Publications by authors named "Lafrance S"

Objectives: In France, early access to physiotherapy for people with musculoskeletal disorders (MSKDs) depends on prescription and referral by the family physician in the physician-led model of care. The readiness of French people for direct access to physiotherapy is not known. This survey aims to identify the perceptions of French adults regarding physiotherapists' competence to diagnose and manage MSKDs if they were primary care practitioners, confidence in their ability to provide quality care, and satisfaction with the last episode of care for those concerned; and to identify factors associated with these three variables.

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Article Synopsis
  • The study compared the effectiveness of a single session of education and exercise to multiple sessions of a comprehensive physiotherapy intervention for adults with spinal disorders referred for surgery but deemed nonsurgical by experts. !* -
  • Results showed no significant differences in pain severity, but the multiple-session group reported better pain interference improvement at 6 weeks and higher satisfaction levels overall. !* -
  • Both groups experienced positive changes over time, but the addition of more therapy sessions did not lead to better clinical outcomes compared to just one education and exercise session. !*
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Background: Access to care is a major challenge for patients with musculoskeletal disorders (MSKDs). Telemedicine is one of the solutions to improve access to care. However, initial remote diagnosis of MSKDs involves some challenges, such as the impossibility of touching the patient during the physical examination, which makes it more complex to obtain a valid diagnosis.

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To evaluate the effect of a workplace injury prevention and wellness program compared to no intervention (control) on musicians' playing-related musculoskeletal pain intensity. The hypothesis was that musicians who completed the program would have a greater reduction in pain intensity than the control group. Pragmatic parallel randomized controlled trial.

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To evaluate the efficacy of exercise interventions with differing frequency, intensity, type, and time (FITT) on shoulder pain and disability in people with rotator cuff-related shoulder pain (RCRSP). Intervention systematic review with meta-analyses. Electronic searches were conducted up to May 2023.

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To summarize the FITT (frequency, intensity, time, type), components of exercise programs included in randomized controlled trials (RCTs) that compared 2 or more programs for managing rotator cuff-related shoulder pain (RCRSP). Scoping review. Electronic searches were conducted up to May 2023.

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Questions: What is the diagnostic and surgical triage concordance between advanced practice physiotherapists (APPTs) and physicians? What is the clinical efficacy of advanced practice physiotherapy care compared with usual medical care?

Design: Systematic review with meta-analyses.

Literature Search: Medline, Embase, Cochrane CENTRAL and CINAHL were searched up to March 2022.

Study Selection Criteria: Concordance studies on diagnostic or surgical triage between APPTs and physicians and randomised controlled trials comparing the clinical efficacy of an advanced practice physiotherapy (APP) model of care compared with usual medical care for participants with musculoskeletal disorders.

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Introduction: To optimise the management of Musculoskeletal disorders (MSKDs), many countries have implemented direct access to physiotherapy; however, the core competencies required for first contact physiotherapists (PTs) have not been precisely defined. The aim of this scoping review is to identify and describe the core competencies required for first contact PTs treating adults with MSKDs.

Methods: We conducted a scoping review of the literature by searching eight databases and grey literature up to July 2023.

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Introduction: In this novel advanced practice physiotherapy (APP) model of care, advanced practice physiotherapists (APPTs) assess, triage, and manage adults with spinal disorders to alleviate the growing demands in specialized spine medical care.

Objectives: To describe this APP model of care, to assess change in disability 3 months after rehabilitation care and to assess surgical triage and diagnostic concordance between APPTs and spine surgeons.

Methods: In this retrospective observational study, consecutive patients who completed the 3-month follow-up data were analyzed.

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Megasynthase enzymes such as type I modular polyketide synthases (PKSs) and nonribosomal peptide synthetases (NRPSs) play a central role in microbial chemical warfare because they can evolve rapidly by shuffling parts (catalytic domains) to produce novel chemicals. If we can understand the design rules to reshuffle these parts, PKSs and NRPSs will provide a systematic and modular way to synthesize millions of molecules including pharmaceuticals, biomaterials, and biofuels. However, PKS and NRPS engineering remains difficult due to a limited understanding of the determinants of PKS and NRPS fold and function.

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Background: The diagnosis of cervicogenic headache (CGH) remains a challenge for clinicians as the diagnostic value of detailed history and clinical findings remains unclear.

Objectives: To update and evaluate available evidence of the prevalence and the diagnostic accuracy of the detailed history and clinical findings for CGH in adults with headache.

Design: Systematic review with meta-analysis.

