0000000000240743
AUTHOR
France Mourey
Evaluation of the animal-assisted therapy in Alzheimer's disease
Animal-assisted therapy sessions have been set up in a protected unit for patients with a dementia-related syndrome. The aim is to measure the effects of animal-assisted therapy on behavioural disorders in daily life and care. The results obtained provided some interesting areas to explore and recommendations with a view to optimising the implementation of such a system.
Parcours de soins de la personne âgée, du diagnostic kinésithérapique aux nouvelles technologies, vous saurez tout. Préférences sensorielles, vieillissement et fragilité
La fonction d’equilibration repose sur l’integration de donnees sensorielles autorisant une regulation sensori-motrice des activites musculaires [1] , [2] , [3] . Les donnees relatives a l’evolution de notre corps dans l’environnement, utiles pour coordonner la posture et le mouvement, proviennent principalement de l’appareil visuel, de l’oreille interne et des capteurs de la somesthesie [4] , [5] . Cependant, la ponderation de ces entrees peut varier d’un individu a un autre, et en fonction des contraintes de l’environnement : ces variations constituent des preferences sensorielles [6] , [7] . Des situations particulieres, telles que la privation d’une de ces entrees suite a un accident, p…
Sensory reweighting in frail aged adults: Are the balance deficiencies mainly compensated by visual or podal dependences?
Abstract Background Postural control is based on the integration of different sensory inputs. The process of scaling the relative importance of these sensory cues (visual, vestibular and proprioceptive) depends on individuals and creates sensory preferences, leading to sensory dependences when one particular source is preponderant. In this context, the literature showed a frequent visual dependence (visual inputs weighting) in aged adults. However, the somaesthetic inputs can also be prioritised in a podal-dependent profile. In the frail aged adults, none study has shown the distribution of these two dependences. Research question Which sensory orientation profile is preferentially adopted …
Imagerie motrice en rééducation gériatrique
Introduction La reeducation geriatrique s’adresse a des patients âges fragiles sur le plan posturo-moteur. L’imagerie motrice (IM) est une technique de physiotherapie interessante [1] notamment en reeducation neurologique [2] [3] ou musculo-squelettique [4] . Son utilisation en reeducation geriatrique est encore peu developpee. Le protocole experimental suivant vise a tester l’efficacite de l’IM pour l’amelioration de la commande motrice du membre superieur, essentielle dans le maintien de l’independance fonctionnelle des personnes âgees. Methode Seize personnes âgees (m = 86,3 ans ± 5,9) ont participe, divisees en 2 groupes de 8 (groupe temoin : GT et groupe entraine GE). La tâche de prehe…
Analysis of postural control in elderly subjects suffering from Psychomotor Disadaptation Syndrome (PDS).
PDS is a geriatric affliction, described in 1999, characterized by postural impairments, including backward disequilibrium, freezing, a deterioration in the ability to anticipate postural adjustments, anxiety and fear of falling, inducing loss of autonomy. This study compared 10 subjects suffering from PDS, aged 87.3+/-4.9 years, with 10 control subjects, aged 85.4+/-7.9 years concerning postural control (body sway amplitude). In all participants, postural control was assessed using the SwayStar system in natural (spontaneous) and standardized stances, eyes open and eyes closed over a period of 40 s. It was found that: (1) with eyes open, subjects with PDS showed greater body sway amplitude…
Anticipatory Postural Adjustments and kinematic arm features when postural stability is manipulated
International audience; Beyond the classical paradigm that presents the Anticipatory Postural Adjustments (APAs) as a manner to create forces that counteract disturbances arising from the moving segment during a pointing task, there is a controversial discussion about the role APAs to facilitate the movement and perform a task accurately. In addition, arm kinematics features are classically used to infer the content of motor planning for the execution and the control of arm movements, The present study aimed to disentangle the conflicting role of APAs during an arm-pointing task in which the subjects reach a central diode that suddenly turns on, while their postural stability was manipulate…
L’évaluation systémique au service du diagnostic physiothérapique en gériatrie
L’evaluation geriatrique de la fonction d’equilibration est habituellement realisee sous une visee fonctionnelle autorisee par de nombreux tests valides [1] , [2] , [3] , [4] , [5] , [6] . Cependant, ces differents tests ne permettent pas de determiner l’etiologie precise des troubles de l’equilibre et par consequent n’orientent pas le reeducateur dans son bilan diagnostic kinesitherapique. Une approche systemique a ete concue en reponse a cette problematique. Le « Balance Evaluation Systems Test » (BESTest), [7] propose par l’equipe de Fay Horak en 2010, evalue six sous-systemes essentiels dans le controle de l’equilibre. Dans une logique similaire, le raisonnement EquiMoG (Equilibre et Mo…
[Psychomotor disadaptation syndrome].
