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Annales de readaptation et de medecine physique : revue scientifique de la Societe francaise de reeducation fonctionnelle de readaptation et de medecine physique最新文献

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Évaluation isocinétique, fonctionnelle et proprioceptive du footballeur à deux ans postopératoire de la reconstruction du ligament croisé antérieur du genou 足球运动员膝关节前交叉韧带重建术后2年的等速、功能和本体感觉评估
A. Ben Moussa Zouita , S. Zouita , C. Dziri , F.Z. Ben Salah , K. Zehi

Injuries to the anterior cruciate ligament (ACL) of the knee are common in sport and are treated routinely in the world of sports medicine. In order to resume competitive sport in safety, it is important to know the actual level of performance achieved by the operated leg some time after the ligament repair.

Objectives

The objective of this work was to evaluate the recovery of the operated leg in Tunisian sportsmen two years after surgery by using isokinetic testing (60° s–1), the one-leg hop distance test (i.e. a functional activity that one often finds in sport) and proprioceptive assessment. A secondary objective was to detect any possible correlations between the various outcomes.

Materials and method

The ACL group was composed of 26 top-level Tunisian footballers having undergone ACL ligament repair. Two years after surgery, the following assessments were performed: an isokinetic test with an angular velocity of 60° s–1, a proprioceptive assessment in both active and passive modes and the functional one-leg hop distance test.

Results

Our investigations confirmed a muscle deficit of 16% in the hamstring muscles of the injured leg. In both active and passive modes, normal proprioception is observed at a flexion of 60° and in total extension but not in a mid-way position. The performance level of the operated leg (in terms of distance) had an average symmetry value of 93.40 ± 2.7%.

Conclusion

Playing football appears to influence the isokinetic strength profile in sportsmen after ACL repair. The repair procedure leads to bilateral proprioceptive disruption at 15° of knee flexion, on average.

膝关节前交叉韧带(ACL)损伤在运动中很常见,在运动医学领域是常规治疗。为了安全地恢复竞技运动,了解韧带修复一段时间后手术腿的实际表现水平是很重要的。目的本研究的目的是通过等速运动测试(60°s-1)、单腿跳跃距离测试(即运动中经常发现的功能活动)和本体感觉评估来评估突尼斯运动员手术后两年内手术腿的恢复情况。次要目的是检测各种结果之间可能存在的相关性。材料与方法选择26例突尼斯顶级足球运动员前交叉韧带修复术。手术后两年,进行以下评估:角速度为60°s-1的等速测试,主动和被动模式的本体感觉评估以及功能性单腿跳距离测试。结果我们的调查证实了受伤腿部腘绳肌16%的肌肉缺损。在主动和被动两种模式下,正常的本体感觉出现在屈曲60°和完全伸展时,而不是在中间位置。手术腿的运动水平(按距离计算)平均对称性值为93.40±2.7%。结论足球运动对前交叉韧带修复后运动员的等速力量分布有影响。修复手术平均在膝关节屈曲15°处导致双侧本体感觉中断。
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引用次数: 10
Efficacité à court- et moyen terme d’un programme d’école du dos. Étude de cohorte rétrospective réalisée sur 328 lombalgiques chroniques de 1997 à 2004 背部学校项目的短期和中期有效性。1997 - 2004年对328名慢性腰痛患者进行的回顾性队列研究
M. Maurice , A. Blanchard-Dauphin , P. Laurent , A. Thevenon , V. Tiffreau

Objectives

To assess the short- and midterm effects of a back school programme on patients with chronic low back pain. To determine positive factors to the effectiveness of back school.

Methods

A retrospective cohort study about 328 chronic low back pain patients who participated to back school from 1997 to 2004. One hundred and thirty-two patients had comparative study at six months. The descriptive study used the “before and after” method. Logistic regression analysis was performed to evaluate factors statistically associated with improvement of pain and functional, social and occupational status.

Results

The six months results showed effectiveness of back school on pain and functional status. The impact on quality of life was low. It made reduction of the period of sick leave but not recurrence of them. Predictors to effectiveness of back school were identified: to be young and to have regular physical activity. To be anxious, overweight and to receive worker's compensation were devafourable factors to effectiveness of back school.

Conclusion

Even if the number of lost to follow up is high, these results are encouraging. A long-term follow-up is necessary to confirm the initial benefits of back school. We although have to assess the role of physical activity in mid-term effectiveness of this back school.

