Poststroke Postural Sway Improved by Botulinum Toxin: A Multicenter Randomized Double-blind Controlled Trial.

Objective: To assess the effects of injecting botulinum toxin into the lower limb muscles of people with hemiparesis post stroke in terms of their sway areas.

Design: A multicenter randomized double-blind trial on the effects of active botulinum toxin treatment vs placebo.

Setting: Clinical examinations and postural sway assessments were performed before botulinum toxin injection and again 4-6 weeks after the injection.

Evidence-based position paper on Physical and Rehabilitation Medicine professional practice for persons with stroke. The European PRM position (UEMS PRM Section).

Background: Stroke is a major cause of disability worldwide, with an expected rise of global burden in the next twenty years throughout Europe. This EBPP represents the official position of the European Union through the UEMS Physical and Rehabilitation Medicine (PRM) Section and designates the professional role of PRM physicians for people with stroke. The aim of this study is to improve PRM physicians' professional practice for persons with stroke in order to promote their functioning and enhance quality of life.

Knee-ankle-foot orthoses for treating posterior knee pain resulting from genu recurvatum: Efficiency, patients' tolerance and satisfaction.

Objective: To assess the efficiency of knee-ankle-foot orthoses for treating painful genu recurvatum, and to determine users' tolerance and satisfaction.

Patients: Patients included in the study had a genu recurvatum during the stance phase, confirmed by a medical doctor on physical examination. A total of 27 patients with 31 knee-ankle-foot orthoses were included.

Return to surfing using an adapted prosthesis: A case report.

Background: Surfing with transfemoral knee prosthesis requires flexion of the hip, knee, and ankle and balance between flexibility and stiffness of the prosthetic limb. We report on Mr D, a transfemoral amputee, who wanted to surf again. Case Description and Methods: Technical specifications were based on Mr D's complaint.

Plastic changes in spinal synaptic transmission following botulinum toxin A in patients with post-stroke spasticity.

Objective: The therapeutic effects of intramuscular injections of botulinum toxin-type A on spasticity can largely be explained by its blocking action at the neuromuscular junction. Botulinum toxin-type A is also thought to have a central action on the functional organization of the central nervous system. This study assessed the action of botulinum toxin-type A on spinal motor networks by investigating post-activation depression of the soleus H-reflex in post-stroke patients.

Orthopaedic shoes along with physical therapy was effective in Charcot-Marie-Tooth patient over 10 years.

Background: The aim was to investigate the effectiveness of custom-made orthopaedic shoes (derby shoes) along with physiotherapy (twice a week) on a person with Charcot-Marie-Tooth over a period of 10 years.

Case Description And Methods: A 66-year-old woman with Charcot-Marie-Tooth disease, who did not have other health conditions, complained of pain and frequent falls. Physical examination, including ankle, knee and hip muscle strength; sensory evaluation of foot and joint range of motion; self-reported assessment of pain, frequency of falls and sprains; and gait analyses, including spatial and temporal parameters and motion analyses, were performed in 2001, 2007 and 2011.

A census of students with disabilities and the support provided at the University of Aix-Marseille.

Access to the college cycle for students with disabilities and their employability have become a priority for universities. The Handicap Mission manages it within the Aix-Marseille University (AMU). Few studies have focused on the students with disabilities' insertion/integration within the universities and on the compensations.

PRM programmes of care and PRM care pathways: European approach, developments in France.

The development of European Union of Medical Specialists (UEMS) physical and rehabilitation medicine programmes of care (PRMPC) and physical and rehabilitation medicine care pathways (PRMCP) in France is a good example of the positive interaction between European and national organizations. PRMPC were defined at the European level to offer a robust template for the description and assessment of physical and rehabilitation medicine (PRM) clinical activity in various fields and contexts. An accreditation procedure was organized as a peer review.

A position paper on Physical & Rehabilitation Medicine programmes in post-acute settings. Union of European Medical Specialists Section of Physical & Rehabilitation Medicine (in conjunction with the European Society of Physical & Rehabilitation Medicine).