We describe the psychomotor disadaptation syndrome and report the last findings on its physiopathology and therapeutic. This syndrome was first described by Pr Gaudet's team in 1986 and named "psychomotor regression syndrome". This name has been recently changed into "psychomotor disadaptation syndrome".The psychomotor disadaptation syndrome is a decompensation of postural function, gait and psychomotor automatisms due to the alteration of the posture and motor programming. That alteration is linked to subcortical-frontal lesions. Clinically, the psychomotor disadaptation syndrome is characterized by postural impairments (retro-propulsion or backward disequilibrium), non-specific gait disor…
Activité physique et prévention des chutes chez les personnes âgées
Les chutes chez les personnes âgées sont fréquentes : près d’une personne de plus de 65 ans sur trois et une personne de plus de 80 ans sur deux chutent chaque année. L’état de santé, les capacités fonctionnelles, les facteurs comportementaux ou les caractéristiques de l’environnement constituent autant de facteurs de risque. Au-delà des traumatismes physiques et psychologiques tels que la peur de tomber qui en résultent, les chutes peuvent entraîner des limitations fonctionnelles, une diminution de la qualité de vie, une perte d’autonomie voire une entrée en institution.Dans un contexte de vieillissement de la population, la prévention des chutes et la préservation de l’autonomie dans les …
Et si l’important n’était pas la chute mais de réussir à se relever du sol ?
L’incidence des chutes lors du vieillissement reflete l’importance de ne pas banaliser cet evenement. De plus, la station prolongee au sol est source de complications graves chez le sujet âge [1] . En effet, la moitie des personnes restant au sol plus d’une heure decede dans les 6 mois apres la chute [2] . Notre sensibilite de kinesitherapeute est attiree par une autre donnee statistique : la moitie des personnes âgees qui ont chute sont incapables de se relever seule malgre l’absence de blessure grave [3] . L’incapacite de se relever du sol constitue un facteur predictif de chute [4] . Cette impossibilite peut etre mise en lien avec deux causes principales : la presence de contraintes biom…
Multidisciplinary management in geriatric day-hospital is beneficial for elderly fallers: A prospective study of 28 cases
We determined whether management including medical, psychological, and physiotherapeutic approaches, over a period of 6 weeks, has a beneficial effect on motor abilities, psychological status, and independence of elderly fallers with psychomotor disadaptation syndrome (PDS). We included 28 subjects (mean age 81.4 years). They were assessed from a medical, motor, and psychological point of view at both the inclusion and the end of the multidisciplinary intervention. A follow-up was conducted with multidisciplinary assessment at 6 and 9 months after the beginning of the study in order to evaluate duration of benefits of the management. The statistical analysis concerned only subjects who took…
Rehabilitation and functional recovery in patients with hip fracture: A prospective study
International audience
Étude comparative de deux modes d’entraînements physiques en Ehpad
Resume Cette etude a compare les effets de deux types d’entrainements chez 22 personnes âgees d’un service d’Etablissement d’hebergement de personnes âgees dependantes (Ehpad). Les sujets ont ete separes en deux groupes de maniere randomisee. Seulement 16 d’entre eux ont participe a l’ensemble des seances et sont inclus dans les analyses statistiques. Le « groupe force » a realise des exercices analytiques de musculation en salle et le « groupe aerobie » a realise des seances de marche continue et intermittente dans un couloir. Chaque groupe a effectue cinq semaines d’entrainement specifique. Avant et apres entrainement, la population a ete evaluee avec deux tests : le « 30 s-chair-stand te…
Is backward disequilibrium in the elderly caused by an abnormal perception of verticality? A pilot study
International audience; OBJECTIVE: We hypothesised that backward disequilibrium (BD), defined by a posterior position of the centre of mass with respect to the base of support, could be caused by a backward tilt in the perception of verticality. METHODS: The relationship between BD, the perception of verticality, and the history of falls in 25 subjects aged 84.5+/-7.4 years was analysed. An original ordinal scale, the BD scale (BDS), was used to quantify BD. Postural (PV) and haptic verticals (HV) were measured in sagittal plane. RESULTS: BDS scores closely correlated with the number of falls (r = 0.81, p =10(-5)). The more the PV was tilted backward, the greater the BDS scores (r = -0.95, …
Advanced 3D movement analysis algorithms for robust functional capacity assessment.