目的评估背部学校项目对慢性腰痛患者的短期和中期效果。确定影响返校效果的积极因素。方法对1997 ~ 2004年参加背校的328例慢性腰痛患者进行回顾性队列研究。132例患者在6个月时进行比较研究。描述性研究采用“前后对比”方法。采用Logistic回归分析评估与疼痛、功能、社会和职业状况改善相关的因素。结果6个月的结果显示,背部训练对疼痛和功能状态有明显的改善。对生活质量的影响很低。它减少了病假的时间,但没有再次发生。确定了影响回校效果的预测因素:年轻和有规律的体育活动。焦虑、超重和领取工伤赔偿是影响返校效果的不利因素。结论虽然失访人数较多,但结果令人鼓舞。长期的随访是必要的,以确认返回学校的初步效益。尽管我们必须评估体育活动在这所学校的中期有效性中的作用。
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引用次数: 4
Muscle assessment in healthy teenagers 健康青少年的肌肉评估
J.-C. Bernard, R. Bard, A. Pujol, A. Combey, D. Boussard, C. Begue, A.M. Salghetti

Objectives

To describe muscle parameters in healthy teenagers and compare them to teenagers with chronic low back pain.

Methods

A comparative study of 276 control teenagers and 51 teenagers with chronic low back pain (CLBP), benefiting from a specific treatment, 14.5 years average age. The control group is made up of teenagers without back pain and teenagers who reported some back pain when we asked them, but without specific treatment. The results to four static tests assessing trunk flexors, trunk extensors, hip extensors and quadriceps endurance are statistically compared. In the control group, associations between different clinical measures and possible back pain are looked for.

Results

The two groups are homogeneous, concerning age, weight, standing height, sitting height and BMI (p > 0,05). Low back pain is more common in girls, either in the control group (n = 48; 69% of girls) or in the group with CLBP (n = 51; 78%). CLBP is associated with a poor endurance strength of the trunk extensors (median: 2 min 31 s in the control group to 1 min 45 s in the CLBP), with hip extensors weakness (median: 2 min 20 s in the control group to 1 min 24 s in the CLBP), and with quadriceps weakness (median: 2 min 39 s in the control group to 1 min 20 s in the CLBP), (p = 0.000). No significant difference was found between trunk flexors endurance in the two groups (median: 2 min 11 s in the control group to 2 min 13 s in the CLBP). In the control group, 48 teenagers reported back pain “often”, “very often” or “all the time”; no links were found between pain and muscle flexibility, measured with finger-floor distance, heel-cheek distance, and popliteal angle. Only the sitting height was found statistically higher (p = 0.003) in the control teenagers who reported back pain (87 cm) related to the ones who have no pain (85 cm). Sport influences global strength in lower limbs and changes the ratio of quadriceps to hip extensors, in favour of quadriceps. Neither pain nor the ratio of trunk flexors to trunk extensors are modified by sport. There is a linear relation between Shirado's and Sorensen's logarithmic values: it is consequently possible to predict the Shirado value when we have the Sorensen one. Trunk extensors, hip extensors and quadriceps endurance is lower in the CLBP group, 14.5 years of age.

目的描述健康青少年的肌肉参数,并将其与慢性腰痛青少年进行比较。方法对276例正常青少年和51例接受特定治疗的慢性腰痛(CLBP)青少年进行对比研究,平均年龄14.5岁。对照组由没有背痛的青少年和当我们询问他们时报告有背痛但没有特殊治疗的青少年组成。对躯干屈肌、躯干伸肌、髋伸肌和股四头肌耐力的静态测试结果进行统计学比较。在对照组中,寻找不同临床措施与可能的背部疼痛之间的联系。结果两组在年龄、体重、站高、坐高、BMI (p >0 05)。腰痛在女孩中更为常见,无论是在对照组(n = 48;69%的女孩)或CLBP组(n = 51;78%)。CLBP与躯干伸肌耐力强度差(对照组中值为2分31秒至CLBP中值为1分45秒)、髋关节伸肌无力(对照组中值为2分20秒至CLBP中值为1分24秒)和股四头肌无力(对照组中值为2分39秒至CLBP中值为1分20秒)相关,(p = 0.000)。两组躯干屈肌耐力无显著差异(中位数:对照组2分11秒至CLBP组2分13秒)。在对照组中,48名青少年报告背痛“经常”、“非常经常”或“一直”;通过测量手指到地板的距离、脚跟到脸颊的距离和腘窝角,没有发现疼痛和肌肉柔韧性之间的联系。只有报告背部疼痛(87厘米)的对照组青少年的坐姿高度(p = 0.003)高于没有背痛(85厘米)的对照组青少年。运动影响下肢的整体力量,改变股四头肌与髋伸肌的比例,有利于股四头肌。运动既不能改变疼痛,也不能改变躯干屈肌与躯干伸肌的比例。Shirado和Sorensen的对数值之间存在线性关系:因此,当我们有Sorensen的对数值时,可以预测Shirado值。14.5岁CLBP组躯干伸肌、髋伸肌和股四头肌耐力较低。
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引用次数: 25
Polyarthrite rhumatoide : Aspects therapeutiques hors medicaments et chirurgie - aspects médico-sociaux et organisationnels Mars 2007 类风湿性关节炎:药物和手术以外的治疗方面-医学-社会和组织方面2007年3月
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引用次数: 18
Capsulite rétractile de hanche : à propos de trois cas 髋关节收缩性囊炎:约3例
R. Joassin , M. Vandemeulebroucke , J.-F. Nisolle , P.H. Hanson , T. Deltombe

