Biomedical subjects

Patrick Loisel

Publications and source records attributed to Patrick Loisel.

23 records · Page 2Linked to original sources

PubMed2002

Electromyographic assessment of back muscle weakness and muscle composition: reliability and validity issues.

OBJECTIVE: To assess the reliability and construct validity of various electromyographic indices developed to assess back muscle weakness and muscle fiber composition. DESIGN: A prospective study with repeated measures performed on 3 days along with comparisons of groups presenting different back strength and/or back muscle fiber composition. SETTING: A biomechanics laboratory within a rehabilitation center. PARTICIPANTS: Forty male volunteers (20 healthy, 20 with chronic low back pain) were assessed on 3 different days to assess reliability and to make group comparisons. Thirteen healthy women were also assessed once to obtain a third group with known lower strength and different back muscle fiber composition. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Surface electromyography was recorded for 4 pairs of homologous back muscles while the subjects performed, on a dynamometer, static trunk extension efforts. Electromyographic parameters were computed to assess muscle weakness and muscle fiber composition. The reliability of the data collected across the 3 sessions and comparisons between groups were determined. RESULTS: Electromyographic parameters generally showed good to excellent reliability, but were insensitive to differences in back muscle strength and did not appear to be related to muscle composition. Some trends were observed in the electromyographic parameters across the force levels, but the large interindividual variability impeded statistical comparisons. CONCLUSIONS: The assessment of muscle weakness and muscle fiber composition through electromyographic analysis does not appear feasible, at least on an individual basis, for the muscles of the back.

Adult↗

PubMed2001

Therapeutic Return to Work: Rehabilitation in the workplace.

Therapeutic Return to Work is a work rehabilitation program linking graded work exposure with functional restoration therapy for chronic low back pain. This study evaluates the impact of the program on stable return to work (RTW) and compares it with the impact on RTW of three frequently used ways of management of back pain (normative comparison). At two year follow-up, 93% of participants of the Therapeutic Return to Work program were working. This rate was higher than in the comparison groups. Although limited by its norm-referenced evaluation design, the results of this study indicate the importance of placing the work site in the center of the of work rehabilitation process. In this program occupational therapists make full use of the client's natural environment.

Journal Article↗

PubMedDate not supplied

From evidence to community practice in work rehabilitation: the Quebec experience.

BACKGROUND: The causes of prolonged disability due to back pain are multiply determined, involving medical, social, and environmental factors. Possible solutions to the problem of prolonged back pain disability have emerged from recent research but few efforts have been made to transfer evidence-based programs to large community settings. OBJECTIVE: This article describes three phases of the process of transfer of evidence from rehabilitation research to community practice in the province of Quebec. METHODS AND RESULTS: Phase A: Based on literature review and expert knowledge, the Sherbrooke model was developed and assessed through a population-based, randomized clinical trial. Results at 1-year follow-up showed quicker return to regular work and improvement of quality of life; the 6-year follow-up showed the cost-effectiveness of the method. Phase B: Based on the Sherbrooke model experience and recent evidence, a new program addressing the disability paradigm was developed and implemented in the province of Quebec (Canada). Results at 1- and 3-year follow-ups showed that only 24% of workers were not working owing to their musculoskeletal disorder. The program is presently being tested through a population-based, randomized clinical trial in a population of construction workers. Phase C: To implement the program at a provincial level, a network for management, research and education in work rehabilitation was developed. An external assessment is presently planned to evaluate return to work and economic outcomes and quality of implementation of the program in various settings.

Adult↗

PubMedDate not supplied

The cross-cultural adaptation of the DASH questionnaire in Canadian French.

The purpose of this study was to perform a cross-cultural adaptation of the original version of the Disability of Arm, Shoulder and Hand (DASH) questionnaire to Canadian French. The cross-cultural adaptation followed five steps: forward translations into Canadian French, a synthesis of the translations, back translations into English, revision by a committee of experts, and test of the prefinal version. The content validity and the internal consistency of the Canadian French version of the questionnaire were assessed by experts involved in the study and by subjects who participated in the pilot study. Results indicate that the scores were adequately distributed without floor or ceiling effect. Item completion was excellent and item responses had a good distribution. Internal consistency of the total score was high (Cronbach alpha = 0.94) and item-total correlations were substantial for most items (0.43-0.88). These results are similar to previous studies on the DASH questionnaire supporting linguistic and conceptual equivalence of the Canadian French version.

Adult↗

PubMedDate not supplied

Electromyographic activity imbalances between contralateral back muscles: An assessment of measurement properties.

Electromyographic (EMG) contralateral imbalances of back muscles are often interpreted as an aberrant back muscle pattern related to back pain. This study assessed different measurement properties (influence of the control of asymmetric efforts and of the force level, reliability, and sensitivity to low back status) of EMG imbalance parameters. Healthy controls (n = 34) and chronic low back pain subjects (n = 55) stood in a dynamometer measuring the principal (extension) and coupled (lateral bending, axial rotation) L5/S1 moments during isometric trunk extension efforts. The results showed that back pain subjects did not produce higher coupled moments than controls. Providing feedback of the axial rotation moment to correct asymmetric efforts during the task did not reduce EMG contralateral imbalances, except for some extreme cases. Normalized EMG imbalance parameters remain relatively constant between 40% and 80% of the maximal voluntary contraction. The reliability of EMG imbalance parameters was moderate, at best. Finally, neither low back status nor pain location had an effect on EMG contralateral imbalances. We conclude that the clinical relevance of EMG contralateral imbalances of back muscles remains to be established.

Adult↗