SummaryObjectives: We developed a novel system for in home functional capacities assessment in frail older adults by analyzing the Timed Up and Go movements. This system aims to follow the older people evolution, potentially allowing a forward detection of motor decompensation in order to trigger the implementation of rehabilitation. However, the pre-experimentations conducted on the ground, in different environments, revealed some problems which were related to KinectTM operation. Hence, the aim of this actual study is to develop methods to resolve these problems.Methods: Using the KinectTM sensor, we analyze the Timed Up and Go test movements by measuring nine spatio-temporal parameters, …
Physical and Psychological Effectiveness of Cardiac Rehabilitation: Age Is Not a Limiting Factor!
There is little data regarding the impact of patient age on the physical and psychological effectiveness of cardiac rehabilitation (CR). The aim of the present study was therefore to compare the effects of an exercise-based CR program on physical and psychological parameters in young, old, and very old patients. We also aimed to identify the features that best predicted CR outcome.A total of 733 patients were divided into 3 subgroups: YOUNG (65 years old), OLD (between 65 and 80 years old), and VERY OLD (≥ 80 years old). Physical variables such as peak workload and estimated peak VOPerformance in all tests and scores for all questionnaires were significantly improved in all patients (P0.05)…
Enhancement of Anticipatory Postural Adjustments by Virtual Reality in Older Adults with Cognitive and Motor Deficits: A Randomised Trial.
Background: Postural activities involved in balance control integrate the anticipatory postural adjustments (APA) that stabilize balance and posture, facilitating arm movements and walking initiation and allowing an optimal coordination between posture and movement. Several studies reported the significant benefits of virtual reality (VR) exercises in frail older adults to decrease the anxiety of falling and to induce improvements in behavioural and cognitive abilities in rehabilitation processes. The aim of this study was thus to test the efficiency of a VR system on the enhancement of the APA period, compared to the use of a Nintendo Wii system. Methods: Frail older adults (n = 37) were i…
Assessment of cardiac autonomic nervous activity in frail elderly people with postural abnormalities and in control subjects
Heart rate variability (HRV), which is considered to reflect the activity of the autonomic nervous system (ANS), has been shown to decline with age. The aim of the present study was to explore cardiac ANS in older patients showing frontal-subcortical dysfunction with "Psychomotor Disadaptation Syndrome" (PDS), through the 24-h HRV. We enrolled 14 patients with PDS (mean age: 84.5+/-6.9 years), they were compared to 13 frail control subjects (mean age: 80.6+/-6.7 years). Cardiac ANS activity was assessed by 24-h ECG recordings from three leads with a Holter digital monitor. The decrease in cardiac ANS activity observed in PDS subjects was greater than the alteration found in normally aging s…
Kinematic analysis of motor strategies in frail aged adults during the Timed Up and Go: how to spot the motor frailty?
Asma Hassani,1 Alexandre Kubicki,2,3 Vincent Brost,1 France Mourey,2,4 Fan Yang1 1Laboratoire LE2I CNRS 6306, Université de Bourgogne, Dijon, France; 2Institut National de la Santé et de la Recherche Médicale (INSERM), Cognition Action et Plasticité Sensori-Motrice, Campus Universitaire, Université de Bourgogne, Dijon, France; 3Centre Hospitalier Universitaire de Dijon, Hôpital de Champmaillot, Dijon, France; 4Faculté de Médecine, Université de Bourgogne, Dijon, France Objective: The purpose of this work was to analyze and compare the movement kinematics of sit-to-stand (STS) and back-to-sit (B…
Postural Adjustments and Kinematic Index Finger Features in Frail Older Adults under Different Equilibrium Constraints
Background: Anticipatory postural adjustments (APAs) are significantly affected by age and may represent restrictions on functional independence. Previous studies in young adults have already highlighted that changing postural stability (i.e., seated vs. upright posture) affects the motor planning and APAs. In frail older adults (FOAs), the effect of these different conditions of postural stability have not yet been established, and the present study aimed to disentangle this issue. Methods: Participants executed an arm-pointing task to reach a diode immediately after it turned on, under different conditions of stability (seated with and without foot support and in an upright posture). A ki…