Objectif

Revue de la littérature concernant la capsulite rétractile de hanche à partir de trois cas cliniques.

Méthode

À partir de trois cas cliniques, décrire la démarche diagnostique et la prise en charge thérapeutique.

Discussion

La capsulite de hanche, pathologie rare mais probablement sous-estimée touche préférentiellement les femmes d’âge moyen. L’examen clinique objective une limitation douloureuse de la mobilité articulaire de la hanche. Le diagnostic est confirmé par la réalisation d’une arthrographie qui démontre une capacité articulaire inférieure à 12 ml. L’arthrose et le syndrome douloureux régional complexe de type 1 sont les deux principaux diagnostics différentiels. Le traitement médical ou chirurgical est proposé en fonction de l’étiologie. La rééducation est fondamentale pour limiter les déficiences et incapacités fonctionnelles résiduelles.

Conclusion

Peu décrite dans la littérature, la capsulite rétractile de hanche n’est cependant pas une rareté clinique. Fréquemment idiopathique, elle peut aussi être associée à une pathologie articulaire. Le traitement de base consiste en l’association d’injection intra-articulaire de corticoïde dépôt et d’une prise en charge en rééducation. Arthroscopie et mobilisation sous anesthésie sont utiles pour les cas récalcitrants.

目的3例髋关节收缩性囊炎的文献综述。方法以三个临床病例为基础,描述诊断方法和治疗方法。讨论髋关节囊炎,一种罕见但可能被低估的疾病,主要影响中年女性。临床检查的目的是限制髋关节活动的疼痛。诊断由关节造影证实,关节容量小于12ml。骨关节炎和1型复杂局部疼痛综合征是两个主要的鉴别诊断。根据病因提出医疗或外科治疗。康复是限制残余功能损伤和残疾的基础。结论在文献中很少描述,然而,髋关节收缩性囊炎在临床并不罕见。常为特发性,也可与关节疾病有关。基本治疗包括关节内皮质激素注射和康复治疗相结合。关节镜检查和麻醉活动对顽固性病例是有用的。
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引用次数: 7
Évaluation musculaire de l’adolescent sain. Comparaison avec une population d’adolescents lombalgiques 健康青少年肌肉评估。与患有腰痛的青少年人群的比较
J.-C. Bernard, R. Bard, A. Pujol, A. Combey, D. Boussard, C. Begue, A.-M. Salghetti

Objectifs

Décrire les paramètres musculaires d’une population d’adolescents sains puis les comparer à une population d’adolescents lombalgiques.

Méthode

Étude comparative entre une population témoin de 276 adolescents et une population de 51 adolescents lombalgiques traités spécifiquement, de 14,5 ans de moyenne d’âge. La population témoin regroupe des adolescents sans douleur rachidienne et des adolescents signalant des rachialgies à l’interrogatoire, mais sans prise en charge spécifique. Les résultats de quatre tests statiques mesurant l’endurance des abdominaux, des spinaux, des fessiers et des quadriceps sont comparés statistiquement. Des corrélations sont recherchées entre différents paramètres cliniques et la présence ou l’absence de douleur rachidienne dans notre population témoin.