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Article Synopsis
  • A clinical practice guideline was created to assess, manage, and facilitate the return to work for adults with rotator cuff disorders in Quebec, Canada.
  • The guideline includes 73 recommendations and 3 clinical decision algorithms, emphasizing the importance of a thorough initial assessment and recommending active rehabilitation over surgery for most patients.
  • It highlights the need for early collaboration on return-to-work plans involving healthcare providers and the patient to ensure effective recovery and reintegration into the workplace.
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To present the methods used to develop a clinical practice guideline (CPG) with recommendations endorsed by key stakeholders for assessing, managing, and supporting return to work for adults with rotator cuff disorders. Clinical practice guideline development. A steering committee composed of the research team of this project led the development of this CPG in 5 phases, which followed the standards of the NICE and AGREE II collaborations.

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Objective: To update and appraise the efficacy of physiotherapy for adults with cervicogenic headache.

Literature Survey: Bibliographic searches were conducted up to October 2021 for randomized controlled trials (RCTs), assessing the efficacy of physiotherapy interventions for adults with cervicogenic headache, in five databases: CINAHL, Physiotherapy Evidence Database (PEDro), PubMed, Sage Journals, and Wiley Online Library.

Methodology: Data extraction of included trials was conducted by two reviewers according to a standardized extraction form.

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Background And Purpose: Musculoskeletal disorders (MSKDs) are the most common causes of disabilities for older adults. The aim of this systematic review and meta-analysis is to assess the effectiveness of multimodal interventions including exercise rehabilitation for older adults with chronic MSKDs.

Methods: A literature search was conducted up to February 2019 in 5 bibliographical databases to identify randomized controlled trials (RCTs) that compared multimodal interventions including exercise rehabilitation with usual medical care or no intervention.

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Background: The objective of this systematic review is to appraise evidence on the economic evaluations of advanced practice physiotherapy (APP) care compared to usual medical care.

Methods: Systematic searches were conducted up to September 2021 in selected electronic bibliographical databases. Economic evaluation studies on an APP model of care were included.

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Objectives: To assess the effectiveness and cost-effectiveness of a single session compared with multiple sessions of education and exercise for older adults with spinal pain treated conservatively in an advanced practice physiotherapy model of care.

Methods And Analysis: In this pragmatic randomised controlled trial, 152 older adults (≥65 years old) with neck or back pain initially referred for a consultation in neurosurgery, but treated conservatively, will be recruited through the advanced practice physiotherapy neurosurgery CareAxis programme in the Montreal region (Quebec, Canada). In the CareAxis programme, older patients with spinal pain are triaged by an advance practice physiotherapist and are offered conservative care and only potential surgical candidates are referred to a neurosurgeon.

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Objective: To compare the efficacy of region-specific exercises to general exercises approaches for adults with spinal or peripheral musculoskeletal disorders (MSKDs).

Data Sources: Electronic searches were conducted up to April 2020 in Medline, Embase, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health.

Study Selection: Randomized control trials (RCTs) on the efficacy of region-specific exercises compared to general exercises approaches for adults with various MSKDs.

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Objective: The purpose of this review was to compare the efficacy of motor control exercises (MCEs) to strengthening exercises for adults with upper- or lower-extremity musculoskeletal disorders (MSKDs).

Methods: Electronic searches were conducted up to April 2020 in Medline, Embase, Cochrane CENTRAL, and CINAHL. Randomized controlled trials were identified on the efficacy of MCEs compared to strengthening exercises for adults with upper- or lower-extremity MSKDs.

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Objective: To appraise the available evidence on advanced practice physiotherapy (APP) models of care (MoC) in specialized secondary care such as orthopaedic, rheumatology or neurosurgery outpatients' clinics for adults with spinal pain.

Methods: Systematic review with meta-analysis. Electronic searches were conducted up to July 2020 in Medline, Embase, Cochrane CENTRAL and CINAHL.

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Article Synopsis
  • The study systematically reviewed clinical practice guidelines (CPGs) for managing rotator cuff disorders in adults, focusing on recommendations and their methodologies.
  • Nine CPGs published from 2008 onward were analyzed using a standardized framework and assessed for methodological quality, revealing that only three had high quality.
  • Key recommendations included active treatment options like exercise programs and varying opinions on pain medications and surgical approaches, highlighting the need for more rigorous and consistent guidelines in this area.
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  • Rotator cuff calcific tendinopathy involves the buildup of crystals in rotator cuff tendons and may be treated with ultrasound-guided lavage, though its effectiveness is still debated.
  • A systematic review analyzed previous studies to determine how ultrasound-guided lavage compares to other treatments, focusing on pain relief and functional improvement.
  • Results suggest that ultrasound-guided lavage might reduce pain and enhance function better than shockwave therapy and corticosteroid injections, though the evidence is considered low-quality and more research is needed.
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Multiple immunotherapeutics have been approved for cancer patients, however advanced solid tumors are frequently refractory to treatment. We evaluated the safety and immunogenicity of a vaccination approach with multimodal oncolytic potential in non-human primates (NHP) (). Primates received a replication-deficient adenoviral prime, boosted by the oncolytic Maraba MG1 rhabdovirus.

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