Biomedical subjects

Jean-Louis Croisier

Publications and source records attributed to Jean-Louis Croisier.

7 recordsLinked to original sources

PubMed2007

An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy.

BACKGROUND: Lateral epicondylitis represents a frequent overuse injury. In spite of many conservative treatment procedures, prolonged symptoms and relapse are frequently observed. OBJECTIVE: To compare the outcome of patients performing an isokinetic eccentric training with that of age-, gender-, activity-matched patients receiving a non-strengthening classical rehabilitation. METHODS: Ninety-two patients with unilateral chronic lateral epicondylar tendinopathy (mean duration of symptoms 8+/-3 months) were assigned either to a control group (n = 46) or to an eccentrically trained group (n = 46). The control group underwent a passive standardised rehabilitation programme that excluded strengthening exercises. In addition to this programme, the trained group also performed eccentric exercises based on the repetitive lengthening of the active musculo-tendinous unit. The latter exercises started with submaximal contraction intensity and slow speed movement. Modalities were progressively intensified (increase in intensity contraction and speed movement) over a long period of treatment. Programme effectiveness was assessed through pain score evaluation, a disability questionnaire, muscle strength measurement and ultrasonographic examination. RESULTS: Compared to the non-strengthening control group, the following observations were made in the eccentrically trained group: (1) a significantly more marked reduction of pain intensity, mainly after one month of treatment; (2) an absence of strength deficit on the involved side through bilateral comparison for the forearm supinator and wrist extensor muscles; (3) an improvement of the tendon image as demonstrated by decreasing thickness and a recovered homogenous tendon structure; and (4) a more marked improvement in disability status during occupational, spare time and sports activities. CONCLUSION: These results highlight the relevance of implementing isokinetic adapted eccentric training in the management of chronic lateral epicondylar tendinopathy.

Adult↗

PubMed2005

Factors correlated with volleyball spike velocity.

BACKGROUND: Spike effectiveness represents a determining element in volleyball. To compete at a high level, the player must, in particular, produce a spike characterized by a high ball velocity. HYPOTHESIS: Some muscular and physical features could influence ball velocity during the volleyball spike. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 19 male volleyball players from the 2 highest Belgian national divisions underwent an isokinetic assessment of the dominant shoulder and elbow. Ball velocity performance (radar gun) during a spike test, morphological feature, and jump capacity (ergo jump) of the player were measured. We tested the relationship between the isokinetic parameters or physical features and field performances represented by spike velocity. We also compared first-division and second-division player data. RESULTS: Spike velocity correlated significantly with strength performance of the dominant shoulder (internal rotators) and of the dominant elbow (flexors and extensors) in the concentric mode. Negative correlations were established with the concentric external rotator on internal rotator ratio at 400 deg/s and with the mixed ratio (external rotator at 60 deg/s in the eccentric mode on internal rotator at 240 deg/s in the concentric mode). Positive correlations appeared with both the volleyball players' jump capacity and body mass index. First-division players differed from second-division players by higher ball velocity and increased jump capacity. CONCLUSION: Some specific strength and physical characteristics correlated significantly with spike performance in high-level volleyball practice. CLINICAL RELEVANCE: Our results could provide useful information for training management and propose some reflections on injury prevention.

Adult↗

PubMed2004

Pressure pain thresholds of tender point sites in patients with fibromyalgia and in healthy controls.

Pressure pain threshold (PPT) is defined as the minimum force applied which induces pain. This measure has proven to be commonly useful in evaluating tenderness symptom. Our aim was to study the intra-examiner reproducibility of PPT measurement, define cutoffs in normal groups, and compare these results with patients with fibromyalgia (FM). Fifty healthy females, 50 healthy males, and 20 patients with FM participated in the study. PPTs were assessed for 18 specific tender point sites by a dolorimeter. The intra-individual coefficient of variation determined by a test-retest PPT measurement procedure with 3-days interval reached, respectively, 17% and 13% in healthy females and males, versus 24% in patients with FM. PPTs were significantly lower in healthy females than in healthy males (p<0.01). Statistical analysis failed to show any differences between the dominant and nondominant side for both normal groups. PPTs were lower over all examined areas in patients with FM than those obtained in healthy females (p<0.000). Lower cutoff levels were calculated from normal values for all specific tender point sites. On average, 14 tender point sites in patients with FM were under the established lower cutoffs. In conclusion, pressure pain sensitivity was influenced by the anatomical localization of tender point and gender differences. Lowest PPTs were localized in trapezius, occiput, anterior cervical, and second rib. The reduction of total tender point score in patients with FM averaged 60% comparatively with normal values. PPT reproducibility and discrimination between the two groups were optimal for the gluteal and knee sites.

Adult↗

PubMed2004

Factors associated with recurrent hamstring injuries.