Résultats

Nos deux populations sont homogènes en terme d’âge, de poids, de taille debout, de taille assise et d’indice de masse corporelle (IMC) (p > 0,05). La lombalgie prédomine chez la fille que ce soit au sein de notre population témoin (n = 48 ; 69 % de filles) ou au sein de notre population de lombalgiques (n = 51 ; 78 %). La lombalgie est associée à une endurance faible des muscles spinaux (médiane : deux minutes 31 secondes témoins pour une minute 45 secondes lombalgiques), des muscles fessiers (médiane : deux minutes 20 secondes témoins pour une minute 24 secondes lombalgiques), et des quadriceps (médiane : deux minutes 39 secondes témoins pour une minute 20 secondes lombalgiques), (p = 0,000). On ne retrouve pas de différence significative entre la valeur des témoins et celle des lombalgiques pour les abdominaux (médiane : deux minutes 11 secondes témoins pour deux minutes 13 secondes lombalgiques). Concernant la population témoin : nous avons trouvé 48 adolescents rapportant des douleurs rachidiennes « souvent », « très souvent » ou « tout le temps » ; nous n’avons pas retrouvé de corrélation entre l’extensibilité musculaire mesurée par la distance doigts-sol, talon-fesse, angle poplité et la douleur. Seule la taille assise est significativement plus grande (p = 0,003) pour les témoins douloureux (87 cm) par rapport aux non douloureux (85 cm). La pratique du sport influence la force globale des membres inférieurs et modifie le ratio quadriceps sur fessiers au bénéfice des quadriceps. La douleur ainsi que les ratios abdominaux sur spinaux ne sont pas influencés par la pratique sportive. Il existe une relation linéaire entre les valeurs logarithmiques du Shirado et du Sorensen : il est donc possible de prédire la valeur du Shirado en fonction de la valeur de Sorensen.

Conclusion

L’endurance des muscles spinaux, fessiers et quadriceps est diminué

目的描述健康青少年人群的肌肉参数,并将其与腰痛青少年人群进行比较。方法对276名青少年和51名平均年龄14.5岁的腰痛青少年进行了对照研究。对照组包括没有脊柱疼痛的青少年和在审讯时报告脊柱疼痛但没有具体治疗的青少年。对腹肌、脊柱肌、臀肌和股四头肌的四种静态耐力试验结果进行了统计比较。在我们的对照组中,我们寻求不同的临床参数与脊柱疼痛的存在或不存在之间的相关性。结果两组人群在年龄、体重、站立身高、坐着身高和身体质量指数(bmi) (p >0.05)。在我们的对照组中,下腰痛在女孩中普遍存在(n = 48;69%的女性)或我们的腰痛患者(n = 51;78%)。腰痛与肌肉的耐力低spinaux(中位数:两分钟31秒为一分钟45秒目击者腰椎),肌肉肌会(中位数:两分钟20秒为一分钟24秒目击者腰椎),和四头肌(中位数:两分钟39秒为一分钟20秒目击者腰椎),(p =意义)。对照组和下腹组的值没有显著差异(中位数:对照组2分11秒,下腹组2分13秒)。关于对照组:我们发现48名青少年报告脊柱疼痛“经常”、“非常经常”或“一直”;我们没有发现通过手指-地面距离、脚跟-臀部、腘绳角测量的肌肉伸展力与疼痛之间的相关性。只有疼痛对照组(87厘米)的坐姿尺寸明显大于无疼痛对照组(85厘米)的坐姿尺寸(p = 0.003)。运动练习影响下肢的整体力量,改变股四头肌与臀肌的比例,有利于股四头肌。疼痛和腹部与脊柱的比例不受运动练习的影响。Shirado和Sorensen的对数值之间存在线性关系,因此可以根据Sorensen的值来预测Shirado的值。结论平均年龄14.5岁的腰痛患者脊柱、臀肌和股四头肌的耐力下降。
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引用次数: 13
Intérêt d’une mobilisation très précoce après la pose d’une prothèse totale de hanche ? Élaboration de recommandations françaises pour la pratique clinique 在植入全髋关节假体后,早期活动的好处是什么?制定法国临床实践指南
P. Froehlig , S. Le Mouel , E. Coudeyre , M. Revel , F. Rannou

Aims

To develop clinical practice guidelines for early mobilisation after total hip replacement (THR).

Method

We used the French Society of Physical and Rehabilitation Medicine (Sofmer) methodology, which associates a systematic review of the literature, the collection of information regarding current clinical practice and external review by a multidisciplinary expert panel.