Physical & Rehabilitation Medicine (PRM) programmes in post-acute settings cover interventions for the rehabilitation of people with a variety of disabling health conditions. The setting of the intervention is more important than the timing and these programmes can be carried out in a variety of facilities. This paper describes the role of PRM services and of PRM specialists in delivering rehabilitation programmes to people, who have initially been admitted to hospital.

European Union of Medical Specialists (UEMS) section of Physical & Rehabilitation Medicine: a position paper on physical and rehabilitation medicine in acute settings.

Physical and rehabilitation medicine (PRM) specialists have an important role in the clinical care of patients during the acute phase of a disabling health condition. This phase is defined as once definitive care or resuscitation has taken place and a patient's need to stay in hospital as an inpatient is primarily for PRM services for rehabilitation. This paper describes 4 options for the delivery of services for people, who continue to require to be inpatients and who will benefit from PRM interventions.

Improvement of gait in a stroke patient. A 7-year longitudinal study.

Purpose: To report on the gait improvement obtained in a stroke patient after applying three treatments for spastic equinus varus foot: botulinum toxin injection (BTI), tibial nerve neurotomy (TNN), and orthopaedic surgery (triple arthrodesis), during a 7-year longitudinal follow-up period.

Method: A quantified analysis of a stroke patient's gait was performed on a Gaitrite walking mat before and after applying BTI 3 years, TNN 4 years and orthopaedic surgery 7 years after the stroke.

Results: After the three treatments, the spasticity disappeared, the range of ankle motion improved and voluntary command of the tibialis anterior became possible.

Interdisciplinary team working in physical and rehabilitation medicine.

Effective team working plays a crucial role in Physical and Rehabilitation Medicine (PRM). As part of its role of optimizing and harmonizing clinical practice across Europe, the Professional Practice Committee of Union of European Medical Specialists (UEMS) Physical and Rehabilitation Medicine (PRM) Section reviewed patterns of team working and debated recommendations for good practice at a meeting of national UEMS delegates held in Riga, Latvia, in September 2008. This consensus statement is derived from that discussion and from a review of the literature concerning team working.

Orthotic fitting improves gait in a patient with generalized secondary dystonia.

Objective: To determine whether an orthotic fitting improved gait in an adult patient presenting with generalized secondary dystonia.

Patient: The patient had stance and gait disturbances associated with pain, ankle instability and fatigability. Clinical examination showed the presence of dystonia in the foot and ankle, along with equinovarus foot, mainly on the left side.

Evaluation of patients with gait abnormalities in physical and rehabilitation medicine settings.

The first step in the assessment of patients with gait abnormalities in physical and rehabilitation medicine settings is a clinical examination based on the International Classification of Functioning, Disabilities and Health. Body structure, activities and participation, and environmental factors (physical and human factors) must all be assessed. Qualitative and quantified assessments of gait are part of the activity and participation evaluation.

Changes in postural control in hemiplegic patients after stroke performing a dual task.

Objective: To determine the effects of an attentional task on hemiplegic patients' postural control performances.

Design: Retrospective study.

Setting: Department of physical and rehabilitation medicine at a university hospital.

Gait recovery in a distal spinal muscular atrophy patient wearing a patellar tendon-bearing orthosis and orthopaedic shoes.

Objective: To illustrate that a patient with distal spinal muscular atrophy can recover gait with a combination of orthoses and orthopaedic shoes.

Subject: A 28-year-old man with distal spinal muscular atrophy affecting only the distal muscles of the lower limbs. Clinical examination showed a bilateral pes cavus with a varus and a 90 degrees equinus of the ankle joint.

Kinematic and kinetic asymmetries in hemiplegic patients' gait initiation patterns.

Objective: To assess the kinetic and kinematic characteristics of hemiplegic stroke patients' gait initiation patterns during the various gait initiation phases.

Design And Subjects: Gait initiation was studied in 3 hemiplegic subjects with a spastic equinus varus foot and 3 control subjects.

Methods: Temporal and kinetic analysis of gait initiation was performed with 2 AMTI force plates, and kinematic analysis of gait initiation with an ELITE optoelectronic system.