A history of muscle injury represents a predominant risk factor for future insult in that muscle group. The high frequency of re-injury and persistent complaints after a hamstring strain comprise major difficulties for the athlete on return to athletic activities. Some of the risk factors associated with the possible recurrence of the injury are, in all probability, already implicated in the initial injury. One can distinguish between those events peculiar to the sport activity modalities (extrinsic factors) and other contributing factors based on the athletes individual features (intrinsic factors). For both categories, the persistence of mistakes or abnormalities in action represent an irrefutable component contributing to the re-injury cycle. Additional factors leading to chronicity can come from the first injury per se through modifications in the muscle tissue and possible adaptive changes in biomechanics and motor patterns of sporting movements. We emphasise the role of questionable approaches to the diagnosis process, drug treatment or rehabilitation design. To date, the risk factors examined in the literature have either been scientifically associated with injury and/or speculated to be associated with injury. In this context, quantifying the real role of each factor remains hypothetical, the most likely ones corresponding to inadequate warm-up, invalid structure and the content of training, muscle tightness and/or weakness, agonist/antagonist imbalances, underestimation of an extensive injury, use of inappropriate drugs, presence of an extensive scar tissue and, above all, incomplete or aggressive rehabilitation. Such a list highlights the unavoidable necessity of developing valid assessment methods, the use of specific measurement tools and more rigorous guidelines in the treatment and rehabilitation. This also implies a scientific understanding as well as specifically qualified medical doctors, physiotherapists and trainers acting in partnership.

Athletic Injuries↗

PubMed2002

Muscle performance in patients with fibromyalgia.

OBJECTIVES: To compare muscle performance in women with fibromyalgia and in healthy women. PATIENTS AND METHODS: Sixteen women with fibromyalgia syndrome (FMS) and 85 healthy women who were physically inactive or engaged in recreational sports underwent measurements of four parameters: maximal concentric isokinetic muscle strength of the knee extensors and flexors in the dominant limb, isometric grip strength on a Colin dynamometer, muscle fatigue resistance during 30 maximal concentric isokinetic contractions of the dominant knee flexors and extensors at 180 degrees angular velocity, and static endurance during posture maintenance. RESULTS: All muscle variables were decreased in the FMS patients as compared to the controls. The decreases were more marked during aerobic than during anaerobic exercise. Mean decreases were 39% (P<0.001) for muscle strength, 40% (P<0.0001) for fatigue resistance, and 81% (P<0.0001) for static endurance. Pain during exercise as evaluated using a visual analog scale was more marked in the FMS patients. CONCLUSION: This study of the three pathways supplying energy to muscle confirms that muscle function is globally impaired in FMS patients. The results suggest that the impairment predominates on aerobic processes.

Adult↗

PubMed2002

Blood flow variation in human muscle during electrically stimulated exercise bouts.

OBJECTIVES: To evaluate, with a high spatial resolution, the blood flow variations in human skeletal muscle during neuromuscular electric stimulation (NMES) and hence to gain better understanding of the mechanisms of muscle spatial recruitment during NMES. DESIGN: One thigh was submitted to 3 stimulation bouts of different durations (S1=4min, S2=8min, S3=12min) with a workload corresponding to 10% of quadriceps maximal isometric voluntary torque. SETTING: A cyclotron research center at a Belgian university. PARTICIPANTS: Ten healthy male volunteers. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participants were studied with positron emission tomography and H(2)(15)O. Tissue blood flow was evaluated during the last 4 minutes of each stimulation bout in multiple regions of interest (ROIs) selected in the transverse section of the stimulated thigh. RESULTS: Mean tissue blood flow was significantly lower during S1 (5.9+/-1.3mL. min(-1). 100g(-1)) than during S2 (10.6+/-3.4mL. min(-1). 100g(-1)) and S3 (11.6+/-3.7mL. min(-1). 100g(-1)) (P<.05). For each ROI, an arbitrary tissue blood flow activation level of 5mLmin(-1)100g(-1) was fixed. The mean percentage of activated ROIs reached 42.4%, 62.7%, and 63.6% during S1, S2, and S3, respectively. Between S1 and S3, the newly recruited ROIs were preferentially located far from the electrode. CONCLUSION: During NMES, new muscular regions situated far from the stimulation site are recruited. These recruitment mechanisms are particular and contrast with the recruitment of motor units seen during voluntary contraction.

Adult↗

PubMedDate not supplied

Hamstring muscle strain recurrence and strength performance disorders.

We determined the frequency of strength disorders in 26 athletes with a history of hamstring muscle injury and recurrent strains and discomfort. We also assessed the effectiveness of rehabilitation to correct muscle performance. After concentric and eccentric isokinetic assessment, 18 athletes were found to have strength deficits, as determined by statistically selected cutoffs of peak torque, bilateral differences, and the flexors/quadriceps ratio. The discriminating character of the eccentric trial was demonstrated, combining a preferential eccentric peak torque deficit and a significant reduction of the mixed eccentric flexors/concentric quadriceps ratio. The athletes with muscle imbalances followed a rehabilitation program individually adapted from their strength profile. Treatment length was from 10 to 30 sessions and resulted in isokinetic parameter normalization in 17 of 18 subjects. Isokinetically corrected subjects were observed for 12 months after return to athletics. None sustained a clinically diagnosed hamstring muscle reinjury. Subjective intensity of pain and discomfort were significantly reduced, and they all returned to their prior level of competition. These results demonstrate that persistent muscle strength abnormalities may give rise to recurrent hamstring injuries and discomfort. An individualized rehabilitation program emphasizing eccentric training based on specific deficits contributes to a decrease in symptoms on return to sports.

Adult↗