Results

Recommending early mobilisation after THR is not established by a review of the literature. A survey of French clinical practice allows for recommending early mobilisation in the context of complex hip issues. Trials with good methodology must be developed to evaluate the interest of early functional mobilisation corresponding to when patients first stand and take their first steps after surgery. These trials should focus mainly on the final pain, functional status, and reduction of handicap.

目的为全髋关节置换术(THR)后早期活动制定临床实践指南。方法采用法国物理和康复医学学会(Sofmer)的方法,该方法结合了文献的系统综述,收集了有关当前临床实践的信息,并由多学科专家组进行了外部评审。结果:通过文献回顾并不能确定THR后早期动员的建议。一项法国临床实践的调查允许在复杂髋关节问题的背景下推荐早期活动。必须开发具有良好方法学的试验,以评估患者术后第一次站立和迈出第一步时早期功能活动的兴趣。这些试验应主要关注最终疼痛、功能状态和残疾的减少。
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引用次数: 2
Étude comparative de la dyspraxie : évaluation neuropsychologique d’enfants porteurs d’une dyspraxie développementale ou consécutive à la prématurité 运动障碍的比较研究:发育性或早产后运动障碍儿童的神经心理学评估
V. Barray , A. Picard , V. Camos

Objectives

The aim of the present study was to compare and contrast developmental dyspraxia and dyspraxia following preterm birth.

Material

Three different domains (attention–executive function, sensorimotor and visuospatial functions) were evaluated using Nepsy battery tests and the Purdue pegboard test.

Method

The results of a neuropsychological evaluation of 32 children with developmental dyspraxia (the DVLT group) were compared with those of 16 children with dyspraxia following preterm birth (the AP group). The population inclusion and exclusion criteria were set according to Gérard's (Gérard C-L. Le concept de dyspraxie. In: Gérard C-L, Brun V, editors. Les dyspraxies de l’enfant. Paris: Masson; 2005. p. 15–24.) definition of dyspraxia.

Results

The two groups had similar visuospatial performance. However, differences between the DVLT and AP children appeared in a test of attention–executive function (visual attention, specifically) and in some sensorimotor tests, with better performance by the DVLT group in all situations.

Conclusion

The difficulties exhibited by preterm-born children (poor upper limb motor control, more severe dyspraxia and the presence of oculomotor impairments) could explain the latter's poor performance relative to children with developmental dyspraxia. Indeed, oculomotor impairments are especially likely to impair performance in visual attention and visuomotor accurary tests — the two situations in which preterm-born children performed worse.

目的本研究的目的是比较和对比发育性运动障碍和早产后的运动障碍。材料三个不同的领域(注意-执行功能,感觉运动和视觉空间功能)被评估使用Nepsy电池测试和普渡钉板测试。方法对32例发育性运动障碍患儿(DVLT组)与16例早产后运动障碍患儿(AP组)进行神经心理学评价。人群的纳入和排除标准是根据gsamrard (gsamrard C-L)制定的。运动障碍的概念。编辑:gassrard C-L, Brun V。婴儿的运动障碍。巴黎:马森;2005. 第15-24页)运动障碍的定义。结果两组的视觉空间表现相似。然而,在注意执行功能测试(特别是视觉注意)和一些感觉运动测试中,DVLT组和AP组之间存在差异,DVLT组在所有情况下都表现更好。结论早产儿表现出的困难(上肢运动控制能力差、更严重的运动障碍和存在动眼肌障碍)可以解释后者相对于发展性运动障碍儿童的表现差。的确,眼动障碍尤其可能损害视觉注意力和视觉运动准确性测试的表现——在这两种情况下,早产儿的表现更差。
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引用次数: 14
Les muscles de l’amputé tibial 胫骨截肢的肌肉
N. Fraisse , N. Martinet , T.-J. Kpadonou , J. Paysant , A. Blum , J.-M. André

Objective

The objective of this article is to review anatomical, histological and physiological muscle changes following below-knee amputation.

Materials and Methods

We searched the PubMed and Reedoc databases for studies evaluating modifications of the below-knee stump and changes over time in its anatomy, volume and histology. We also looked at postamputation modifications in gait and balance.

