODS: Seven SCIP's (male) performed 45 min of wheelchair ergometry three times per week, for 6 weeks. Training effects on maximal dynamic performance and endurance capacity were studied by comparison of performance and cardiorespiratory responses observed during both a maximal progressive test (10 W/2 min) and the same training session performed before and after training. RESULTS: Training induced significant improvements in maximal tolerated power (+19.6%), in peak oxygen consumption (VO2,+16%), and in oxygen pulse (O2p,+18.7%). At ventilatory threshold, significant improvements were also observed in power output (+63%), VO2VT(+ 34.1), ventilation VEVT(+ 37.1%), and V2pVT(+ 19.9% ). Heart rate and ventilation were significantly lower (-11 and -14.6%, respectively) after training at the same work rate, while VO2 was unchanged. Between the first and the last training session, the total physical work was improved by 24.7%, whereas heart rate was unchanged. CONCLUSION: An interval-training programme individualised to each paraplegic subject using a wheelchair ergometer can significantly improve the fitness level and endurance capacity.

Adult↗
PubMed2003

Urodynamic effect of acute transcutaneous posterior tibial nerve stimulation in overactive bladder.

PURPOSE: Of the various treatments proposed for urge incontinence, frequency and urgency electrostimulation has been widely tested. Different techniques have been used with the necessity of surgical implantation (S3 neuromodulation or sacral root stimulation) or without requiring surgery (perineal transcutaneous electrostimulation). Recently peripheral electrical stimulation of the posterior tibial nerve was proposed for irritative symptoms in first intention or for intractable incontinence. Clinical studies have demonstrated good results and urodynamic parameters were improved after chronic treatment. However, to our knowledge no data concerning acute stimulation and immediate cystometry modifications have been reported. We verified urodynamic changes during acute posterior tibial nerve stimulation. MATERIALS AND METHODS: A total of 44 consecutive patients with urge incontinence, frequency and urgency secondary to overactive bladder were studied. There were 29 women and 15 men with a mean age +/-SD of 53.3 +/- 18.2 years. Of the patients 37 had detrusor hyperreflexia due to multiple sclerosis (13), spinal cord injury (15) or Parkinson's disease (9), and 7 had idiopathic detrusor instability. Routine cystometry at 50 ml. per minute was done to select the patients with involuntary detrusor contractions appearing before 400 ml. maximum filling volume. Repeat cystometry was performed immediately after the first study during left posterior tibial nerve stimulation using a surface self-adhesive electrode on the ankle skin behind the internal malleolus with shocks in continuous mode at 10 Hz. frequency and 200 milliseconds wide. Volume comparison was done at the first involuntary detrusor contraction and at maximum cystometric capacity. The test was considered positive if volume at the first involuntary detrusor contraction and/or at maximum cystometric capacity increased 100 ml. or 50% during stimulation in compared with standard cystometry volumes. RESULTS: Mean first involuntary detrusor contraction volume on standard cystometry was 162.9 +/- 96.4 ml. and it was 232.1 +/- 115.3 ml. during posterior tibial nerve stimulation. Mean maximum cystometric capacity on standard cystometry was 221 +/- 129.5 ml. and it was 277.4 +/- 117.9 ml. during stimulation. Posterior tibial nerve stimulation was associated with significant improvement in first involuntary detrusor contraction volume (p <0.0001) and significant improvement in maximum cystometric capacity (p <0.0001). The test was considered positive in 22 of the 44 patients. CONCLUSIONS: These results suggest an objective acute effect of posterior tibial nerve stimulation on urodynamic parameters. Improved bladder overactivity is an encouraging argument to propose posterior tibial nerve stimulation as a noninvasive treatment modality in clinical practice.

Female↗
PubMed2002

Anatomical bases of superior gluteal nerve entrapment syndrome in the suprapiriformis foramen.

Observation of a 60 year-old-man with superior gluteal nerve (SGN) entrapment neuropathy in the suprapiriformis foramen encouraged us to explore, through anatomical dissection, the possible morphological etiologies of this condition. Ten SGNs in five embalmed cadavers were dissected via gluteal and pelvic access. The origin, course and distribution of the nervous trunk and its relations were studied. In most cases, the nerve fibers of the SGN arose from ventral branches of L4, L5 and S1 to constitute the nervous trunk in the pelvis, then reached the gluteal area and divided into two branches, cranial and caudal. By running through the suprapiriformis foramen with the cranial gluteal vascular pedicle, the nervous trunk was always up between the superior edge of the piriformis muscle and the greater sciatic notch; rarely some of the nerve fibers went through the muscle. Bone, muscular and vascular morphological factors liable to cause SGN entrapment syndrome, and the circumstances of discovery, were analyzed. The role of hypertrophy of the piriformis muscle, resulting in a narrow suprapiriformis foramen, was confirmed through surgery.

Aged↗
PubMed2002

Intramuscular distribution of nerves in the human triceps surae muscle: anatomical bases for treatment of spastic drop foot with botulinum toxin.

Recent progress has been made in selective functional treatment of hypertonia of spastic origin by local injection of botulinum toxin into the muscles responsible for equinus foot dynamic deformation. The technical aspect of the intervention requires a strategy adapted to the individual patient. Good practice is founded on precise knowledge of the intramuscular nerve distribution of end plate zones, since the target organ of the toxin is the motor end plate. Knowledge about the location of motor end plates, which differs according to the structure of the muscle in question, remains rather poor. Through macroscopic and stereoscopic microscopic dissection of the nerve courses in the triceps surae muscular group in 40 legs, we have ascertained in more detail the distribution of motor end plates, which appear to be more numerous in certain zones of the muscle bellies. These zones were measured morphometrically and divided into segments which are expressed in percentages of a standard leg length. We maintain that these zones are the injection sites most likely to guarantee the best treatment efficacy.

Anti-Dyskinesia Agents↗
PubMed2002

[Isolated pontine infarction: vascular anatomy helps understand clinical signs].

Clinical findings of pontine infarcts are more frequently described as classical crossed-syndrome. The aim of this study was to analyse clinical presentation of isolated pontine infarcts. From the Besancon Stroke Registry, we retrospectively studied 34 patients with isolated pontine infarcts documented on MRI with a strict centro-bicommissural plane as the reference. MRI were analyzed using an arterial territories mapping of brainstem. Among our 34 pts, none developed a classical crossed-syndrome. A thorough knowledge of vascular anatomy of brainstem is necessary to understand clinical findings. Moreover, this knowledge allow to explain the rare occurrence of pontine crossed-syndrome.

Adult↗
PubMed2002

[Acute polyradiculoneuritis during primary herpes simple virus infection].

The herpes virus family, particularly cytomegalovirus and Epstein-Barr virus, are often associated with acute polyradiculoneuritis (APRN). APRN following primary herpes simplex virus infection is much more uncommon, viral reactivation generally being involved. We report a patient who developed APRN following herpes simplex virus primary infection, probably HSV II.

Adolescent↗