Results

Below-knee amputees show muscular atrophy on both the amputated side and nonamputated side, with fewer and smaller muscle fibres (particularly slow-twitch fibres). This amyotrophy varies in magnitude and distribution and can reach about 25% for the quadriceps (predominantly on the medial side), but is nonsignificant for the hamstrings. This amyotrophy results from the anatomical consequences of the surgical act. The loss of one or more of a muscle's insertions or reimplantation into a nonphysiological site prompts greater atrophy. Changes in muscle activation patterns also lead to atrophy. The hamstrings replace the triceps as the main muscles for propulsion and the remaining stump muscles contract so as to ensure a good fit with the prosthesis. The below-knee amputee must adapt to a new muscular state: gait symmetry is altered, energy expenditure for walking is higher and training is needed in order to achieve optimal balance control.

目的回顾膝下截肢术后肌肉的解剖、组织学和生理变化。材料和方法我们检索了PubMed和Reedoc数据库,以评估膝关节下残肢的修饰及其解剖、体积和组织学随时间的变化。我们还研究了截肢后步态和平衡的改变。结果膝以下截肢者截肢侧和非截肢侧均出现肌肉萎缩,肌纤维(尤其是慢肌纤维)减少、缩小。肌萎缩的大小和分布各不相同,股四头肌可达25%左右(主要在内侧),但腘绳肌不明显。这种肌萎缩是由手术行为的解剖后果造成的。失去一个或多个肌肉的插入或重新植入到非生理部位会引起更大的萎缩。肌肉激活模式的改变也会导致萎缩。腘绳肌取代肱三头肌作为主要的推进肌肉,剩余的残肢肌肉收缩,以确保与假体的良好配合。膝下截肢者必须适应一种新的肌肉状态:步态对称性被改变,行走的能量消耗更高,需要训练以达到最佳平衡控制。
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引用次数: 14
Médecine physique et de réadaptation et cancérologie : réflexion éthique à partir de cas cliniques 物理康复医学与癌症:基于临床案例的伦理反思
I. Fayolle-Minon, A. Condemine, V. Phaner, P. Calmels

Introduction

Physical medicine and rehabilitation (PMR) can involve the care of cancer patients requiring rehabilitation for associated deficiencies. In this case, rehabilitation methods may differ due to the evolutive nature of the disease.

Objective

To reflect on this aspect of PMR based on real cases.

Method

Cases study of patients hospitalised in the PMR unit for neurological rehabilitation and diagnosed with cancer.

Results

Twenty-four recorded cases (1998–2006); four cases are described because of difficult problems; in only seven cases the coexisting cancer had no impact on the rehabilitation process.

Discussion and Conclusion

Supportive care for patients with a bad vital prognosis differs from standard rehabilitation and raises therapeutic and relational issues not commonly faced in PMR. Responses when confronted with a terminal disease are not the same as when confronted with a handicap. The role of the rehabilitation team is brought into question when functionality is of secondary importance. The response to physical pain is different in rehabilitation and often implies a behavioural approach, which requires the commitment of the patient to therapeutic programmes. We do not find this approach in oncology and the treatment of pain uses first some drugs. Supportive care of these patients requires a close working relationship with the oncology unit. Thus, a different approach must be taken to rehabilitation. It should always take into account the evolutive nature of cancer, which can undermine the patient's functions or setback the patient's recovery. It also requires the support of a care team, which is fully prepared for these setbacks.

物理医学和康复(PMR)包括对需要康复治疗相关缺陷的癌症患者的护理。在这种情况下,康复方法可能因疾病的进化性质而有所不同。目的结合实际病例对PMR的这方面进行反思。方法对在PMR病房接受神经康复治疗并确诊为癌症的患者进行病例分析。结果1998-2006年共记录病例24例;描述了四个案例,因为困难的问题;只有7例共存的癌症对康复过程没有影响。讨论与结论对生命预后不良患者的支持治疗不同于标准康复,并提出了PMR中不常见的治疗和相关问题。面对绝症时的反应与面对残疾时的反应不同。当功能是次要的时候,康复小组的作用就受到了质疑。对身体疼痛的反应在康复中是不同的,通常意味着一种行为方法,这需要患者对治疗方案的承诺。我们在肿瘤学中没有发现这种方法,治疗疼痛首先使用一些药物。这些患者的支持性护理需要与肿瘤单位建立密切的工作关系。因此,必须对康复采取不同的办法。它应该始终考虑到癌症的进化性质,这可能会破坏患者的功能或阻碍患者的康复。它还需要一个为这些挫折做好充分准备的护理小组的支持。
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引用次数: 1
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Annales de readaptation et de medecine physique : revue scientifique de la Societe francaise de reeducation fonctionnelle de readaptation et de medecine physique
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